Who Is Best to Test? A Systematic Review of Chlamydia Infections in Switzerland

In many countries, community pharmacies provide sexual-health-related services to limit the spread of sexually transmitted infections (STIs), including chlamydia testing. To identify suitable target groups for pharmacy-based chlamydia testing in Switzerland, we aimed to assess chlamydia prevalence, identify risk groups, and delineate screening strategies. We conducted a systematic literature search up to December 2019 in PubMed, EMBASE, and Web of Science, according to the PRISMA guidelines, using as keywords “chlamydia”, “screening”, and “Switzerland”. Two researchers screened the title, abstract, and full-text article and assessed the methodological quality. The literature search generated 108 hits, and nine studies were included. Chlamydia prevalence ranged between 0.8 and 12.8%. Most frequently affected were undocumented women undergoing voluntary termination of pregnancy (12.8%, 95% CI: 8.4–18.9), HIV-positive men who have sex with men (10.9%, 95% CI: 9.2–17.6), and adult offenders (6.5%, 95% CI: 3.2–9.0). Systematic screening was suggested for the first two risk groups and women suffering a miscarriage. To conclude, chlamydia infections are prevalent in Switzerland, but the identified risk groups are difficult to reach for a pharmacy-based testing service. More studies are needed to identify suitable target groups, including customers seeking sexual health services, particularly emergency contraception users who already receive counselling for STIs at community pharmacies.

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Qualitative interviews with healthcare staff in four European countries to inform adaptation of an intervention to increase chlamydia testing

BMJ Open ◽

10.1136/bmjopen-2017-017528 ◽

2017 ◽

Vol 7 (9) ◽

pp. e017528 ◽

Cited By ~ 2

Author(s):

Cliodna McNulty ◽

Ellie J Ricketts ◽

Hans Fredlund ◽

Anneli Uusküla ◽

Katy Town ◽

...

Keyword(s):

General Practice ◽

Health Services ◽

Sexual Health ◽

Complex Intervention ◽

Primary Healthcare ◽

Qualitative Interviews ◽

Randomised Trial ◽

Action Planning ◽

Chlamydia Screening ◽

Chlamydia Testing

ObjectiveTo determine the needs of primary healthcare general practice (GP) staff, stakeholders and trainers to inform the adaptation of a locally successful complex intervention (Chlamydia Intervention Randomised Trial (CIRT)) aimed at increasing chlamydia testing within primary healthcare within South West England to three EU countries (Estonia, France and Sweden) and throughout England.DesignQualitative interviews.SettingEuropean primary healthcare in England, France, Sweden and Estonia with a range of chlamydia screening provision in 2013.Participants45 GP staff, 13 trainers and 18 stakeholders.InterviewsThe iterative interview schedule explored participants’ personal attitudes, subjective norms and perceived behavioural controls around provision of chlamydia testing, sexual health services and training in general practice. Researchers used a common thematic analysis.ResultsFindings were similar across all countries. Most participants agreed that chlamydia testing and sexual health services should be offered in general practice. There was no culture of GP staff routinely offering opportunistic chlamydia testing or sexual health advice, and due to other priorities, participants reported this would be challenging. All participants indicated that the CIRT workshop covering chlamydia testing and sexual health would be useful if practice based, included all practice staff and action planning, and was adequately resourced. Participants suggested minor adaptations to CIRT to suit their country’s health services.ConclusionsA common complex intervention can be adapted for use across Europe, despite varied sexual health provision. The intervention (ChlamydiA Testing Training in Europe (CATTE)) should comprise: a staff workshop covering sexual health and chlamydia testing rates and procedures, action planning and patient materials and staff reminders via computer prompts, emails or newsletters, with testing feedback through practice champions. CATTE materials are available at: www.STItraining.eu.

