title: Chlamydia screening strategies and outcomes in educational settings: a systematic review.
abstract: Chlamydia trachomatis (CT) screening programs have been established in educational settings in many countries during the past 2 decades. However, recent evidence suggests that high uptake of screening and management (treatment, partner notification, and retesting for reinfection) improves program effectiveness. We conducted a systematic review to understand the screening strategies, the extent of screening conducted, and uptake of management strategies in educational settings. Screening studies in educational settings were identified through a systematic search of published literature from 2005 to 2011. We identified 27 studies describing 30 screening programs in the United States/Canada (n = 10), Europe (n = 8), Australia/New Zealand (n = 5), and Asia (n = 4). Most studies targeted both male and female students (74%). Classroom-based strategies resulted in 21,117 testes overall (4 programs), followed by opportunistic screening during routine health examination (n = 13,470; 5 programs) and opportunistic screening at school-based health centers (n = 13,006; 5 programs). The overall median CT positivity was 4.7% (range, 1.3%-18.1%). Only 5 programs reported treatment rates (median, 100%; range, 86%-100%), 1 partner notification rate (71%), 1 retesting rate within a year of an initial CT diagnosis (47%), and 2 reported repeat positivity rates (21.1% and 26.3%). In conclusion, this systematic review shows that a variety of strategies have been used to screen large numbers of students in educational settings; however, only a few studies have reported CT management outcomes.
authors: From the *The Kirby Institute, University of New South Wales, Sydney, NSW, Australia; †Division of Epidemiology, School of Public Health, University of California, Berkeley, CA; ‡Center for Women's Health, Gender and Society, Melbourne School of Population Health, and §Department of General Practice and Primary Health Care Academic Centre, University of Melbourne, Melbourne, Victoria, Australia; ¶Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, CA; and ∥Sydney Sexual Health Centre, Sydney Hospital, Sydney, NSW, Australia.
authors: Muhammad Shahid
authors: MS
authors: Jamil
authors: Heidi M
authors: HM
authors: Bauer
authors: Jane S
authors: JS
authors: Hocking
authors: Hammad
authors: H
authors: Ali
authors: Handan
authors: H
authors: Wand
authors: Jennifer
authors: J
authors: Walker
authors: Laura
authors: L
authors: Douglas
authors: Basil
authors: B
authors: Donovan
authors: John M
authors: JM
authors: Kaldor
authors: Rebecca J
authors: RJ
authors: Guy
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D002690:Chlamydia Infections / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D002692:Chlamydia trachomatis / Q000302:isolation & purification*; D016358:Contact Tracing / Q000379:methods*; D005260:Female; D006266:Health Education / Q000379:methods; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D021141:Nucleic Acid Amplification Techniques / Q000706:statistics & numerical data; D017063:Outcome Assessment, Health Care; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D012572:School Health Services; D012574:Schools; D012725:Sexual Behavior; D013333:Student Health Services; D055815:Young Adult