Medicina comunitaria y educación para la salud

Abstracto

Chlamydial Testing Practice Effectiveness in a High Incidence Area of Northern Canada: An Aggregate Data Analysis and Chart Review

Jeffrey DC Irvine, Stephanie L Young, James D Irvine, Vivian R Ramsden and Brian Quinn

Background: Chlamydia trachomatis infections are increasing in Canada and its North, with female rates several times higher than males. Understanding testing practices may aid in the development of strategies to reduce chlamydial rates. Research questions: To what effect are testing frequencies contributing to the difference in chlamydial rates between females and males? Which testing approaches are most effective in identifying chlamydia infections? Methods: Aggregated data for 2009 to 2012 of Northern Saskatchewan chlamydial testing was analyzed utilizing age, gender, and positivity. Additionally, a chart review on testing practices was conducted on 400 chlamydial tests at a Northern medical clinic. Results: In an area of high incidence of chlamydia infections, the annual incidence of chlamydia for females was 2.49 times the rate in males. Women’s testing rates were 3.46 times the rate in males. However, men had a 1.52 fold greater rate of positivity. For one medical clinic, contact tracing returned the greatest percent positive cases, with 50% positivity. Females were identified to be high risk, and tested significantly more often, than males. Routine tests on patients 30 years old and over were 35.3% of the total tests, although male and female positive rates in these ages were 0.72% and 0.85% respectively. Discussion: If males were tested to a similar frequency as females, male rates may increase. Female and male chlamydia rates were over 4000/100,000 until age 30, suggesting that screening recommendations include both sexes in these ages, especially in high incidence populations. Contact tracing resulted in the most percent positive cases, highlighting its importance. While routine screening occurred frequently, many occurred in older age groups with low prevalence, producing very few positive results.