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Sara Lavelle Chlamydia Screening Programme Lead

Screening for Neisseria Gonorrhoea within a Chlamydia Screening Programme in England: results from the first 18 months. Sara Lavelle Chlamydia Screening Programme Lead Liverpool, South Sefton and Knowsley Chlamydia Screening Programme, UK. Background. National Chlamydia Screening Programme

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Sara Lavelle Chlamydia Screening Programme Lead

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  1. Screening for Neisseria Gonorrhoea within a Chlamydia Screening Programme in England: results from the first 18 months Sara Lavelle Chlamydia Screening Programme Lead Liverpool, South Sefton and Knowsley Chlamydia Screening Programme, UK

  2. Background • National Chlamydia Screening Programme • Opportunıstıc screenıng for men and women aged under 25 years • Chlamydia screening using Transcription Mediated Amplification (TMA)

  3. Consıderatıons • Lack of data to identify prevalence of Neisseria Gonorrhoea (NG) within the community • Ability to offer dual testing at no extra cost

  4. Objectives Of Screening For NG • To identify prevalence within a population screened for Chlamydia Trachomatis (CT) • To monitor confirmatory microscopy, culture and partner findings following reactive TMA gonorrhoea screening tests

  5. Methods • All clients accepting CT Screening offered screening for NG • Use of urine, endocervical and vulvovaginal swabs • Clients with reactive TMA NG tests referred to Genito-Urinary Medicine Department

  6. Screening Period • All clients tested for NG between June 2004 and December 2005 were monitored • Those who were TMA reactive for NG were referred to GUM and microscopy and culture results obtained if possible

  7. Results (1) • 18615 clients (16415 women and 2200 men) screened for CT • 17378 (93%) of clients (15470 women and 1908 men) also accepted screening for NG • 184 (1%) of clients (158 women and 26 men) had reactive TMA NG tests • NG prevalence of 1% for women and 1.4% for men

  8. Results (2) • 26 TMA NG reactive men of which 15(57%) also tested positive for CT • 158 TMA NG reactive women of which 74(47%) also tested positive for CT • CT prevalence in opportunistically screened population was 12.5% for women and 13.5% for men

  9. Comparison Of TMA And Culture • Supportive evidence of positive NG diagnosis was found for 116 (88%) of 131 women and 14 (93%) of 15 men • In one instance, NG was detected by TMA from a vulvovaginal swab, but culture was positive for pharyngeal swab only

  10. Conclusions (1) • Screening for NG in a chlamydia screening programme is acceptable to clients • Screening for NG using TMA offers a method of non-invasive screening within community settings

  11. Conclusions (2) • Study adds to evidence to support TMA testing for NG as an accurate method • There were more NG reactive tests within the chlamydia negative population – single screening may have offered false reassurance • Culture remains essential to obtain resistance profiles

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