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Current Opinion in Infectious Diseases:
doi: 10.1097/QCO.0b013e32801154fb
Sexually transmitted diseases and urinary tract infections

Risk selection and targeted interventions in community-based control of chlamydia

Richardus, Jan Hendrika,b; Götz, Hannelore Ma,b

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Abstract

Purpose of review: To describe recent developments in the community-based approach of high-risk groups for Chlamydia trachomatis infection, and to discuss the assessment of impact of selective systematic screening on the transmission of C. trachomatis in the community.

Recent findings: Two large home-based screening programs in Europe have recently shown that systematic postal screening for C. trachomatis infection is feasible, but certain high-risk groups are poor participators. This underscores the need for risk selection and targeted approaches. A prediction rule has been developed which can assist in identifying high-risk groups and can be used as a tool for (self) selection for screening. The Internet has been shown to be a promising medium to promote chlamydia testing. School-based programs also succeed in including high-risk groups in screening programs. Recently developed dynamic simulation models, which take into account transmission of C. trachomatis, can assist in the development and evaluation of targeted screening strategies.

Summary: Chlamydia will not likely be controlled by one standard approach. Risk selection strategies need further development and different systematic approaches at the community level, including postal screening, school-based screening, and the Internet may produce the desired public health effect of decreasing morbidity and reducing the transmission of C. trachomatis in the community.

© 2007 Lippincott Williams & Wilkins, Inc.

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