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Rationale, design, and results of the first screening round of a comprehensive, register-based, Chlamydia screening implementation programme in the Netherlands.

van Bergen JE, Fennema JS, van den Broek IV, Brouwers EE, de Feijter EM, Hoebe CJ, Koekenbier RH, de Coul EL, van Ravesteijn SM, Götz HM - BMC Infect. Dis. (2010)

Bottom Line: One-fifth of the invitees requested a test kit, of whom 80% sent in a sample for testing.The overall positivity rate was 4.2%.Insight into the feasibility, effectiveness, cost-effectiveness, and impact of this large-scale screening programme will determine whether the programme will be implemented nationally.

View Article: PubMed Central - HTML - PubMed

Affiliation: STI AIDS Netherlands, Amsterdam, The Netherlands. jvanbergen@soaaids.nl

ABSTRACT

Background: Implementing Chlamydia trachomatis screening in the Netherlands has been a point of debate for several years. The National Health Council advised against implementing nationwide screening until additional data collected from a pilot project in 2003 suggested that screening by risk profiles could be effective. A continuous increase in infections recorded in the national surveillance database affirmed the need for a more active approach. Here, we describe the rationale, design, and implementation of a Chlamydia screening demonstration programme.

Methods: A systematic, selective, internet-based Chlamydia screening programme started in April 2008. Letters are sent annually to all 16 to 29-year-old residents of Amsterdam, Rotterdam, and selected municipalities of South Limburg. The letters invite sexually active persons to login to http://www.chlamydiatest.nl with a personal code and to request a test kit. In the lower prevalence area of South Limburg, test kits can only be requested if the internet-based risk assessment exceeds a predefined value.

Results: We sent invitations to 261,025 people in the first round. One-fifth of the invitees requested a test kit, of whom 80% sent in a sample for testing. The overall positivity rate was 4.2%.

Conclusions: This programme advances Chlamydia control activities in the Netherlands. Insight into the feasibility, effectiveness, cost-effectiveness, and impact of this large-scale screening programme will determine whether the programme will be implemented nationally.

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Operational flowchart of the Chlamydia screening programme.
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Figure 1: Operational flowchart of the Chlamydia screening programme.

Mentions: Figure 1 presents the framework of the logistics. The local Public Health Services send invitations to all 16 to 29-year-olds in Amsterdam, Rotterdam, and South Limburg. Municipal population registers supply the addresses. The order of invitations is cluster-randomised per area or municipality according to postal codes lists within clusters in each of the three participating regions. The invitations contain an information leaflet and a letter, advising those who are (or have been) sexually active to participate. The invitation letters provide a unique ID number (login code) that enables the invitee to request a test kit at http://www.chlamydiatest.nl (Figure 2). The invitation letter and information materials (text and website) have been developed and pretested with the relevant age, sex, and cultural groups. In the lower prevalence area, South Limburg, anyone who visits the website must first do a short online risk assessment, and can only request a test kit if the risk score reaches a predefined level of 6 or more, compatible with an estimated positivity rate of 4-5% (see Additional file 1).


Rationale, design, and results of the first screening round of a comprehensive, register-based, Chlamydia screening implementation programme in the Netherlands.

van Bergen JE, Fennema JS, van den Broek IV, Brouwers EE, de Feijter EM, Hoebe CJ, Koekenbier RH, de Coul EL, van Ravesteijn SM, Götz HM - BMC Infect. Dis. (2010)

Operational flowchart of the Chlamydia screening programme.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2959064&req=5

Figure 1: Operational flowchart of the Chlamydia screening programme.
Mentions: Figure 1 presents the framework of the logistics. The local Public Health Services send invitations to all 16 to 29-year-olds in Amsterdam, Rotterdam, and South Limburg. Municipal population registers supply the addresses. The order of invitations is cluster-randomised per area or municipality according to postal codes lists within clusters in each of the three participating regions. The invitations contain an information leaflet and a letter, advising those who are (or have been) sexually active to participate. The invitation letters provide a unique ID number (login code) that enables the invitee to request a test kit at http://www.chlamydiatest.nl (Figure 2). The invitation letter and information materials (text and website) have been developed and pretested with the relevant age, sex, and cultural groups. In the lower prevalence area, South Limburg, anyone who visits the website must first do a short online risk assessment, and can only request a test kit if the risk score reaches a predefined level of 6 or more, compatible with an estimated positivity rate of 4-5% (see Additional file 1).

Bottom Line: One-fifth of the invitees requested a test kit, of whom 80% sent in a sample for testing.The overall positivity rate was 4.2%.Insight into the feasibility, effectiveness, cost-effectiveness, and impact of this large-scale screening programme will determine whether the programme will be implemented nationally.

View Article: PubMed Central - HTML - PubMed

Affiliation: STI AIDS Netherlands, Amsterdam, The Netherlands. jvanbergen@soaaids.nl

ABSTRACT

Background: Implementing Chlamydia trachomatis screening in the Netherlands has been a point of debate for several years. The National Health Council advised against implementing nationwide screening until additional data collected from a pilot project in 2003 suggested that screening by risk profiles could be effective. A continuous increase in infections recorded in the national surveillance database affirmed the need for a more active approach. Here, we describe the rationale, design, and implementation of a Chlamydia screening demonstration programme.

Methods: A systematic, selective, internet-based Chlamydia screening programme started in April 2008. Letters are sent annually to all 16 to 29-year-old residents of Amsterdam, Rotterdam, and selected municipalities of South Limburg. The letters invite sexually active persons to login to http://www.chlamydiatest.nl with a personal code and to request a test kit. In the lower prevalence area of South Limburg, test kits can only be requested if the internet-based risk assessment exceeds a predefined value.

Results: We sent invitations to 261,025 people in the first round. One-fifth of the invitees requested a test kit, of whom 80% sent in a sample for testing. The overall positivity rate was 4.2%.

Conclusions: This programme advances Chlamydia control activities in the Netherlands. Insight into the feasibility, effectiveness, cost-effectiveness, and impact of this large-scale screening programme will determine whether the programme will be implemented nationally.

Show MeSH
Related in: MedlinePlus