Ginige Samitha, Fairley Christopher K, Hocking Jane S, Bowden Francis J, Chen Marcus Y
Melbourne Sexual Health Centre, The Alfred Hospital, Melbourne, Australia.
BMC Public Health. 2007 Jun 4;7:95. doi: 10.1186/1471-2458-7-95.
Despite guidelines recommending opportunistic chlamydia screening of younger women, screening rates in some countries remain low. Our aim was to review the evidence for specific interventions aimed at increasing chlamydia screening rates in primary care.
A Medline search was conducted for controlled trials that assessed the effectiveness of interventions aimed at improving chlamydia screening rates in primary health care settings. The Medline search was done for studies in English published prior to December 2005 using the following key words: chlamydia, screening, intervention, primary care and GPs. In addition, the references cited in the articles were reviewed. Studies in English published prior to December 2005 were reviewed.
Four controlled studies met the inclusion criteria--3 were randomized studies and one was not. Strategies to increase screening rates included the use of educational packages targeting primary care physicians and the correction of barriers to screening within clinic systems. In 3 studies, the intervention was associated with an increase in screening rates of between 100% and 276% (p < 0.04). In the fourth study, the intervention was associated with a significant attenuation in declining screening rates over time (4% versus 34% decline, p = 0.04).
There are only a limited number of randomized or controlled studies that demonstrate improved chlamydia screening of younger women in primary care.
尽管指南建议对年轻女性进行衣原体机会性筛查，但一些国家的筛查率仍然很低。我们的目的是回顾旨在提高初级保健中衣原体筛查率的特定干预措施的证据。
对评估旨在提高初级卫生保健机构中衣原体筛查率的干预措施有效性的对照试验进行了Medline检索。使用以下关键词对2005年12月之前发表的英文研究进行了Medline检索：衣原体、筛查、干预、初级保健和全科医生。此外，还对文章中引用的参考文献进行了回顾。对2005年12月之前发表的英文研究进行了回顾。
四项对照研究符合纳入标准——三项为随机研究，一项不是。提高筛查率的策略包括使用针对初级保健医生的教育包以及纠正诊所系统内的筛查障碍。在三项研究中，干预措施使筛查率提高了100%至276%（p < 0.04）。在第四项研究中，干预措施与随着时间推移筛查率下降的显著减缓相关（下降4%对34%，p = 0.04）。
仅有数量有限的随机或对照研究表明在初级保健中对年轻女性的衣原体筛查有所改善。
