Opportunistic screening for chlamydial infection at time of cervical smear testing in general practice: prevalence study

BMJ 1998; 316 doi: (Published 31 January 1998) Cite this as: BMJ 1998;316:351
  1. Pippa Oakeshott, clinical lecturera (,
  2. Sally Kerry, statisticiana,
  3. Sima Hay, research assistanta,
  4. Phillip Hay, senior lecturerb
  1. a Department of General Practice and Primary Care, St George's Hospital Medical School, London SW17 0RE
  2. b Department of Genitourinary Medicine, St George's Hospital Medical School
  1. Correspondence to: Dr Oakeshott
  • Accepted 28 May 1997


Genital infection with Chlamydia trachomatis is the most common, curable sexually transmitted disease in England and Wales.1 In the United States and Sweden screening programmes have been shown to be effective in reducing the prevalence both of cervical infection with C trachomatis and of sequelae such as pelvic inflammatory disease.1 2 In Britain a national selective screening programme has recently been recommended,3 but more data on the prevalence of chlamydial infection in different healthcare settings are needed.1 3 There have been no large studies of more than 1000 patients done on the patient populations from inner city general practices in the United Kingdom.1 The aim of this study was to determine the prevalence and predictors of chlamydial infection in women aged <35 having cervical smear tests in inner London general practices.

Subjects, methods, and results

Thirty seven practice nurses and 108 general practitioners from 30 practices participated in the study. The total patient population served by the practices was 192 000. The mean Jarman underprivileged area score was 23 (range 15-33). (A positive score indicates social deprivation and compares with a mean score for England and Wales of 0.) Twelve practices had only one or two practitioners.

Each practice was asked to recruit consecutive women aged <35 who were attending for a cervical smear test, record their clinical details, test them for chlamydia, and ask them to …

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