Background:
Patients diagnosed with Chlamydia trachomatis (CT) infection are often at risk of subsequent re-infection. Detecting re-infection is an important element in disease control and crucial in preventing reproductive health sequela. Washington State adopted policy guidelines in July of 2002 recommending rescreening of women diagnosed with CT 10 – 18 weeks subsequent to original diagnosis.

Objective:
To assess the timeliness of adoption and uptake of a rescreening policy and to determine the percent of women with CT rescreened through IPP project clinics.

Method:
IPP clinics were surveyed in March 2003 to determine what proportion adopted the recommendations, implemented a system to assure that patients were identified for rescreening and had implemented procedures to notify patients. IPP laboratory data were obtained for 2001 through 2004 to determine the number and percent of positive patients with a subsequent rescreening test.

Result:
87% (n=55) of clinics adopted the recommendations as their standard of care. The majority also reported implementing at least one procedure to assure that patients were rescreened. Analyses of the IPP data revealed that rescreening among female patients, defined as a repeat test 10 to 24 weeks from initial infection, increased significantly from 9.3% in 2001 to 19.4% in 2004 (trend significant at p< 0.001). The likelihood of rescreening among female patients was also found to be positively associated with reported Black or Asian race (OR 1.20, p = 0.022 and OR 1.31, p < 0.01).

Conclusion:
Policy recommendations encouraging rescreening of CT positive women in Washington State led to significant increases in the number and percentage of IPP-participating clinic patients rescreened subsequent to initial CT infection.

Implications:
Programs should consider provider-level interventions, such as policy recommendations, as a potential method to increase the number and proportion of CT-positive patients rescreened to detect and treat repeat infection.