Public Health Strategy Division, Health Protection Agency, 61 Colindale Avenue, London NW9 5EQ, UK.
Sex Transm Infect. 2012 Aug;88(5):375-81. doi: 10.1136/sextrans-2011-050267. Epub 2012 Feb 28.
England's National Chlamydia Screening Programme provides opportunistic testing for all 15-24-year-olds in healthcare and non-healthcare settings. The authors undertook an evaluation of a population service-based postal chlamydia screening and treatment service, with registration and access to the service via the internet, in order to target screening interventions more effectively in future.
Individuals aged between 18 and 24 years, within the North East Essex Primary Care Trust, were identified for chlamydia screening by the service between 1 December 2008 and 31 January 2009. Associations between test uptake and positivity, and individuals' personal characteristics, were examined. The efficacy of partner notification was estimated, and the costs of screening were compared with the national average.
Uptake of chlamydia screening was 11.5%, with lower response rates among men, individuals older than 20 years and those living in more deprived areas. The chlamydia positivity was 4.4% and higher in those reporting multiple sexual partners, individuals older than 20 years and those living in more deprived areas. The proportion of partners notified per index case was 0.17. The service contributed to 3431 of the overall 11,209 annual chlamydia screens of the Primary Care Trust in 2008-2009, at a cost of £ 78 per screening test completed and £ 1764 per case detected.
Our evaluation shows that this service model can contribute substantially to the overall coverage of chlamydia screening tests. However, the costs of service provision per case detected and treated, using this model, were high compared to the National Chlamydia Screening Programme.
英格兰国家衣原体筛查计划为所有 15-24 岁的人在医疗和非医疗环境中提供机会性检测。作者评估了一种基于人群的邮政衣原体筛查和治疗服务，该服务通过互联网进行注册和访问，以便在未来更有效地针对筛查干预措施。
2008 年 12 月 1 日至 2009 年 1 月 31 日期间，东北埃塞克斯初级保健信托基金内年龄在 18 至 24 岁之间的个人通过该服务确定进行衣原体筛查。检查了测试接受率和阳性率与个人特征之间的关联。估计了性伴侣通知的效果，并比较了筛查的成本与全国平均水平。
衣原体筛查的接受率为 11.5%，男性、20 岁以上的人和生活在贫困地区的人反应率较低。衣原体阳性率为 4.4%，报告有多个性伴侣、20 岁以上的人和生活在贫困地区的人阳性率更高。每例索引病例通知的性伴侣比例为 0.17。该服务为 2008-2009 年初级保健信托基金的 11209 例年度衣原体筛查中的 3431 例做出了贡献，每完成一次筛查测试的费用为 78 英镑，每例发现的病例的费用为 1764 英镑。
我们的评估表明，这种服务模式可以为衣原体筛查测试的总体覆盖率做出重大贡献。然而，与国家衣原体筛查计划相比，使用这种模式发现和治疗每例病例的服务提供成本较高。
