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Screening may be used to combat chlamydia
Irish Examiner 09/01/2007

By Stephen Rogers

LEADING health researchers have been appointed to examine all options — including a National Screening Programme — to combat the massive rise in the number of young people contracting chlamydia.

The Royal College of Surgeons (RCS) has been awarded a two-year €500,000 contract by the Health Protection Surveillance Centre to examine the best options for more widespread testing for the infection which accounts for one third of all sexually transmitted infections.

The size of the problem is evidenced by the 19.6% rise in the number of detected cases of chlamydia to 3,353 cases. That does not include the likely thousands who are unaware they have contracted the silent disease which can lead to infertility and even death in some cases.

The decision to commission the research was taken by the HPSC on the back of a report by the chairperson of the Sexually Transmitted Infections Subcommittee, Mary C Cronin. In a 2005 report she pointed out that a National Chlamydia Screening Programme (NCSP) was being ‘rolled out’ in England, targeting young men and women under the age of 25 who are attending healthcare facilities not traditionally associated with providing specialist sexual health services including contraceptive clinics, general practices, young people’s services, antenatal services and infertility units.

“Screening is also encouraged through innovative outreach strategies, such as “pee in a pot” days at military bases, university campuses, prisons and other non-traditional settings,” she said. Aidan O’Hora of the HPSC said here in Ireland the research to be carried out by the RCS will examine what the best options are for introducing screening of young people who, because they are a healthy age group and consequent good health, would not be in regular contact with medical services.

The RCS will examine what the implications would be of introducing testing in a variety of settings, whether they be primary hospitals, secondary settings or community settings. Those implications will include such areas as the financial cost of running such a service, the burden on laboratories of providing test results and the care needed for those infected.

The researchers have also been tasked with developing a sex-education message for its clients. In women, untreated chlamydia infection can spread into the uterus or fallopian tubes and cause pelvic inflammatory disease. This happens in up to 40% of women with untreated chlamydia and can cause permanent damage to the fallopian tubes, uterus, and surrounding tissues. The damage can lead to chronic pelvic pain, infertility, and potentially fatal ectopic pregnancy (pregnancy outside the uterus). Women infected with chlamydia are up to five times more likely to become infected with HIV, if exposed.