An interface of Chlamydia testing by community family planning clinics andreferral to hospital genitourinary medicine clinics

Objectives. To assess compliance with the protocol for the management of wo men with Chlamydia trachomatis diagnosed in community family planning (FP) clinics; to assess the rate of attendance at genitourinary medicine (GUM) c linics by these women; to assess the rate of adequate treatment and to asse ss the level of communication between GUM clinics and FP clinics. Method. R etrospective review of FP clinic records and case notes to identify, all wo men with positive or equivocal Chlamydia results during a 6 month period, a nd a retrospective review of records from five local GUM clinics. Results. One hundred and twelve women were identified from FP clinic records with po sitive or equivocal Chlamydia results. Eighty-nine (79.5%) were referred to a GUM clinic. Twelve out of 14 women not referred had equivocal results. T he median delay from the test being taken to the results being seen by a do ctor was 9 days, and to the woman being referred was 10 days. Fifty-eight ( 51,7%, n = 112) women definitely attended a local GUM clinic. The FP clinic s provided a letter of referral in 76 (85.4%, n = 89) women and the GUM cli nics provided a letter of reply in 21 (48.8%, n = 43) women,who attended wi th a referral letter: Three months after testing, only 54 (48.2%) of the 11 2 women with positive or equivocal Chlamydia tests were known by the referr ing FP clinic to have been treated. Conclusions. The majority of women with positive or equivocal Chlamydia results were referred to a GUM clinic acco rding to the protocol. Attendance at GUM clinics was disappointing, as only 51.7% of the 112 women with positive or equivocal results had documented e vidence of having attended. This raises the question not whether commnity c linics should be testing, but whether they should be initiating treatment a nd partner notification. Collaborative work between GUM clinics and communi ty clinics around partner notification is needed as well as funding for tra ining and additional pharmacy costs. Further collaborative work between GUM and FP and reproductive healthcare (RHC) to evaluate the role of community clinics in the diagnosis and management of chlamydial infection and other sexually transmitted infections (STIs) is needed.