Feasibility and utility of screening adolescent mothers for Chlamydia at their children's health care visits.
OBJECTIVE
Assess the feasibility of offering and barriers to accepting urine-based screening for Chlamydia trachomatis (CT) among asymptomatic adolescent mothers during their children's health care visits.


METHODS
Providers were automatically cued to offer CT-screening to 13 through 21 year old mothers when they opened the child's medical record. Recording the mothers' screening decisions removed the flag for 6 months. Providers were also prompted to assess the perceived importance of CT prevention, likelihood of having CT, and the worst aspect of having CT.


RESULTS
Mothers usually brought their children to the clinic. Hence, providers could act on 97% of the 318 flags they saw. They responded appropriately 75% of the time. Only 96 (42%) of the 229 mothers who were asked agreed to screening. The primary reasons for declining were "monogamous" and "tested within 6 months". Almost everyone said CT was a top preventive health priority, but that they would be surprised if they were infected. Mothers who agreed to screening were less likely to have a child less than 6 months of age (26.0% vs. 57.1%; P < 0.0001). They were also more likely to rate knowledge of partner infidelity (39.4% vs. 13.6%; P = 0.03) and less likely to rate medical problems (15.2% vs. 40.9%; P = 0.01) the worst aspect of having CT. None of the 21 urine samples obtained within 6 months of delivery were positive for CT. Thereafter, 5 (9.1%) of the 55 urines were positive.


CONCLUSIONS
It is feasible and useful to screen adolescent mothers for CT at their children's health care visits. The best way to increase the efficacy and strengthen the impact of urine-based CT-screening in this setting is to initiate testing after the 6th postpartum month and heighten awareness of STD-risk among adolescent mothers.
Jumping-Eagle
Sara
S
Department of Pediatrics, Division of Adolescent Medicine, University of Colorado Health Sciences Center, The Children's Hospital, 1056 East 19th Street, Denver, Colorado 80218, USA.
Sheeder
Jeanelle
J
Kelly
Lisa S
LS
Stevens-Simon
Catherine
C
D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities; D002648:Child; D002690:Chlamydia Infections / Q000175:diagnosis*; D002692:Chlamydia trachomatis / Q000302:isolation & purification* / Q000472:pathogenicity; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008427:Maternal Health Services / Q000379:methods*; D009035:Mothers; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000379:methods; D049590:Postpartum Period; D016482:Urinalysis / Q000379:methods; D014556:Urine / Q000382:microbiology