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Sexual and reproductive health services provided by community pharmacists: a scoping review

BMJ Open ◽

10.1136/bmjopen-2020-047034 ◽

2021 ◽

Vol 11 (7) ◽

pp. e047034

Author(s):

Javiera Navarrete ◽

Nese Yuksel ◽

Theresa J Schindel ◽

Christine A Hughes

Keyword(s):

Reproductive Health ◽

Scoping Review ◽

Sexual And Reproductive Health ◽

Community Pharmacists ◽

Cochrane Library ◽

Future Research ◽

Chlamydia Screening ◽

Community Pharmacies ◽

Pharmacy Services ◽

Reproductive Health Services

ObjectivesPharmacists are increasingly providing patient-focused services in community pharmacies, including in the area of sexual and reproductive health (SRH). Specific SRH areas have been the focus of research, but a broader perspective is needed to position pharmacists as SRH providers. This review explored research that described and evaluated professional pharmacy services across a broad range of SRH areas.DesignScoping reviewData sourcesMedline, EMBASE, CINAHL, Web of Science, Scopus and Cochrane Library (January 2007–July 2020).Study selectionStudies reporting on the description and evaluation of professional pharmacy SRH services provided by community pharmacists.Data extractionTwo investigators screened studies for eligibility, and one investigator extracted the data. Data were analysed to primarily describe professional pharmacy services and intervention outcomes.ResultsForty-one studies were included. The main SRH areas and professional pharmacy services reported were sexually transmitted and bloodborne infections (63%) and screening (39%), respectively. Findings showed that pharmacists’ delivery of SRH services was feasible, able to reach vulnerable and high-risk groups, and interventions were highly accepted and valued by users. However, integration into daily workflow, pharmacist remuneration, cost and reimbursement for patients, and policy regulations were some of the barriers identified to implementing SRH services. Studies were primarily in specific areas such as chlamydia screening or hormonal contraception prescribing, while studies in other areas (ie, medical abortion provision, long-acting reversible contraception prescribing and vaccine delivery in pregnant women) were lacking.ConclusionThis scoping review highlights the expansion of pharmacists’ roles beyond traditional product-focused services in a number of SRH areas. Given the potential feasibility, users’ acceptability and reach, pharmacists are ideally situated to enhance SRH care access. Future research describing implementation and evaluation of professional pharmacy services in all SRH areas is needed to promote access to these services through community pharmacies and position pharmacists as SRH providers worldwide.

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Screening for gastric cancer: East and West, features of diagnostic criteria

Experimental and Clinical Gastroenterology ◽

10.31146/1682-8658-ecg-181-9-73-78 ◽

2020 ◽

pp. 73-78

Author(s):

A. A. Avanesyan ◽

O. V. Chukina ◽

Yu. V. Kokovina ◽

T. M. Chirkina ◽

I. G. Bakulin

Keyword(s):

Quality Of Life ◽

Gastric Cancer ◽

Diagnostic Criteria ◽

Cause Of Death ◽

Tumor Development ◽

Risk Groups ◽

The West ◽

Systematic Screening ◽

Diagnosis Of Cancer

Gastric cancer is the leading cause of death among all cancer deaths. Identification of risk groups and special carcinogens will prevent the development of the tumor or detect it in the early stages, which will significantly increase the quality of life of patients with high risks of developing gastric cancer. For the timely detection of tumor development, it is optimal to use systematic screening. Undoubtedly, the approaches to the diagnosis of cancer have significant differences in the countries of the West and the East.

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Prevalence of co-infections with other sexually transmitted infections in patients newly diagnosed with anogenital warts in Guangzhou, China

International Journal of STD & AIDS ◽

10.1177/0956462419890496 ◽

2020 ◽

Vol 31 (11) ◽

pp. 1073-1081

Author(s):

Liuyuan Wang ◽

Bin Yang ◽

Lai S Tso ◽

Peizhen Zhao ◽

Wujian Ke ◽

...

Keyword(s):

