[In Poitou-Charentes family planning centers, Chlamydia trachomatis infection in women is more frequently detected through the presence or absence of risk factors than in accordance with official guidelines].
BACKGROUND
The French health authorities recommend systematic screening for Chlamydia trachomatis (Ct) urogenital infections in dedicated sexual health centers (planning centers) for women under 25 years old and for women who have changed partners during the last year. The two main purposes of this study were to assess adherence to this recommendation in planning centers and to identify possible obstacles to this screening.


METHODS
We conducted an observational prospective study from April to August 2013 in planning centers of Poitou-Charentes. Data on declarative screening practices and possible obstacles to Ct screening were collected qualitatively. Real center practices were also recorded to assess conformity with guidelines. Quantitative data were collected about real activities in each center. Screening percentage among women younger than 25 years and among those who had changed partners during the year was computed for each center. The main endpoint was percentage of centers that did not follow the recommendations. Declared practices were compared to observational practices using real practices data.


RESULTS
Twelve out of 17 planning centers in the region participated. Six centers declared they performed systematic screening for Ct infection in women under 25 and 2 centers in women who had changed partners during the year. No center fully complied with the recommendations. Forty-three percent (601/1390) of women with standard screening criteria were screened and 52 % (102/197) of women without these criteria were screened. Depending on the center, declared practices could overestimate or underestimate the observed practices. The declared obstacles were lack of time, patient refusal, budget issues and no specific organization.


CONCLUSIONS
Poitou-Charentes planning centers screen for Ct infection in women younger than 25 years old and those who have changed partners during the last year depending on risk factors (unprotected sex, infected partner…). Which patients need this screening has to be clarified.
Département de médecine générale, université de Poitiers, 3, rue de la Milétrie, 86000 Poitiers, France. Electronic address: stephanie.grandcolin@univ-poitiers.fr.
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Grandcolin
Département de médecine générale, université de Poitiers, 3, rue de la Milétrie, 86000 Poitiers, France.
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Lioni
Département de médecine générale, université de Nantes, 44000 Nantes, France.
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Jourdain
Département de santé publique, université de Poitiers, 86000 Poitiers, France.
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Albouy-Llaty
D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities / Q000592:standards / Q000706:statistics & numerical data*; D002648:Child; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000453:epidemiology*; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D003430:Cross-Sectional Studies; D005260:Female; D005602:France / Q000453:epidemiology; D019983:Guideline Adherence / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D008403:Mass Screening / Q000379:methods / Q000592:standards; D008875:Middle Aged; D011247:Pregnancy; D015995:Prevalence; D012307:Risk Factors; D055815:Young Adult
Centre de planification; Chlamydia trachomatis; Dépistage; Planning service; Screening