Screening and diagnostic practices for chlamydia infections in New Zealand

Aims. To identify screening and diagnostic practices for chlamydia infectio n in New Zealand. Methods. Postal survey of doctors and nurses at all sexual health, family p lanning, youth and student clinics, and randomly selected general practitio ners (GPs). Results. Most respondents recognised chlamydia infection as a cause of pelv ic inflammatory disease and infertility in females, and epididymitis and no n-gonococcal urethritis in males. Ectopic pregnancy and conjunctivitis were less commonly recognised by GPs and student and youth centre doctors. Ster ile pyuria and arthritis were well recognised only by sexual health doctors . Female doctors were significantly more likely to recognise signs and symp toms than male doctors. GPs were less likely than other respondents to scre en for chlamydia infection. Sexual health doctors and nurses were more like ly to remove cervical secretions prior to taking endocervical specimens. Co ntact tracing was regarded as very important by only a quarter of family pl anning respondents, compared with over 80% of other respondents. Conclusions. While respondents recognised most signs, symptoms, and sequela e of chlamydia infection, some important features were not well recognised. Screening practices varied, and many endocervical specimens were taken inc orrectly. Given the long-term health consequences and cost of chlamydia inf ection sequelae, screening guidelines are urgently required.