Skip to main content
PMC home page
The British Journal of General Practice logoLink to The British Journal of General Practice
. 2002 Aug;52(481):623–627.

Follow-up, treatment, and reinfection rates among asymptomatic chlamydia trachomatis cases in general practice.

Irene G M van Valkengoed 1, Servaas A Morré 1, Adriaan J C van den Brule 1, Chris J L M Meijer 1, Lex M Bouter 1, Jacques Th M van Eijk 1, A Joan P Boeke 1
PMCID: PMC1314379  PMID: 12171219

Abstract

BACKGROUND: Adequate treatment and follow-up of patients is essential to the success of a screening programme for Chlamydia trachomatis. There has been a lack of data on follow-up, confirmation of infections, and reinfection rates among asymptomatic patients in general practice. AIM: 7b study the rates of diagnostic confirmation of C trachomatis infection, successful treatment, and reinfection one year after cases were detected in a screening programme for asymptomatic infections. DESIGN OF STUDY: Prospective cohort study SETTING: Fifteen general practices in Amsterdam, The Netherlands. METHOD: One hundred and twenty-four patients with asymptomatic C trachomatis infections were requested to provide a cervical or urethral swab and a urine specimen, for the purpose of diagnostic confirmation before being treated. One year after the first screening, all of the patients were invited for a second screening. All samples were tested using the ligase chain reaction (Abbott Laboratories, Chicago, USA). RESULTS: Out of 124 patients, 110 (89%) attended the scheduled appointment for diagnostic confirmation and treatment; 92 (84%) of them were confirmed to be positive and received treatment. At the second screening a year later, none of the 56 patients who had received treatment and who had been screened a second time were reinfected. CONCLUSION: No asymptomatic patients werefound to have reinfections with C trachomatis one year after diagnostic confirmation and treatment. This underlines the effectiveness of the screening and treatment strategy

