LBa No Child Left Infected: Findings From a Universal High School CT/GC Screening Pilot in Los Angeles County

Wednesday, March 10, 2010: 4:00 PM
Grand Ballroom C (M4) (Omni Hotel)
Susan J. Walker, MPH, CHES1, Ali Stirland, MBChB, MSc1, Binh Goldstein, PhD1, Rosina Franco, MD2, Raymond Perry, MD3, Sarah Guerry, MD1, Jeanette Brown, PHN1 and Tanya M. Phares, DO, MPH4, 1Sexually Transmitted Disease Program, Los Angeles County Department of Public Health, Los Angeles, CA, 2Student Medical Services, Los Angeles Unified School District, Los Angeles, CA, 3School of Public Health, University of California at Los Angeles, Los Angeles, CA, 4Communicable Disease Control & Prevention, Los Angeles County Department of Public Health, Los Angeles, CA

Background: Sexually active high school students are at risk for chlamydia (CT) and gonorrhea (GC) infection but may not seek testing. The Los Angeles County, Sexually Transmitted Disease Program (STDP) and the Los Angeles Unified School District piloted a universal screening program in a high school in a geographic area of highest CT/GC morbidity.

Objectives: 1) To determine the feasibility of offering CT/GC screening to an entire high school population, and 2) to estimate the prevalence of CT/GC.

Methods: From October-December 2009, teams visited classrooms to provide a brief presentation on CT/GC and an opportunity to test.  Students elected in private whether to submit a urine sample.  Make-up sessions were held for students initially absent.  Confidential results were available online or by phone.  STDP clinicians contacted infected students on campus for treatment and partner services.  

Results: From an enrollment of 2,096, 1,806 (86%) students heard the presentation and 1,136 (63%) of these accepted testing.  Of those tested, 55% were African-American, 44% were Hispanic, and 47% were female, reflecting the school population.  Overall CT and GC prevalence was 4.1% and 0.4%, respectively.  All GC cases were among females.  Prevalence of any infection was 7 times higher among African-American females than among Hispanic females, 10.2% (31/305) vs. 1.3% (3/227), with African-American females over age 16 having the highest prevalence of 12.9%.  Initially absent students had twice the prevalence of the original group: 7.3% (7/96) vs. 3.9% (41/1040).  All of the positives were treated.

Conclusions: The overall prevalence of CT was high among students tested in this high school population, with highest morbidity found among African-American females.  Gonorrhea prevalence was low in females and not found in males

Implications for Programs, Policy, and/or Research: School screening programs can be an effective method of detecting and treating CT/GC in high risk adolescents.  Particular efforts should be made to reach African-American females and absent students.

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