Assessing Chlamydia Rates and Screening in a Community Health Care Setting

Abstract

Introduction: Chlamydia trachomatis is the most prevalent treatable sexually transmitted disease, with peak prevalence in young women, resulting in a CDC recommendation for annual screening. A community health center in Phoenix Arizona implemented this recommendation in 2010. Objective: Determine the prevalence of Chlamydia and assess changes in screening based on a protocol for screening at a community health center. Hypothesis: The prevalence of Chlamydia in the center’s population is greater than the national average of 6.8%, and the rate of screening will have increased with a protocol in place. Methods: Data from 2011 were collected by review of 1,074 charts, noting type of visit, if symptomatic for Chlamydia, if Chlamydia screening performed and results. Data from 2008, prior to screening protocol, were obtained via review of 313 charts, recording if the women were screened and result obtained. Results: The 2011 review revealed a Chlamydia rate in the women who were screened of 8.7%: when broken down by age the prevalence ranged up to 12.5% in 16 year olds. The study also demonstrated that in 2011, after the institution of the protocol for screening, 66% of the women in the designated age group were screened for Chlamydia at the visit or in the prior year, an increase of 39 percentage points when compared with 2008. The 2008 screening rate was 27%, with 3.5% of the women having a positive result using point-of-care testing. Discussion: Transition from point-of-care testing to send out NAAT testing may have impacted the detection rate of Chlamydia in the women screened. The 2011 data demonstrate a Chlamydia prevalence of 8.7% (6.7-11.1), which based on the 95% CI is not significantly above the national average of 6.8%. The screening rate in 2011 showed a statistically and clinically significant improvement of 39 percentage points for women utilizing the clinic.