Major chlamydia study set to publish
News release from the National Coordinating Centre for Health Technology Assessment
7 August 2006
At the start of Sexual Health Week (7-13 August 2006) new research is set to answer some of the biggest questions about chlamydia, informing the development of the National Chlamydia Screening Programme. The results of six linked studies, commissioned by the NIHR Health Technology Assessment (HTA) programme, include the finding that using trained practice nurses to notify partners is as effective as referral to a specialist health advisor and costs the same, and that chlamydia affects as many men as women, so they should be targeted as intensively as women. Currently screening is focused on women, as the repercussions of chlamydia can be more serious for them.
The Chlamydia Screening Studies (ClaSS) project, one of the largest of its kind, was commissioned by the HTA programme to investigate the most effective way to screen for chlamydia. It is the world's most commonly reported sexually transmitted infection, causing over 100,000 new cases a year in men and women throughout England and Wales, costing the NHS over £100 million per year in associated treatment costs.
More than 4,500 patients took part in the multi-centre series of studies, led by Dr Nicola Low and Prof. Matthias Egger, formerly of University of Bristol . Researchers investigated the overall prevalence of chlamydia; the most effective procedures for notifying partners; the performance of different screening strategies and tests; as well as the emotional, social and psychological effects of screening.
The core study was a survey in which patients were invited by post to provide a urine sample and (for women) swab specimens and to mail them to a lab for testing. Researchers found that the prevalence of chlamydia in asymptomatic young men was close to that of women (6.2% women compared to 5.3% men), indicating that they should be targeted as intensively as women for screening. The research suggested general practices are the best place to carry this out as nearly two thirds of men attended their general practice in one year, making opportunistic screening more feasible. The research also showed that home-based specimen collection can be offered by post as a feasible and acceptable alternative to clinic-based screening for those who prefer it.
Researchers also identified features that might enhance the uptake of opportunistic screening. They suggested that practice registers could be used by central chlamydia screening offices to ensure that patients are not undergoing repeat testing in different health care settings; to invite people to be screened if they have not presented during the year; and to recall those who have been screened once to invite them for regular annual screening.
It was found that nurse-led partner notification, with support from specialist health advisers, could be implemented within the National Chlamydia Screening Programme. Practice nurses were as effective as referral to a Genito-Urinary Medicine (GUM) clinic for the notification and treatment of partners of people diagnosed with chlamydia, and they cost the same. This approach was found to be preferred by patients.
“We hope that the findings of these studies will help to inform the ongoing development of the National Chlamydia Screening Programme, which is in the process of establishing another 50 screening sites across the UK ,” says Dr Low. “Our research has identified some interventions that could be evaluated in a randomised trial to help determine the effectiveness of opportunistic screening. For example, the use of practice registers at central screening offices, and issuing postal invitations offering home-based specimen collection for some patients. We also identified that practice nurses could play a bigger role in the notification and treatment of partners.”
The complete findings of ClaSS are set to be published this autumn in the Health Technology Assessment journal series. For full project details and to register to be email alerted when the full project is published visit the HTA programme website, http://www.hta.ac.uk/project.asp?PjtId=1137. For more information on Sexual Health week visit http://www.fpa.org.uk/
Notes:
Active screening means that people are actively sought and invited for screening (also known as population, or call-recall screening). Opportunistic programmes offer screening tests to health service users even if attendances are unrelated to the disease being screened for.
Chlamydia prevalence is highest in sexually active women aged 16 to 24 years and men aged 18 to 29 years
Notes for editors
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The HTA programme is a programme of the National Institute for Health Research (NIHR) and produces high quality research information about the effectiveness, costs, and broader impact of health technologies for those who use, manage and provide care in the NHS. It is the largest of the NIHR programmes and publishes the results of its research in the Health Technology Assessment journal, with more than 400 issues published to date. The journal’s 2007 Impact Factor (3.87) ranked it in the top 10% of medical and health-related journals. All issues are available for download free of charge from the website, www.hta.ac.uk The HTA programme is coordinated by the National Coordinating Centre for Health Technology Assessment (NCCHTA), based at the University of Southampton.
- The National Institute for Health Research provides the framework through which the research staff and research infrastructure of the NHS in England is positioned, maintained and managed as a national research facility. The NIHR provides the NHS with the support and infrastructure it needs to conduct first-class research funded by the Government and its partners alongside high-quality patient care, education and training. Its aim is to support outstanding individuals (both leaders and collaborators), working in world class facilities (both NHS and university), conducting leading edge research focused on the needs of patients. www.nihr.ac.uk
Contact details
Naomi Stockley, Programme Manager (Communications)
Telephone: 02380 595 646, Email: ns5@soton.ac.uk
Helen Nikandrou, Assistant Programme Manager (Communications)
Telephone: 02380 595 584, Email: h.nikandrou@soton.ac.uk
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