1 / 21

Renee Gindi 1 , Heidi Bauer 2 , Joan Chow 2 , Melanie Deal 1

Evaluating Efforts to Increase Testing for Repeat Chlamydia Infection Among Women in California Family Planning Clinics. Renee Gindi 1 , Heidi Bauer 2 , Joan Chow 2 , Melanie Deal 1

cai
Télécharger la présentation

Renee Gindi 1 , Heidi Bauer 2 , Joan Chow 2 , Melanie Deal 1

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Evaluating Efforts to Increase Testing for Repeat Chlamydia Infection Among Women in California Family Planning Clinics Renee Gindi1, Heidi Bauer2, Joan Chow2, Melanie Deal1 1California Family Health Council, Berkeley, CA 2 California Sexually Transmitted Disease Control Branch, Berkeley, CA

  2. Background • Repeat chlamydial infection can lead to increased risk of sequelae • Studies estimate that >10% of women with chlamydia are re-infected within 4 months • Most repeat infections are due to re-infection from untreated partner • CDC Guidelines • Clinicians should consider advising all [non-pregnant] women with chlamydial infection to be re-screened 3-4 months after treatment.

  3. Study Objectives • Estimate the baseline re-screening rate in selected California family planning clinics • Promote the CDC guidelines and re-screening recommendations to family planning clinic staff • Evaluate re-screening rates before and after the release of the CDC guidelines

  4. Methods: Data • Line-listed chlamydia test data from 1999-2003 at 13 family planning clinics • Defining “re-screening” • Second test between 3-4 months • Second test between 1-6 months • Excludes: • Males • Initial positive tests after July 1, 2003 • Cases re-screened within 30 days • Statistical analysis • Trends • Grouped by pre/post-guidelines release

  5. Methods: Guideline Promotion • May 2002: CDC STD Treatment Guidelines released • May 2002: CFHC e-mail to 250 clinics • June 2002: CIPP memo to 250 clinics • Nov 2002: guidance document distribution to 19 agencies at conference • Apr 2003: guidance document distribution to 31 agencies at conference

  6. Results: Study Population 64,652 tests between Jan 1999-Jun 2003 3,149 positive tests (4.8%) 2,953 (unique) women with a positive test 1,282 women with a second test (50%) 651 women with a second test between 1-6 mo (22%) 134 women with a second test between 3-4 mo (4.5%)

  7. Rates of re-screening within 3-4 months 3.48% 5.97% GUIDELINES 6.19% 3.65%

  8. Rates of re-screening within 1-6 months 22.8% 19.8% GUIDELINES

  9. Distribution of time to re-screen among those re-screened within 6 months

  10. Distribution of time to re-screen among those re-screened within 6 months 14% 25%

  11. Median time to re-screen among those re-screened within 6 months Median=90 days Median=76 days

  12. Discussion • Overall rates of re-screening remain low • 4.5% within 3-4 months • 22% within 1-6 months • Increase in re-screening between 3-4 months • Statistical significance varied based on mode of analysis • Guideline promotion may have lengthened the time to re-screening

  13. Limitations: Data • Secondary data • Did not collect “chlamydia re-test” as reason for visit • Test date used as approximation for treatment date • Short observational period • 12 months after CDC guidelines released • Data from LA and SF not included

  14. Limitations: Intervention • Distributed entire CDC STD Treatment Guidelines document • Targeted guidance documents highlighted other chlamydia screening practices in addition to re-screening

  15. Next Steps • Performance measures for providers and clinics • Give feedback to providers and clinics • Eliminate financial barriers to re-screening • Educate clients about risks of re-infection • Make re-screening more convenient for clients • Increase emphasis on partner management

  16. Q&A

  17. Additional Materials

  18. Repeat infection rates

  19. Rates of select contraceptive method use

  20. Rates of re-screening within 1-6 monthsby half-year

  21. Rates of Test of Cure

More Related