Sexual Health ◽

Sexually Transmitted Infections ◽

Mycoplasma Genitalium ◽

Risk Groups ◽

Health Clinic ◽

Surveillance Systems ◽

Newly Diagnosed ◽

Anogenital Warts ◽

Sexually Transmitted ◽

Medical Histories

Prevalence of co-infecting sexually transmitted infections (STIs) among patients newly diagnosed with anogenital warts is under-reported. Our objective is to determine the prevalence of six common STIs, Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Mycoplasma genitalium (MG), genital herpes (herpes simplex virus type 2 [HSV-2]), HIV, and syphilis for patients visiting a sexual health clinic in Guangzhou, China. Demographics, sexual health, and medical histories were collected at patient intake. Patients diagnosed with anogenital warts (N = 200) were invited to participate. We collected urine samples, and urethral, cervical, and rectal swabs to test for CT, NG, and MG, and blood samples for serological detection of HSV-2, syphilis, and HIV. Overall 49 (24.5%) had a co-infection (22.2% of men and 27.7% of women). All six STIs were observed among men: CT (6.8%), NG (3.4%), MG (5.1%), HIV (4.3%), HSV-2 (4.3%), and syphilis (1.7%). Women had fewer STIs, but at higher rates: CT (13.3%), MG (6.0%), and HSV-2 (8.4%). Individual men had up to two co-infections, while women had no more than one co-infection. Chlamydia was the most common STI. Patients aged 18–25 years (35.4%) had the highest prevalence. Although opportunistic screening is often applied for high-risk groups, expansion to patients with anogenital warts in all health-care settings would improve detection of problematic asymptomatic co-infections, thereby increasing China’s capacity to contribute toward global surveillance systems.

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‘Catching chlamydia’: combining cash incentives and community pharmacy access for increased chlamydia screening, the view of young people

Australian Journal of Primary Health ◽

10.1071/py12135 ◽

2015 ◽

Vol 21 (1) ◽

pp. 79 ◽

Cited By ~ 5

Author(s):

Rhian M. Parker ◽

Allison Bell ◽

Marian J. Currie ◽

Louise S. Deeks ◽

Gabrielle Cooper ◽

...

Keyword(s):

Young People ◽

Community Pharmacy ◽

Cross Sectional Study ◽

Chlamydia Screening ◽

Community Pharmacies ◽

Cross Sectional ◽

Cash Incentive ◽

Age Appropriate ◽

Accepted Practice ◽

The One

In Australia and elsewhere, chlamydia screening rates for those aged between 16 and 30 years continue to be low. Innovative, age-appropriate approaches are necessary to increase chlamydia screening among this target group to prevent short- and long-term consequences of the infection such as pelvic inflammatory disease, chronic pelvic pain, ectopic pregnancy and infertility. Studies have demonstrated that offering chlamydia screening in community pharmacies may be a useful adjunct to current screening services. Approximately 90% of Australians visit a pharmacy at least once a year. Chlamydia screening and education in community pharmacies with remuneration may provide another option for opportunistic testing as part of a national chlamydia screening scheme. Compensation is an accepted practice in the field of research and has been demonstrated to improve adherence to health promotion activities. In 2011, a cross-sectional study of community pharmacy-based chlamydia screening offered in conjunction with an A$10 cash incentive to participate was conducted in the Australian Capital Territory. As part of this study young people were asked about their experience of, and views about, pharmacy-based chlamydia screening. The views of consented participants were collected using the one-page questionnaire consisting of 10 closed questions and one open-ended question. Participants completed the questionnaire when they returned their urine sample and before being given the cash incentive. Overall participants were highly satisfied with the pharmacy-based chlamydia screening service. Over 60% of questionnaire respondents felt that the payment did affect their decision to have the chlamydia test, and 23% stated that it made no difference. Young people reported that pharmacy-based screening is acceptable and convenient. Accessibility and the small cash incentive played significant roles in increasing participation.

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11. SEX AND SPORT: A COMMUNITY BASED PROJECT OF CHLAMYDIA TESTING AND TREATMENT IN RURAL AND REGIONAL VICTORIA

Sexual Health ◽

10.1071/shv4n4ab11 ◽

2007 ◽

Vol 4 (4) ◽

pp. 288

Author(s):

F. Kong ◽

C. Kyle-Link ◽

J. Hocking ◽

M. Hellard

Keyword(s):

