Repeated re-testing of women with a history of chlamydia is a cost-effective strategy for preserving reproductive health

Researchers from the Harvard School of Public Health assessed the cost-effectiveness and clinical benefits of currently existing guidelines and new, proposed guidelines for screening women for chlamydia.

They found that the most beneficial and cost-effective strategy is to screen all women yearly from age of 15 and up to age 29 and re-test women found to be infected with chlamydia at six month intervals. Current recommendations advise annual screening for chlamydia in all sexually active women under the age of 25 followed by a single repeat test within 3-4 months for those who test positive.

Chlamydia, described as the “silent” sexually transmitted disease because symptoms don’t readily appear, is an infection caused by the bacterium Chlamydia trachomatis. While men and women are both susceptible to chlamydial infection, women suffer the most serious consequences of unrecognized infection, including pelvic inflammatory disease, chronic pelvic pain, ectopic pregnancy and infertility. Chlamydia can also be passed from an infected mother to her child during childbirth resulting in pneumonia and conjunctivitis in the newborn. When detected early, chlamydia can be easily and effectively treated with oral antibiotics.

Dr. Sue Goldie, senior author of the study and an Associate Professor of Decision Science at the Harvard School of Public Health said, “Our study was motivated by two alarming statistics. First, less than 40% of women who should get screened for chlamydia actually receive the test. Second, women who are found to have the infection are at 3-5 fold risk over uninfected persons to become reinfected within the next six months. Since the majority of chlamydial infections do not produce symptoms, regular screening is a key intervention to control this disease.”

According to Dr. Delphine Hu, lead author of the study, screening for chlamydia can now be done with simple laboratory tests using either urine or vaginal specimens which do not require pelvic examinations. The study results show that repeated re-testing of women with a history of chlamydia every 6 months is a cost-effective strategy for preserving reproductive health.

The research was supported by the Agency for Healthcare Research and Policy Fellowship Award.