P3.366 Chlamydia Screening in Educational Settings: A Systematic Review of Strategies and Outcomes

Abstract

Background: Low Chlamydia trachomatis (CT) testing rates in primary-care (5-20%) in many countries have encouraged screening programmes in non-clinical settings. We describe the strategies and outcomes of screening programmes in educational settings. Methods: We systematically reviewed English-language studies reporting on CT screening programmes in educational settings (school/college/university) published between 2005 and 2011. We classified programmes into groups on the basis of screening strategies and report the median testing rate (number invited/screened) and CT positivity from studies where data were available. Results: We identified 28 studies describing 32 screening programmes in America/Canada (n = 13), Europe (n = 8), Australia/New Zealand (n = 7) and Asia (n = 4). Most targeted both male and female students (71%). Programs were in secondary schools (n = 14), post-secondary schools (n = 16) and both secondary and post-secondary schools (n = 2). Across all programmes, 55369 tests were conducted. The highest testing rates were in programmes involving screening students in class rooms (four programmes), opportunistic screening of students undergoing routine health examinations (six programmes), and opportunistic screening of students visiting school-based health centres for other reasons (six programmes), with median testing rates of 66%, 54% and 46% respectively. Lower testing rates were found in programmes involving screening in other school locations e.g. canteen/study stall (four programmes) with a median testing rate of 30%. The median CT positivity was 4.7% (range:1.3-18.1%); 4.1% in males, 5.8% females. Conclusion: The review demonstrated that education facilities can be used for CT screening. Testing programmes were established in a range of educational facilities, in a variety of countries, and accessed large numbers of males and females. The CT positivity supports educational institutions as a setting to conduct screening. Targeting students in classrooms and opportunistic screening at school clinics and routine health examinations appears to achieve high testing rates in the school setting.