Health Services ◽

Sexual Health ◽

Treatment Program ◽

Health Centre ◽

Community Setting ◽

Sexual Risk Behaviour ◽

Local Health ◽

Community Based ◽

Telephone Consultation ◽

Chlamydia Testing

Chlamydia is the most common notifiable infectious disease in Australia with the number of notifications increasing 92% over the past 5 years. The "Sex and Sport" Project is piloting a community based chlamydia testing and treatment program reaching young people in a specific community setting, sporting clubs. This multifaceted approach utilises health education, population screening and collection of data on risk taking behaviour as the first steps in enhancing health and shaping future service provisions. The project's primary aim is to assess the feasibility of an outreach testing and treatment program. Secondary aims are to measure the prevalence of chlamydia and assess sexual risk behaviour in this population. Strong community collaborations and integration into local health services through the Primary Care Partnerships is important in the project's sustainability; in particular key community members respected by sporting clubs needed to be identified, capacity developed to deliver effective health promotion messages and improve young people's access to sexual health services. Additionally, local knowledge has guided overall program implementation and provides opportunities for capacity building to regionally based services. For example, poor access to sexual health services is being addressed by the participants being able to access services via telephone consultation with Melbourne Sexual Health Centre. Approximately 1000 Victorians aged 16-25 years from the Loddon Mallee region of Victoria will be tested between June and September 2007. This paper will report on the feasibility, challenges and possible solutions in establishing a community based outreach testing and treatment program.

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Introduction of screening guidelines for men who have sex with men at an STD clinic, the Melbourne Sexual Health Centre, Australia

Sexual Health ◽

10.1071/sh05006 ◽

2005 ◽

Vol 2 (4) ◽

pp. 241 ◽

Cited By ~ 12

Author(s):

Nichole A. Lister ◽

Anthony Smith ◽

Christopher K. Fairley

Keyword(s):

Sexual Health ◽

Health Centre ◽

Health Clinic ◽

Chlamydia Screening ◽

Screening Guidelines ◽

Computer Reminder ◽

Sex With Men ◽

New Guidelines ◽

One Year ◽

The Impact

Background: A recent audit indicated that a substantial proportion of men who have sex with men (MSM) were not screened for rectal gonorrhoea and chlamydia at the Melbourne Sexual Health Clinic, Melbourne, Australia. In response, screening guidelines for MSM were introduced at the clinic using a computer reminder. The aim of this study was to evaluate the impact of the guidelines and alert on screening MSM for gonorrhoea and chlamydia. Methods: The medical records of MSM were reviewed for gonorrhoea and chlamydia screening by site (pharyngeal, urethral and rectal), four months before the implementation of the guidelines and alert (July to October 2002), and one year thereafter (beginning November 2002). Results: After the introduction of the guidelines there was a significant increase in rectal chlamydia testing (55% to 67%, P < 0.001), and significant reduction in pharyngeal chlamydia and gonorrhoea testing (65% to 28%, P < 0.001, and 83% to 76%, P = 0.015 respectively). The proportion of tests that were positive by any site did not change (7% to 7%). Conclusions: The introduction of a computer reminder for new guidelines was temporally associated with screening that conformed more closely to clinical guidelines.

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Sexual health services in community pharmacy for women on opioid substitution treatment: a qualitative study

European Journal of Public Health ◽

10.1093/eurpub/ckaa073 ◽

2020 ◽

Vol 30 (4) ◽

pp. 733-738

Author(s):

Laura Medina-Perucha ◽

Jenny Scott ◽

Sarah Chapman ◽

Julie Barnett ◽

Charlotte Dack ◽

...

Keyword(s):

Health Services ◽

Sexual Health ◽

Structural Changes ◽

Sexual Transmission ◽

Community Pharmacies ◽

Substitution Treatment ◽

Structured Interviews ◽

Framework Analysis ◽

Opioid Substitution Treatment ◽

Opioid Substitution

Abstract Background Women on opioid substitution treatment (WOST) are at heightened risk for the sexual transmission of sexually transmitted infections and blood-borne viruses. This study aimed to explore the opportunities to promote their sexual health in community pharmacies in UK. Methods Semi-structured interviews were conducted with 20 WOST and 14 community pharmacists (CPs). A focus group was run with three CPs. Participants were recruited in drug services and a service for sex workers (WOST), and in CP. Data collection took place between October 2016 and September 2017. Data were analyzed using Framework Analysis and directed Content Analysis. Results CPs could play a role in promoting sexual health among WOST. Sexual health screening, treatment and condom supply were suggested as potential ways of delivering pharmacy-based sexual health services. These services should be actively offered to WOST, delivered in a private space and free of cost. We identified several challenges to overcome in order to design and implement sexual health services for WOST in community pharmacies. Conclusions This study highlights the potentially key role CPs can have promoting sexual health and addressing health inequities among WOST. Improvements in pharmacists’ training are required in order to address stigma towards WOST, and promote trust and positive rapport. Structural changes are also needed to broaden the services available for this group of women and improve their access to healthcare.

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