CTF Summary Table: Screening for Chlamydial Infection

Canadian Task Force on Preventive Health Care

Summary Table of Recommendations

Screening for Chlamydial Infection

Prepared by H. Dele Davies, MD, MSc, FRCPC, Assistant Professor of Microbiology, of Infectious Diseases and of Pediatrics, University of Calgary, Alberta

These recommendations were finalized by the Task Force in October 1992

MANEUVER EFFECTIVENESS LEVEL OF EVIDENCE <REF> RECOMMENDATION

Screening for chlamydia (culture or polymerase chain reaction (PCR) for all sites; or direct fluorescent antibody (DFA) for genitourinary (GU), conjunctival (CJ), rectal and nasopharyngeal sites; enzyme-linked immuno-assays (EIA) for GU or CJ specimens; DNA probes for GU specimens) and treatment (erythromycin for pregnant women; tetracyclines or azithromycin for non-pregnant women and men). Pregnant Women Erythromycin treatment of screened women leads to some improved perinatal and postnatal outcomes for children. Cohort studies <23-27> (II-2) Fair evidence to support screening and treating pregnant women. (B)

High-Risk Group* Available screening tests are accurate and reliable. Cohort studies: DFA <7-9>, EIA <10>, and PCR <13, 14> (II-2) Fair evidence to support screening of high-risk groups. (B)*

Treatment is effective in eliminating chlamydia. No studies show that screening leads to reduction of complications. Randomized controlled trials <15-21> (I)

Economic evaluation studies suggest that screening high-risk populations may prevent symptoms and reduce overall cost of infection. Modelling <35-38>

General Population Available screening tests are accurate and reliable but have poor positive predictive value and economic viability when prevalence is low. There have been no studies demonstrating that screening and early detection leads to reduction in complications. Modelling <35-38> Fair evidence to support exclusion of routine screening in the general population. (D)

* High risk groups are: sexually active females less than 25 years old, or women with new or multiple partners in the preceding year, who use non-barrier contraception, or who have cervical friability, mucopurulent discharge or intermenstrual bleeding.

Link to Full Text of this review

Link to Structured Abstract of this review

Link to Selected References list of this review

Link to 1996 update: Screening for chlamydial infections

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MANEUVER	EFFECTIVENESS	LEVEL OF EVIDENCE <REF>	RECOMMENDATION
Screening for chlamydia (culture or polymerase chain reaction (PCR) for all sites; or direct fluorescent antibody (DFA) for genitourinary (GU), conjunctival (CJ), rectal and nasopharyngeal sites; enzyme-linked immuno-assays (EIA) for GU or CJ specimens; DNA probes for GU specimens) and treatment (erythromycin for pregnant women; tetracyclines or azithromycin for non-pregnant women and men).	Pregnant Women Erythromycin treatment of screened women leads to some improved perinatal and postnatal outcomes for children.	Cohort studies <23-27> (II-2)	Fair evidence to support screening and treating pregnant women. (B)
	High-Risk Group* Available screening tests are accurate and reliable.	Cohort studies: DFA <7-9>, EIA <10>, and PCR <13, 14> (II-2)	Fair evidence to support screening of high-risk groups. (B)*
	Treatment is effective in eliminating chlamydia. No studies show that screening leads to reduction of complications.	Randomized controlled trials <15-21> (I)
	Economic evaluation studies suggest that screening high-risk populations may prevent symptoms and reduce overall cost of infection.	Modelling <35-38>
	General Population Available screening tests are accurate and reliable but have poor positive predictive value and economic viability when prevalence is low. There have been no studies demonstrating that screening and early detection leads to reduction in complications.	Modelling <35-38>	Fair evidence to support exclusion of routine screening in the general population. (D)