Chlamydia screen not cost effective

A national screening campaign for a common sexually transmitted infection that can cause infertility is not cost effective, academics…

A national screening campaign for a common sexually transmitted infection that can cause infertility is not cost effective, academics found.

More than 6,000 men and women last year were diagnosed with chlamydia – a silent infection with no symptoms that can remain undetected, untreated, and lead to complications like ectopic pregnancies.

But Ireland’s small population and the strain already on the health service means a screening programme would not be cost effective, researchers said.

Dr Emer O’Connell, consultant in public health medicine, said screening for chlamydia is available in many countries.

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“However, some countries such as Australia are reviewing the effectiveness of this measure,” she said.

“In Ireland, due to our small population and the strain already on our health service, a screening programme for chlamydia would not be cost effective because it would be difficult to achieve the necessary coverage levels to reduce the level of infection.”

Chlamydia is the most commonly reported bacterial STI in Ireland, with highest numbers reported in patients in their 20s.

The number of cases has soared from 1,000 in 1997, to 3,353 in 2005, 5,781 in 2009 and 6,008 by 2011 - accounting for more than half of all STIs reported.

As it remains undetected it can spread easily and causes pelvic inflammatory disease in up to 30 per cent of infected women who are not treated, leading to ectopic pregnancy and infertility.

The chlamydia screening pilot study in Ireland found stigma was often a barrier that stopped young people seeking or accepting an STI test.

However, 95 per cent of professionals and 75 per cent of students would take a test if offered.

Eight out of 10 could inform their current partner if they tested positive for chlamydia, but this rate fell to 55-60 per cent in the case of telling previous partners.

More than 6,000 people took part in the study, funded by the HSE’s Health Protection Surveillance Centre and supported by the Health Research Board.

Dr Diarmuid O’Donovan, of NUI Galway, said the study shows how to protect the sexual health of young Irish people.

“Given these findings, a national sexual health plan should include primary prevention activities such as sex education, condom distribution and the provision of information on how to seek care for STIs,” he added.

“Therefore, we recommend the inclusion of primary care-delivered Chlamydia detection and case management services as part of a national action plan to promote sexual health.”

The study was carried out by researchers from NUI Galway, the Royal College of Surgeons in Ireland (RCSI) and the Health Service Executive (HSE).

Separately an expert group on sexual health said improving, promoting and protecting people’s sexual health will have major benefits for the overall health and wellbeing of the nation.

The Royal College of Physicians of Ireland (RCPI) policy group called for a co-ordinated programme for information and education services for the general population, including young people.

It also wants standardised and quality assured training for healthcare providers, the continued provision of sexual assault treatment units, and a further development of accessible, flexible, coordinated clinical service for all areas of sexual health.

Professor Colm Bergin, co-chair of the RCPI group, said: “What we’re hoping to see is that our policy statements provide impetus for engagement with government and policy makers, so that we can all see Ireland benefit from a comprehensive national sexual health programme.”

The group said it is critical parents and educators continue to receive appropriate support, and for targeted education programmes for groups known to be at-risk of poor sexual health.

“The public must have access to appropriate, accessible information to promote good sexual health,” it added.

The reports were launched as part of sexual health awareness week, which ruins until Thursday.

PA