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Quality Improvement Reports

Opportunistic screening for Chlamydia at a community based contraceptive service for young people

BMJ 2003; 326 doi: (Published 05 June 2003) Cite this as: BMJ 2003;326:1252
  1. V Moens, family planning doctor1,
  2. G Baruch, director and psychoanalyst (GBaruch{at},
  3. P Fearon, lecturer in psychology2
  1. 1 Brandon Centre for Counselling and Psychotherapy for Young People, London NW5 3LG
  2. 2 Subdepartment of Clinical Health Psychology, University College London, London WC1E 6BT
  1. Correspondence to: G Baruch
  • Accepted 2 April 2003


Problem The suspected high prevalence of Chlamydia infection that is undiagnosed and untreated among high risk women who attend a contraceptive service for young people.

Design Cross sectional study from a community screening service.

Background and setting An inner city contraceptive and psychotherapy service for young people aged 12–21 years.

Key measure for improvement Prevalence of infection commensurate with or above findings from the national screening pilot (13.8% for > 16 year olds, 10.5% for 16–19 year olds, and 7.2% for 20 to 24 year olds).

Strategies for change Offering testing (of a first catch urine sample) for Chlamydia to all young people using the contraceptive service who were not previously screened; launching a publicity campaign about the new service; training medical staff and reception staff to deliver the service to maximise take up of screening and of treatment by infected cases; and surveying results from testing to monitor significant patterns of infection requiring further action.

Effects of change Percentage of clients with infection exceeded targets for each age group, 76% with a positive or equivocal result returned for treatment, 87% of those treated returned for a test of cure, and 99% of tests of cure were negative. Prevention work was initiated in a school with a particularly heavy concentration of infected clients.

Lessons learnt A contraceptive service for young women is a highly acceptable location for effective Chlamydia screening.


  • Contributors VM initiated and planned the study, wrote the report, and conducted the clinical work with Kylie Greaves, the other part time family planning doctor at the Brandon Centre. GB contributed to the planning and management of the study and wrote the report. PF did the statistical analysis. GB is guarantor.

  • Funding Camden and Islington Health Authority (2000-1) and South Camden Primary Care Group (2001-2).

  • Competing interests None declared.

  • Accepted 2 April 2003
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