Completeness of and duration of time before treatment after screening women for Chlamydia trachomatis infections

Objective: To assess the proportion of women with verified treatment after positive screening tests for C. trachomatis infection and to evaluate the d uration of time until treatment. Design: Retrospective cohort analysis linking the date of a positive genita l C. trachomatis test with the documented date of treatment. Setting: Family planning, sexually transmitted disease, obstetrical/gynecol ogic, adolescent, and walk-in clinics in Philadelphia from March 1, 1994 th rough December 31, 1995. Participants: Included 4,158 women with screening tests positive for C. tra chomatis. Main Outcome Measures: Documented treatment of chlamydia-infected women and duration of time between initial clinic visit and therapy. Results: Over a 21-month period, 4,158 women had endocervical screening tes ts positive for C. trachomatis, Twenty-four percent of these women were tre ated presumptively (on the day of specimen collection), with sexually trans mitted disease clinics yielding the highest percentage (70.9%) of presumpti vely treated patients. Of the 3,143 chlamydia-positive women not treated pr esumptively, treatment was subsequently verified in 96.2%. The median inter val between screening and treatment was 21 days. Private adolescent clinics had the lowest median interval of 14 days between screening and treatment, whereas public family planning clinics showed the largest median screening to treatment interval of 26 days. Conclusions: Large-scale screening programs in public health settings can b ring nearly all C. trachomatis-infected patients to treatment. However, new strategies are needed to shorten the duration of time before treatment of selected subsets of women who screen positive for C. trachomatis.