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

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

Current Opinion in Infectious Diseases: February 2007 - Volume 20 - Issue 1 - p 60–65
doi: 10.1097/QCO.0b013e32801154fb
Sexually transmitted diseases and urinary tract infections

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.

aDivision of Infectious Disease Control, Municipal Public Health Service Rotterdam Area

bDepartment of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands

Correspondence to Jan Hendrik Richardus, MD, PhD, Division of Infectious Disease Control, Municipal Public Health Service Rotterdam Area (GGD Rotterdam e.o.), PO Box 70032, 3000 LP Rotterdam, The Netherlands Tel: +31 10 4339 438; fax: +31 10 4339 237; e-mail:

© 2007 Lippincott Williams & Wilkins, Inc.