Outreach health adviser in a community clinic screening programme improves management of genital chlamydia infection.
OBJECTIVE
To assess the effectiveness of an outreach health adviser on treatment, partner notification and outcome for clients diagnosed with genital chlamydia (CT) infection at a community young people's clinic.


METHODS
From August 1999 to March 2000, a genitourinary medicine (GUM) based health adviser helped to develop testing and undertook outreach management of clients aged under 26 years diagnosed with CT infection. In addition to facilitating referral to GUM, she gave antibiotic treatment based on a GUM derived patient group direction to those not wishing to travel to the GUM clinic. She also advised them on contact tracing and the need for a compliance check (CC).


RESULTS
Chlamydia positive tests with ligase chain reaction (LCR), on first void urine, were obtained for 62 (12.9%) of 481 female clients, one (5%) of 20 male clients, and nine (53%) of 17 male contacts of female positive cases. All 72 testing positive received their result and were treated. Two urine samples positive for CT showed positive LCR tests for gonorrhoea. Proportions of named contacts seen (67%) and reattendances for compliance checks (60%) were similar to those for women seen in GUM services.


CONCLUSIONS
Health adviser input with the ability to treat can be effective in reducing the growth of identified but untreated genital chlamydia infection consequent upon community based screening. Such a strategy appears comparable with, and can add to, GUM based treatment of infection. It helps to address the need for alternative management strategies in the light of the national sexual health strategy.
Jones
K
K
PACE, Abacus Centres for Contraception and Reproductive Health, Liverpool, UK. kjjonah@yahoo.co.uk
Webb
A
A
Mallinson
H
H
Birley
H
H
D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities / Q000458:organization & administration*; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000188:drug therapy; D003159:Community-Institutional Relations / Q000592:standards*; D016358:Contact Tracing / Q000379:methods; D004739:England; D005260:Female; D005831:Genital Diseases, Female / Q000175:diagnosis* / Q000188:drug therapy; D005832:Genital Diseases, Male / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000458:organization & administration; D008485:Medical Audit; D017063:Outcome Assessment, Health Care; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010865:Pilot Projects; D015397:Program Evaluation; D014686:Venereology / Q000458:organization & administration*