Full Text

The Full Text of this article is available as a PDF (78.4 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Burstein G. R., Gaydos C. A., Diener-West M., Howell M. R., Zenilman J. M., Quinn T. C. Incident Chlamydia trachomatis infections among inner-city adolescent females. JAMA. 1998 Aug 12;280(6):521–526. doi: 10.1001/jama.280.6.521. [DOI] [PubMed] [Google Scholar]
  2. Chernesky M. A., Jang D., Lee H., Burczak J. D., Hu H., Sellors J., Tomazic-Allen S. J., Mahony J. B. Diagnosis of Chlamydia trachomatis infections in men and women by testing first-void urine by ligase chain reaction. J Clin Microbiol. 1994 Nov;32(11):2682–2685. doi: 10.1128/jcm.32.11.2682-2685.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Cohen D. A., Nsuami M., Martin D. H., Farley T. A. Repeated school-based screening for sexually transmitted diseases: a feasible strategy for reaching adolescents. Pediatrics. 1999 Dec;104(6):1281–1285. doi: 10.1542/peds.104.6.1281. [DOI] [PubMed] [Google Scholar]
  4. Dean D., Suchland R. J., Stamm W. E. Evidence for long-term cervical persistence of Chlamydia trachomatis by omp1 genotyping. J Infect Dis. 2000 Aug 17;182(3):909–916. doi: 10.1086/315778. [DOI] [PubMed] [Google Scholar]
  5. Dixon-Woods M., Stokes T., Young B., Phelps K., Windridge K., Shukla R. Choosing and using services for sexual health: a qualitative study of women's views. Sex Transm Infect. 2001 Oct;77(5):335–339. doi: 10.1136/sti.77.5.335. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Duncan B., Hart G., Scoular A., Bigrigg A. Qualitative analysis of psychosocial impact of diagnosis of Chlamydia trachomatis: implications for screening. BMJ. 2001 Jan 27;322(7280):195–199. doi: 10.1136/bmj.322.7280.195. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Gaydos C. A., Crotchfelt K. A., Howell M. R., Kralian S., Hauptman P., Quinn T. C. Molecular amplification assays to detect chlamydial infections in urine specimens from high school female students and to monitor the persistence of chlamydial DNA after therapy. J Infect Dis. 1998 Feb;177(2):417–424. doi: 10.1086/514207. [DOI] [PubMed] [Google Scholar]
  8. Haddon L., Heason J., Fay T., McPherson M., Carlin E. M., Jushuf I. H. Managing STIs identified after testing outside genitourinary medicine departments: one model of care. Sex Transm Infect. 1998 Aug;74(4):256–257. doi: 10.1136/sti.74.4.256. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Howell M. R., Quinn T. C., Gaydos C. A. Screening for Chlamydia trachomatis in asymptomatic women attending family planning clinics. A cost-effectiveness analysis of three strategies. Ann Intern Med. 1998 Feb 15;128(4):277–284. doi: 10.7326/0003-4819-128-4-199802150-00005. [DOI] [PubMed] [Google Scholar]
  10. Katz B. P., Danos C. S., Quinn T. S., Caine V., Jones R. B. Efficiency and cost-effectiveness of field follow-up for patients with Chlamydia trachomatis infection in a sexually transmitted diseases clinic. Sex Transm Dis. 1988 Jan-Mar;15(1):11–16. doi: 10.1097/00007435-198801000-00003. [DOI] [PubMed] [Google Scholar]
  11. Macleod J., Rowsell R., Horner P., Crowley T., Caul E. O., Low N., Smith G. D. Postal urine specimens: are they a feasible method for genital chlamydial infection screening? Br J Gen Pract. 1999 Jun;49(443):455–458. [PMC free article] [PubMed] [Google Scholar]
  12. Marrazzo J. M., Celum C. L., Hillis S. D., Fine D., DeLisle S., Handsfield H. H. Performance and cost-effectiveness of selective screening criteria for Chlamydia trachomatis infection in women. Implications for a national Chlamydia control strategy. Sex Transm Dis. 1997 Mar;24(3):131–141. doi: 10.1097/00007435-199703000-00003. [DOI] [PubMed] [Google Scholar]
  13. Martin D. H., Mroczkowski T. F., Dalu Z. A., McCarty J., Jones R. B., Hopkins S. J., Johnson R. B. A controlled trial of a single dose of azithromycin for the treatment of chlamydial urethritis and cervicitis. The Azithromycin for Chlamydial Infections Study Group. N Engl J Med. 1992 Sep 24;327(13):921–925. doi: 10.1056/NEJM199209243271304. [DOI] [PubMed] [Google Scholar]
  14. Monteiro E. F., Harris J., Gilliatt P. A multidistrict audit on the management of Chlamydia trachomatis in genitourinary medicine clinics in Yorkshire. Int J STD AIDS. 1997 Dec;8(12):792–795. doi: 10.1258/0956462971919147. [DOI] [PubMed] [Google Scholar]
  15. Morré S. A., van Valkengoed I. G., de Jong A., Boeke A. J., van Eijk J. T., Meijer C. J., van den Brule A. J. Mailed, home-obtained urine specimens: a reliable screening approach for detecting asymptomatic Chlamydia trachomatis infections. J Clin Microbiol. 1999 Apr;37(4):976–980. doi: 10.1128/jcm.37.4.976-980.1999. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Ostergaard L., Møller J. K., Andersen B., Olesen F. Diagnosis of urogenital Chlamydia trachomatis infection in women based on mailed samples obtained at home: multipractice comparative study. BMJ. 1996 Nov 9;313(7066):1186–1189. doi: 10.1136/bmj.313.7066.1186. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Richey C. M., Macaluso M., Hook E. W. Determinants of reinfection with Chlamydia trachomatis. Sex Transm Dis. 1999 Jan;26(1):4–11. doi: 10.1097/00007435-199901000-00002. [DOI] [PubMed] [Google Scholar]
  18. Schachter J., Grossman M., Sweet R. L., Holt J., Jordan C., Bishop E. Prospective study of perinatal transmission of Chlamydia trachomatis. JAMA. 1986 Jun 27;255(24):3374–3377. [PubMed] [Google Scholar]
  19. Scholes D., Stergachis A., Heidrich F. E., Andrilla H., Holmes K. K., Stamm W. E. Prevention of pelvic inflammatory disease by screening for cervical chlamydial infection. N Engl J Med. 1996 May 23;334(21):1362–1366. doi: 10.1056/NEJM199605233342103. [DOI] [PubMed] [Google Scholar]
  20. Stamm W. E., Guinan M. E., Johnson C., Starcher T., Holmes K. K., McCormack W. M. Effect of treatment regimens for Neisseria gonorrhoeae on simultaneous infection with Chlamydia trachomatis. N Engl J Med. 1984 Mar 1;310(9):545–549. doi: 10.1056/NEJM198403013100901. [DOI] [PubMed] [Google Scholar]
  21. Stokes T., Schober P., Baker J., Bloor A., Kuncewicz I., Ogilvy J., French A., Henry C., Mears J. Evidence-based guidelines for the management of genital chlamydial infection in general practice. (Leicestershire Chlamydia Guidelines Group). Fam Pract. 1999 Jun;16(3):269–277. doi: 10.1093/fampra/16.3.269. [DOI] [PubMed] [Google Scholar]
  22. Vuylsteke B., Vandenbruaene M., Vandenbalcke P., Van Dyck E., Laga M. Chlamydia trachomatis prevalence and sexual behaviour among female adolescents in Belgium. Sex Transm Infect. 1999 Jun;75(3):152–155. doi: 10.1136/sti.75.3.152. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Weström L., Joesoef R., Reynolds G., Hagdu A., Thompson S. E. Pelvic inflammatory disease and fertility. A cohort study of 1,844 women with laparoscopically verified disease and 657 control women with normal laparoscopic results. Sex Transm Dis. 1992 Jul-Aug;19(4):185–192. [PubMed] [Google Scholar]
  24. van Doornum G. J., Buimer M., Prins M., Henquet C. J., Coutinho R. A., Plier P. K., Tomazic-Allen S., Hu H., Lee H. Detection of Chlamydia trachomatis infection in urine samples from men and women by ligase chain reaction. J Clin Microbiol. 1995 Aug;33(8):2042–2047. doi: 10.1128/jcm.33.8.2042-2047.1995. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. van Valkengoed I. G., Morré S. A., van den Brule A. J., Meijer C. J., Devillé W., Bouter L. M., Boeke A. J. Low diagnostic accuracy of selective screening criteria for asymptomatic Chlamydia trachomatis infections in the general population. Sex Transm Infect. 2000 Oct;76(5):375–380. doi: 10.1136/sti.76.5.375. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from The British Journal of General Practice are provided here courtesy of Royal College of General Practitioners

RESOURCES