What Is the Optimal Time to Retest Patients With a Urogenital Chlamydia Infection? (RCT)

Sex Transm Dis. 2018 Feb;45(2):132-137. doi: 10.1097/OLQ.0000000000000706.

BACKGROUND:

Chlamydia trachomatis is a common, often recurring sexually transmitted infection, with serious adverse outcomes in women. Current guidelines recommend retesting after a chlamydia infection, but the optimum timing is unknown. We assessed the optimal retest interval after urogenital chlamydia treatment.

METHODS:

A randomized controlled trial among urogenital chlamydia nucleic acid amplification test positive heterosexual clients of the Amsterdam sexually transmitted infection clinic. After treatment, patients were randomly assigned for retesting 8, 16, or 26 weeks later. Patients could choose to do this at home (and send a self-collected sample by mail) or at the clinic. Retest uptake and chlamydia positivity at follow-up were calculated.

RESULTS:

Between May 2012 and March 2013, 2253 patients were included (45% men; median age, 23 years; interquartile range, 21-26). The overall uptake proportion within 35 weeks after the initial visit was significantly higher in the 8-week group (77%) compared with the 16- and 26-week groups (67% and 64%, respectively, P < 0.001), and the positivity proportions among those retested were comparable (P = 0.169). The proportion of people with a diagnosed recurrent chlamydia infection among all randomized was similar between the groups (n = 69 [8.6%], n = 52 [7.4%], and n = 69 [9.3%]; P = 0.4).

CONCLUSIONS:

Patients with a recent urogenital chlamydia are at high risk of recurrence of chlamydia and retesting them is an effective way of detecting chlamydia cases. We recommend inviting patients for a re-test 8 weeks after the initial diagnosis and treatment.

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Evidence Check Review for STI Interventions

Sax Institute for the Centre for Population Health, NSW Ministry of Health, October 2015

This Evidence Check Review reports on the effectiveness of interventions which aim to reduce the transmission of three Sexually Transmissible Infections (STIs): chlamydia, gonorrhoea and syphilis.
This rapid review was commissioned by the Centre for Population Health, New South Wales (NSW) Ministry of Health and the Sax Institute to inform the development of the NSW Sexually Transmissible Infections Strategy 2016–2020.
The focus of this review is on the effectiveness of interventions aiming to reduce the transmission of Sexually Transmissible Infections (STIs) in different settings. Consistent with the developing NSW STI strategy, this review focuses on interventions in relation to testing, treatment, partner notification and prevention of re-infection of three priority STIs (chlamydia, gonorrhoea and syphilis), in five priority settings (primary health care; sexual health services; Aboriginal Community Controlled Health Services; antenatal services; and services for young people) for five priority populations (gay and other men who have
sex with men (MSM); gay men living with HIV; young people aged 16–29 years; Aboriginal and Torres Strait Islander people and people involved in sex work).
The review was also tasked with identifying evidence for the effectiveness of interventions in additional settings (including but not limited to drug and alcohol services, emergency departments, mental health services and correctional services).

Substantial evidence for the effectiveness of a broad range of interventions is identified. There are wide variations in the level of resources which are required, with the more expensive interventions not always shown to be the most effective.

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