Comparison of chlamydia control activities in England & Wales with Denmark from 2000 – 2014

PhD project (3/4 yr research project leading to independent research at the doctorate level)

Dr Katy Turner, Dr Hannah Christensen, Dr Bethan Davies


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Rationale

Over the last 10 years many developed countries, have increased the volume of chlamydia testing in young, sexually active people (aged <25). In England & Wales the National Chlamydia Screening Programme (NCSP) has implemented opportunistic testing of individuals aged <25 years annually or on change of sexual partner. The aim is to identify and treat infected individuals and their partners to prevent serious reproductive outcomes in women (pelvic inflammatory disease, ectopic pregnancy and tubal factor infertility) and to reduce the burden of disease in the population by reducing transmission and incidence of infection.
Despite several years of moderately intensive testing in several countries (at above 20% coverage in young women), there is still uncertainty in the effectiveness and cost-effectiveness of such programmes to control chlamydia transmission at a population level and to prevent reproductive sequelea following a diagnosed and treated chlamydia infection.

Aims & objectives

In this project we propose to compare the chlamydia control activities in England and Wales with Denmark which are two countries which have achieved high levels of coverage over time and have similar health care provision models (ie free at the point of access, through NHS and mandatory health insurance, in UK and Denmark respectively).

Methods

We will use routine national data (PHE) and recently improved estimates of the rate of chlamydia testing and diagnosis since 2003 (NCSP). These data are limited by lack of individual follow-up. We will also use a detailed dataset from Denmark describing >500,000 women’s experiences of chlamydia testing linked to hospital episodes of serious reproductive outcomes. We will use data from the NATSAL surveys (UK national surveys of sexual attitudes and lifestyles) to inform sexual behaviour. We will then develop a model to investigate whether the changes in coverage and diagnoses are consistent between the two countries and within countries across different geographical regions. We will explore other differences in organisation and implementation of chlamydia control to inform estimates of the programme level efficacy of the NCSP and Danish programme.

References


Created on Oct. 1, 2015, 9 a.m.

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