Screening For Chlamydia Trachomatis With Routine Pap Smears In General Practice: A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$350,500.00
Summary
Genital chlamydia infection is the most commonly reported infectious disease in Australia. Notifications have increased three fold since 1995; five-fold in the ACT and surveillance data underestimate the true incidence of the disease in the community. Chlamydia is associated with immediate morbidity in men and women including urethritis, epididymo-orchitis, cervicitis, and pelvic pain and long-term complications including pelvic inflammatory disease, ectopic pregnancy and tubal factor infertilit ....Genital chlamydia infection is the most commonly reported infectious disease in Australia. Notifications have increased three fold since 1995; five-fold in the ACT and surveillance data underestimate the true incidence of the disease in the community. Chlamydia is associated with immediate morbidity in men and women including urethritis, epididymo-orchitis, cervicitis, and pelvic pain and long-term complications including pelvic inflammatory disease, ectopic pregnancy and tubal factor infertility. The economic costs of Chlamydial infection in Australia have been estimated to be as high as $160 million each year. In the ACT 73.8% of chlamydial infections occur in the 20-40 year old group. Between 60 and 70% of women in this age range participate in Pap screening every two years. While targeted screening for Chlamydia in women is effective in the US, there are few studies that investigate its value in an Australian setting. In this randomised controlled clinical trial we aim to test the novel hypothesis that the routine offer of chlamydia testing to women between 20 and 40 years who undergo Pap screening significantly increases the detection of Chlamydia in that population. This is the first randomised-controlled trial of its type and is an extension of a current non-randomised pilot study of linked Chlamydia-Pap screening in the primary care setting. The aim is to determine if the program can be incorporated more widely in the ACT. The study will: Measure the impact of linked chlamydia-Pap screening on chlamydia screening participation rates More accurately determine the epidemiology of genital chlamydial infection in this age group and social setting; Undertake an economic evaluation of this approach; Determine if promoting the Pap smear as an opportunity for chlamydial screening increases the uptake of Pap screening in younger women Aid in the development of a National Chlamydia Screening strategyRead moreRead less
Using Mathematical Models To Assess The Impact Of Interventions To Reduce Sexually Transmitted Infections In Australia
Funder
National Health and Medical Research Council
Funding Amount
$562,276.00
Summary
Sexually transmitted infections (STIs) are an increasing public health problem in Australia. Australia's recent National Transmissible Infections Strategy identified chlamydia control, STI prevention in gay men and STIs in Aboriginal and Torres Strait Islander communities as priority areas. We propose to develop mathematical models of STI transmission and use these to help understand and identify the most cost-effective interventions to reduce the impact of STIs on Australian populations.
A Computer Alert To Increase Chlamydia Testing Of High Risk Women In General Practice: A Randomised Controlled Trial.
Funder
National Health and Medical Research Council
Funding Amount
$182,575.00
Summary
Chlamydia trachomatis infection is the most common notifiable sexually transmissible infection (STI) in Australia, with over 30,000 infections notified in 2003, rising by 20% each year. Infection with chlamydia can have considerable complications, particularly for women - it is a leading cause of pelvic inflammatory disease and tubal infertility. Unfortunately, as many as 85% of people with infection do not have any symptoms, so are unaware they have chlamydia; yet chlamydia is easy to diagnose ....Chlamydia trachomatis infection is the most common notifiable sexually transmissible infection (STI) in Australia, with over 30,000 infections notified in 2003, rising by 20% each year. Infection with chlamydia can have considerable complications, particularly for women - it is a leading cause of pelvic inflammatory disease and tubal infertility. Unfortunately, as many as 85% of people with infection do not have any symptoms, so are unaware they have chlamydia; yet chlamydia is easy to diagnose with urine tests and easy to treat with single dose antibiotics. Over 65% of infections diagnosed in women are among those aged 16 to 24 years. Internationally, screening programs for chlamydia have reduced the number of people with the infection and have also reduced the rate of complications arising from infection. However, Australia does not have a screening program and only tests about 4% of 16 to 24 year old women, the largest group at risk of infection, each year. We propose to conduct a study which tests the effect of using a computer based alert. This alert is designed to prompt doctors to discuss chlamydia testing with sexually active women aged 16 to 24 years. A group of general practices will be selected. We will randomly allocate some practices to have the alert installed on their computers and the remaining practices will receive no intervention. We will observe both groups of general practices over 12 months and compare their chlamydia testing rates among women aged 16 to 24 years. We estimate that the alert will increase testing rates from the 4% currently tested to 10%. By testing and treating more women with the infection, we can reduce the number of people in the community with the infection. We will also be collecting information about the dollar cost of chlamydia infection to the community. This study will produce valuable information which can be used by government to inform the design of future chlamydia screening and control programs.Read moreRead less