The need for Chlamydia screening in Ireland

Hdl Handle:
http://hdl.handle.net/10147/303159
Title:
The need for Chlamydia screening in Ireland
Authors:
Kate O’Donnell
Affiliation:
Health Protection Surveillance Centre
Publisher:
Health Protection Surveillance Centre
Issue Date:
10-Oct-2013
URI:
http://hdl.handle.net/10147/303159
Item Type:
Report
Language:
en
Description:
The 2001 Health Strategy contains a recommendation that ‘an Action Plan for Sexual Health’ should be prepared. In this context the National AIDS Strategy Committee (NASC) has recommended that the conclusions of the subcommittee, which is considering the need for chlamydia screening in Ireland, should be considered as a matter of priority . • Genital C. trachomatis is: • the most common bacterial STI worldwide. • a transmissible cause of severe reproductive morbidity, including PID, tubal factor infertility and ectopic pregnancy in women • easily treatable and curable. • The economic and human costs of managing the complications of genital C. trachomatis infection are considerable. Most infections are asymptomatic and therefore screening or case finding is an essential component of control programmes. • The increase in the numbers of reported diagnoses reflect a true underlying increase in the incidence of genital chlamydia infection but also reflect increased screening for and recognition of asymptomatic infection and the increasing use of highly sensitive and specific DNA amplification techniques or nucleic acid amplification tests (NAATs) for diagnosis of C. trachomatis. These tests can be used on non-invasively collected specimens, such as urine and self- collected vulvo-vaginal swabs. They are the diagnostic tests of choice for laboratory diagnosis of C. trachomatis infection and are now routinely used. • Young age and recent change in sexual partner are the most commonly reported risk factors for infection in other countries. There are very limited data available on prevalence of C. trachomatis in Irish settings. The data available from STI clinics, FPCs, student and antenatal settings in Ireland suggest similar trends to those seen in the UK and other parts of Europe. • While further evidence from ongoing research in relation to aspects of screening intervals, natural history of NAATS detected infections and relapse/re-infection rates, which will allow more accurate cost effectiveness analysis, is awaited, there is evidence that case finding for genital chlamydia infection, based on screening for infection among sections of the sexually active population, can reduce the prevalence of genital tract infections and PID in women. • Chlamydia screening programmes are in place in Sweden, the US and Canada. Various models for screening are also currently being examined in other EU countries. • A National Chlamydia Screening Programme (NCSP) is also being ‘rolled out’ in England, targeting young men and women under the age of 25 who are attending healthcare facilities not traditionally associated with providing specialist sexual health services including contraceptive clinics, general practices, young people’s services, antenatal services, colposcopy and infertility units. Screening is also encouraged through innovative outreach strategies, such as “pee in a pot” days at military bases, university campuses, prisons and other non-traditional settings. • Countries with screening programmes such as Sweden and the US and those without screening programmes, have shown similar recent increases in the prevalence of genital C. trachomatis which may be explained by failure to include men in screening programmes, resulting in a circulating pool of untreated asymptomatic genital chlamydia infection, or by increased risk-taking behaviour. Recent commentators have concluded that screening programmes must employ innovative strategies to maximize screening opportunities beyond traditional settings and must also target men in screening programmes.
Keywords:
SCREENING; SEXUAL HEALTH
Local subject classification:
CHLAMYDIA
ISSN:
O-9540177-9-X

Full metadata record

DC FieldValue Language
dc.contributor.authorKate O’Donnellen_GB
dc.date.accessioned2013-10-10T13:31:42Z-
dc.date.available2013-10-10T13:31:42Z-
dc.date.issued2013-10-10-
dc.identifier.issnO-9540177-9-X-
dc.identifier.urihttp://hdl.handle.net/10147/303159-
dc.descriptionThe 2001 Health Strategy contains a recommendation that ‘an Action Plan for Sexual Health’ should be prepared. In this context the National AIDS Strategy Committee (NASC) has recommended that the conclusions of the subcommittee, which is considering the need for chlamydia screening in Ireland, should be considered as a matter of priority . • Genital C. trachomatis is: • the most common bacterial STI worldwide. • a transmissible cause of severe reproductive morbidity, including PID, tubal factor infertility and ectopic pregnancy in women • easily treatable and curable. • The economic and human costs of managing the complications of genital C. trachomatis infection are considerable. Most infections are asymptomatic and therefore screening or case finding is an essential component of control programmes. • The increase in the numbers of reported diagnoses reflect a true underlying increase in the incidence of genital chlamydia infection but also reflect increased screening for and recognition of asymptomatic infection and the increasing use of highly sensitive and specific DNA amplification techniques or nucleic acid amplification tests (NAATs) for diagnosis of C. trachomatis. These tests can be used on non-invasively collected specimens, such as urine and self- collected vulvo-vaginal swabs. They are the diagnostic tests of choice for laboratory diagnosis of C. trachomatis infection and are now routinely used. • Young age and recent change in sexual partner are the most commonly reported risk factors for infection in other countries. There are very limited data available on prevalence of C. trachomatis in Irish settings. The data available from STI clinics, FPCs, student and antenatal settings in Ireland suggest similar trends to those seen in the UK and other parts of Europe. • While further evidence from ongoing research in relation to aspects of screening intervals, natural history of NAATS detected infections and relapse/re-infection rates, which will allow more accurate cost effectiveness analysis, is awaited, there is evidence that case finding for genital chlamydia infection, based on screening for infection among sections of the sexually active population, can reduce the prevalence of genital tract infections and PID in women. • Chlamydia screening programmes are in place in Sweden, the US and Canada. Various models for screening are also currently being examined in other EU countries. • A National Chlamydia Screening Programme (NCSP) is also being ‘rolled out’ in England, targeting young men and women under the age of 25 who are attending healthcare facilities not traditionally associated with providing specialist sexual health services including contraceptive clinics, general practices, young people’s services, antenatal services, colposcopy and infertility units. Screening is also encouraged through innovative outreach strategies, such as “pee in a pot” days at military bases, university campuses, prisons and other non-traditional settings. • Countries with screening programmes such as Sweden and the US and those without screening programmes, have shown similar recent increases in the prevalence of genital C. trachomatis which may be explained by failure to include men in screening programmes, resulting in a circulating pool of untreated asymptomatic genital chlamydia infection, or by increased risk-taking behaviour. Recent commentators have concluded that screening programmes must employ innovative strategies to maximize screening opportunities beyond traditional settings and must also target men in screening programmes.en_GB
dc.language.isoenen
dc.publisherHealth Protection Surveillance Centreen_GB
dc.subjectSCREENINGen_GB
dc.subjectSEXUAL HEALTHen_GB
dc.subject.otherCHLAMYDIAen_GB
dc.titleThe need for Chlamydia screening in Irelanden_GB
dc.typeReporten
dc.contributor.departmentHealth Protection Surveillance Centreen_GB
All Items in Lenus, The Irish Health Repository are protected by copyright, with all rights reserved, unless otherwise indicated.