title: Is the prevention of genital chlamydial infections by community involvement possible?
abstract: This chapter presents different means by which community initiatives have been undertaken to reduce the prevalence and incidence of genital and allied infections caused by Chlamydia trachomatis. As most of these infections in the majority of infected individuals do not produce symptoms that are likely to urge them to attend any health care unit, screening programmes are mandatory to be able to influence the epidemic of infections with this agent. In many societies there has been a skewed gender distribution in the number of chlamydia-positive persons; this probably indicates that diagnostic service activities have been directed more against one gender than the other. The important role of partner notification, as in the case of other sexually transmitted infections, has been documented. Different means of community initiative have included counselling of school children and groups of persons more likely to be infected. Counselling by the pharmacy has an important role in many societies. Selected cohorts have been offered - via the mass media, Internet, radio and television programmes - sampling kits which can be mailed to a laboratory for testing. The establishment of youth clinics has been found effective for detecting teenagers harbouring C. trachomatis, similarly to screening at antenatal clinics. The offer of free consultations, aetiological tests and therapy has been a part of community initiatives, mimicking the services offered for some of the classic sexually transmitted infections. This chapter considers the usefulness of different test methods and stresses the need to retest those found to be positive. Barriers to the successful introduction of screening activities and diagnostic services are also considered.
authors.affiliation: Department of Obstetrics and Gynecology, Lund University, Lund, Sweden.
authors.forename: Per-Anders
authors.initials: PA
authors.lastname: Mårdh
mesh_terms: D000554:Ambulatory Care Facilities / Q000458:organization & administration; D002690:Chlamydia Infections / Q000517:prevention & control*; D002692:Chlamydia trachomatis; D003153:Community Health Services / Q000458:organization & administration*; D005260:Female; D005831:Genital Diseases, Female / Q000517:prevention & control*; D005832:Genital Diseases, Male / Q000517:prevention & control*; D006266:Health Education / Q000379:methods; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods