Screening for Chlamydia trachomatis: sampling for success

As the Department of Health comes under criticism again for its approach to Chlamydia screening at the local level,1,2 there are calls to nationalise the initiative and increase the number of sexually active people in the 14–25 age group tested in order to reach the high volume of testing required to reduce the prevalence of Chlamydia in this high-risk population.2 An increase in testing will obviously have an impact on local laboratory workloads and, as with any clinical investigation, the quality of patient samples is important in order to achieve maximum sensitivity and reliability of the nucleic acid amplification tests used for the identification of Chlamydia. This article explores some of the sampling devices and vessels available to healthcare professionals in the UK and how they can enhance the performance of Chlamydia screening programmes.

Chlamydia in young people
Genital infection with Chlamydia trachomatis is the most commonly diagnosed bacterial sexually transmitted infection (STI) in the UK and its incidence continues to increase, especially in young people under the age of 25.3 However, infection is easy to detect and treat with antibiotics.
 One in 14 young people tested has been found to carry Chlamydia. Although Chlamydia infection is asymptomatic in most (up to 70%4) of carriers, if left untreated it can lead to serious health complications such as infertility, ectopic pregnancy and pelvic pain in women, and to urethritis and epidydimitis in men. It is also associated with arthritis in both sexes. This is why it is important to screen the high-risk group for Chlamydia.

Those most at risk of infection are men and women under the age of 25, especially if they have had a new sexual partner in the past 12 months; those who do not use barrier contraception; and women who are undergoing termination of pregnancy.