Urine based screening for asymptomatic/undiagnosed genital chlamydial infection in young people visiting the accident and emergency department is feasible, acceptable, and can be epidemiologically helpful.
OBJECTIVE
To assess the acceptability and the feasibility of urine based Chlamydia trachomatis screening in asymptomatic young people aged 16-35 years attending an inner city accident and emergency (A&E) department.


METHODS
Cross sectional study.


METHODS
A&E department in a teaching hospital, in south London, UK.


METHODS
From July to November 2001 a urine based chlamydia screening test was offered to 719 consecutive A&E attendees aged 16-35 years and their companions. Participants were given an information sheet and were asked to complete a demographic and sexual health questionnaire. Following informed consent, eligible participants provided first pass urine specimens. Specimens were tested for C. trachomatis using nucleic acid amplification.


RESULTS
Of the A&E attendees asked, 76.5% (550/719) agreed to participate. Prevalence of genital chlamydial infection was 4.2% (18/432; 95% confidence interval (CI) 2.5 to 6.6). 12 of the positive participants (66.7%; 95% CI 40.99 to 86.65) were women, of whom seven were Afro-Caribbean. Nine of the chlamydia positive participants (50%; 95% CI 26.0 to 73.9) were aged 25 years. Three of the positive urine specimens were from companions, of whom a total of 143 were screened. All the positive participants were contactable, and were offered treatment.


CONCLUSIONS
Urine based screening for undiagnosed genital chlamydial infection in the A&E department was acceptable and feasible. The department provides a unique site for screening young patients and companions, men and women.
Aldeen
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T
Department of Genitourinary Medicine, St George's Hospital, London, UK. tdeen2000@hotmail.com
Haghdoost
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A
Hay
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D000293:Adolescent; D000328:Adult; D002690:Chlamydia Infections / Q000175:diagnosis / Q000453:epidemiology / Q000652:urine*; D002985:Clinical Protocols; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008131:London / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000379:methods*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D015995:Prevalence; D012747:Sexual Partners