The findings and conclusions in these presentations have not been formally disseminated by the Centers for Disease Control and Prevention and should not be construed to represent any agency determination or policy.

Tuesday, May 9, 2006

Self-reported Symptoms in Women Participating in an Internet Screening Program for Chlamydia trachomatis

Mathilda Barnes1, Karen Dwyer2, Toni Flemming3, Patricia Rizzo-Price1, Terry Hogan1, and Charlotte Gaydos1. (1) Division of Infectious diseases, Medicine, Johns Hopkins University, 1159 Ross Bldg, 720 Rutland Ave, Baltimore, MD, USA, (2) FASgen, Inc. Alpha Center, FASgen, Inc, 5210 Eastern Ave, Suite 234, Baltimore, MD, USA, (3) Division of Health Promotion and Disease Prevention, STD/HIV Prevention Program, Baltimore City Health Department, 620 N. Caroline Street, Baltimore, MD, USA

Analysis of the questionnaire in a home-sampling kit for Chlamydia trachomatis can provide information regarding genital symptoms reported by women who used the kit.

To determine the presence and types of self-reported symptoms in women who submitted the home-sampling kit and who were either infected or uninfected with C. trachomatis.

An educational C. trachomatis website was designed to offer women the opportunity to sample themselves at home using self-administered vaginal swabs (SAS). Kits could be requested by email from the Internet website, by phone number provided on the website, or be picked up at a pharmacy listed and mapped by location on the website. Kits were provided and returned by mail. The kit included a questionnaire, which also could be completed on line. Swabs were tested by nucleic acid amplification tests. Descriptive data analysis was performed.

Of 567 women, who returned swabs, 50 (8.8%) were infected. Analysis of data by all users of the SAS kit who provided questionnaires demonstrated that 58.9% reported at least one symptom and 21.7% reported multiple symptoms. Of infected women, 66% reported symptoms of any sort, while 58.2% of uninfected women reported any symptoms (p=ns). Of infected women, reported symptoms included: vaginal discharge 53.1%; pain during urination 2.0%; pain during intercourse 16.3%; lower abdominal pain 24.5%; abnormal vaginal bleeding 10.2%; reported no symptoms 32.7%. Of uninfected women, reported symptoms included: vaginal discharge 27.1%; pain during urination 44.9%; pain during intercourse 1.5%; lower abdominal pain 16.1%; abnormal vaginal bleeding 6.0%; reported no symptoms 39.8%.

Most women participating in this program reported some genital symptoms. Overall, presence or absence of symptoms was not associated with being infected with chlamydia. Internet accessed screening appeared to recruit women who reported symptoms.

Women recruited for Internet chlamydia screening represent a group who may benefit from self-sampling programs.