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Chlamydia is a common badually transmitted disease that is curable and easy to diagnose. In Switzerland, more than 10 000 cases were counted in 2015, probably from the top of the iceberg, as the disease usually does not show any symptoms. Chlamydia is feared because it can lead to serious complications in women, such as pelvic inflammatory disease (PID), ectopic pregnancy, and infertility.
Because the disease is difficult to control, health authorities in many developed countries recommend comprehensive testing for young adults. In Australia, for example, a so-called opportunistic screening is done: all adolescents who consult their family doctor are screened for chlamydia – whether they have symptoms or not.
However, as shown by the most comprehensive chlamydia screening study of 90,000 people in Australia to date, tests of young Australians aged 16 to 29 have increased by 150%, but have not resulted in fewer infections. The authors of the study therefore recommend abandoning the previous recommendations to carry out an extensive screening and better treat diagnosed cases. The results have now been published in the journal "The Lancet". Nicola Low of the Institute of Social and Preventive Medicine (ISPM) of the University of Bern also participated in the study, which was conducted under the direction of the University of Melbourne ( AUS).
Include badual partners too
"In Switzerland, the number of chlamydia tests and the number of infections diagnosed are increasing year by year," says Nicola Low of the ISPM, the author of the final report. # 39; study. "To develop an evidence-based disease strategy, there is a need to better understand how the test volume behaves in order to spread." The researchers recommend that primary care provided by general practitioners pay more attention to treating chlamydia cases, including those involving badual partners, rather than increasing the number of tests. Researchers expect more control. The tests are supposed to continue, but once the diagnosis is made, better management of individual cases is necessary, says the recommendation.
"One of the major risk factors for pelvic inflammatory disease in women is reinfection with chlamydia – so we need to stop reinfection and treat badual partners," said Jane Hocking, an epidemiologist at the University of Toronto. University of Melbourne. Indeed, increasing the chances of 16- to 29-year-olds may reduce the incidence of serious pelvic inflammatory disease requiring hospitalization – but not the less severe cases, which often remain undetected.
If detected early, the disease is easy to treat, reducing the risk of injury to the fallopian tube and infertility. "Ideally, the illness is stopped by the family doctor, rather than as a serious case at the hospital," said Jane Hocking.
The largest study in the world
The study involved four Australian universities and the University of Bern. "Our Australian colleagues have asked us to participate in the study because we have many years of experience in screening for chlamydia," said Nicola Low. Surveys were conducted from 2009 to 2015 in 130 general practitioner's offices in rural areas located in various parts of Australia. More than 1,200 general practitioners participated and more than 90,000 people between the ages of 16 and 29 were examined. The study included several tests a year, including measures of pelvic inflammatory inflammation in women and epididymitis in men, which could also be caused by chlamydia.
"We recommend using the limited time available to general practitioners for better case management to better prevent severe inflammation with potentially devastating consequences for women," Low said.
scientific contact:
Teacher. Dr. Nicola Low, Institute of Social and Preventive Medicine (ISPM), University of Bern
Phone: +41 31 631 30 92, [email protected]
Original publication:
Jane S Hocking, Meredith Smith Temple, Rebecca Guy, Basil Donovan, Sabine Braat, Matthew Law, Jane Gunn, David Regan, Alaina Vaisey, Liliana Bulfone, John Kaldor, Christopher K. Fairley and Nicola Low, representing the ACCEPt consortium: Effectiveness in population of opportunistic screening for chlamydia in primary care in Australia: randomized controlled cluster trial. The Lancet, October 20, 2018, doi: https://doi.org/10.1016/S0140-6736 (18) 31816-6
idw 2018/10
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