TP 75 To Re-Test or Not to Re-Test? Findings from the English National Chlamydia Screening Programme Consultation on Routine Re-Testing Following a Chlamydia Diagnosis

Tuesday, June 10, 2014
Exhibit Hall
Sarah C Woodhall, Msc1, Erna Buitendam, MA2, Katy Town, MSc2, Paula Baraitser, BM, MA, MPH2, Francesca McNeil, .2, Janette Clarke, MB ChB BSc FRCP3, Deborah Shaw, .2 and Kate Folkard, MSc2, 1HIV and STI Department, Center for Infectious Disease Surveillance and Control, UK, Public Health England, London, United Kingdom, 2HIV & STI Department, Public Health England, London, United Kingdom, 3Department of Genitourinary Medicine, Leeds Teaching Hospitals Trust, Leeds, United Kingdom

Background: Young adults who test positive for chlamydia are at increased risk of subsequent infection. The English National Chlamydia Screening Programme (NCSP) recommends that sexually active under-25 year olds are tested for chlamydia annually or on change of sexual partner. In 2012-13 the NCSP carried out a consultation on whether individuals diagnosed with chlamydia should be routinely offered a re-test around three months after treatment. 

Methods: Existing models of service delivery were identified using telephone interviews with a convenience sample of service providers (n=19). Views of professionals and young adults were obtained using a web-based questionnaire, expert meeting and focus group. Baseline re-testing rates (the proportion of diagnoses where another test was recorded within 7-14 weeks) among 15 to 24 year olds were calculated for each local authority for January to March 2013 using routinely collected data on all chlamydia tests in England. 

Results: Chlamydia re-testing practices varied from no routine re-testing to the mailing of home sampling kits. Health professionals and young adults were supportive of introducing re-testing following a chlamydia diagnosis. Both groups emphasised that the offer of a re-test should be part of case management and does not replace the need for partner notification or advice on safer sex. In October to December 2012 re-testing rates ranged from 0%–31% (IQR: 7%–17%) for tests in community settings and 0%–50% (IQR: 6%–14%) in genitourinary medicine clinics.

Conclusions: Following this consultation, the NCSP updated their recommendations for case management to include a routine offer of a re-test around three months after treatment. Local areas will be provided with a suite of guidance to support local decision-making and tools for enhanced data collection to investigate reasons for repeat diagnoses. Post-implementation re-testing rates will be presented and compared to baseline rates to explore the impact of the recommendation.