Screening and diagnostic practices for chlamydia infections in New Zealand.

AIMS

To identify screening and diagnostic practices for chlamydia infection in New Zealand.

METHODS

Postal survey of doctors and nurses at all sexual health, family planning, youth and student clinics, and randomly selected general practitioners (GPs).

RESULTS

Most respondents recognised chlamydia infection as a cause of pelvic inflammatory disease and infertility in females, and epididymitis and non-gonococcal urethritis in males. Ectopic pregnancy and conjunctivitis were less commonly recognised by GPs and student and youth centre doctors. Sterile pyuria and arthritis were well recognised only by sexual health doctors. Female doctors were significantly more likely to recognise signs and symptoms than male doctors. GPs were less likely than other respondents to screen for chlamydia infection. Sexual health doctors and nurses were more likely to remove cervical secretions prior to taking endocervical specimens. Contact tracing was regarded as very important by only a quarter of family planning respondents, compared with over 80% of other respondents.

CONCLUSIONS

While respondents recognised most signs, symptoms, and sequelae of chlamydia infection, some important features were not well recognised. Screening practices varied, and many endocervical specimens were taken incorrectly. Given the long-term health consequences and cost of chlamydia infection sequelae, screening guidelines are urgently required.