title: Relative efficiency of chlamydia screening in non-clinical settings in two California counties.
abstract: We examined the relative efficiency of non-clinical sites to screen for chlamydia in youth and young adults. Chlamydia screening targeting youth (under 30 years of age) was performed at non-clinical sites in high-morbidity neighbourhoods of two California counties. Venues were subdivided into community outreach, schools, parenting centres and drug treatment/correctional facilities. Relative efficiency was estimated with multivariate Poisson regression using incidence of chlamydia per person-hours labour adjusting for strategy and county. Among the 1514 youths screened, the overall prevalence of chlamydia was 5.5%. By venue, the highest prevalence was in drug treatment/correction facilities at 11.1% followed by parenting centres at 6.3%, community outreach at 4.9% and schools at 4.6%. Drug treatment/correctional facilities were the most labour time efficient at 9.9 person-hours per chlamydia case. Schools and parenting centres had the lowest cost per screen at 0.9 person-hours per screen. Adjusted relative labour time efficiency (chlamydia cases per paid person-hour) was significantly higher in schools, 2.0 (95% confidence interval [CI] 1.0-4.2), parenting centres, 3.2 (95% CI 1.6-6.6) and drug treatment/correctional facilities, 2.9 (95% CI 1.0-7.8), compared with community outreach. In conclusion, parenting centres and drug treatment centres and correctional facilities are the most efficient venues for chlamydia screening.
authors.affiliation: California Department of Public Health, Sexually Transmitted Diseases (STD) Control Branch, Richmond, USA. shmorris@ucsd.edu
authors.forename: S R
authors.initials: SR
authors.lastname: Morris
authors.forename: H M
authors.initials: HM
authors.lastname: Bauer
authors.forename: M
authors.initials: M
authors.lastname: Chartier
authors.forename: H
authors.initials: H
authors.lastname: Howard
authors.forename: S
authors.initials: S
authors.lastname: Watson
authors.forename: J
authors.initials: J
authors.lastname: Yokotobi
authors.forename: A F
authors.initials: AF
authors.lastname: Taylor
authors.forename: G
authors.initials: G
authors.lastname: Bolan
mesh_terms: D000293:Adolescent; D000328:Adult; D002140:California / Q000453:epidemiology; D002648:Child; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000453:epidemiology*; D002692:Chlamydia trachomatis / Q000302:isolation & purification*; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics*; D015995:Prevalence; D055815:Young Adult