Implementation of a pilot programme for screening for chlamydial infection in general practice.
OBJECTIVE
To determine whether opportunistic screening for Chlamydia trachomatis, based on a selective screening, algorithm, is possible in general practice in Belgium; to assess feasibility of the screening strategy with respect to workload, acceptability, and organisational aspects.


METHODS
Implementation of a pilot screening programme by 37 GPs for a period of 15 weeks. GPs' screening practices were registered and compared with the guidelines they had received. Outcome measures were: the number of patients included in the risk assessment, uptake of screening by eligible patients, prevalence of previously unidentified infection, and uptake of treatment. After the study period GPs evaluated a number of feasibility issues on a scoring form.


RESULTS
326 women underwent the risk assessment and 214 were tested by an amplification assay on a urine sample. Prevalence in woman at risk was 6.4%. Overall effective screening rate was 77.6%; 9 of 11 positives took up treatment. Participating GPs found the strategy feasible and perceived that it was well accepted by their patients.


CONCLUSIONS
The screening strategy was easily implemented by most GPs but some of them dropped out. The guidelines were followed relatively well and there were no major logistic problems. The uptake of treatment wat suboptimal. Efforts must be made to stimulate and educate more GPs to perform screening; laboratory and storage conditions should be optimised; refunding criteria should be revised; and overscreening must be avoided.
Verhoeven
Veronique
V
Academic Centre for General Practice, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium. veronique.verhoeven@ua.ac.be
Avonts
Dirk
D
Van Royen
Paul
P
Denekens
Joke
J
D000328:Adult; D000465:Algorithms; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D017963:Azithromycin / Q000627:therapeutic use; D001530:Belgium; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000188:drug therapy; D005194:Family Practice; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D010865:Pilot Projects; D010818:Practice Patterns, Physicians'; D018570:Risk Assessment
D000900:Anti-Bacterial Agents; D017963:Azithromycin