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Foreword

Chlamydia is a sexually transmitted infection that affects both men and women. The health and economic consequences of chlamydia are serious. Prevention and early detection are vital. As a high proportion of infected people do not have symptoms, chlamydia may remain undiagnosed for many years. The diagnosis may only be considered when late complications, such as pelvic inflammatory disease and infertility, are investigated. Asymptomatic individuals may unknowingly pass the infection to their sexual partners, continuing the chain of transmission. Notifications of chlamydial infections in Victoria are increasing (Victorian Department of Human Services, 2000). This may be confounded by the increase in testing, particularly since the availability of more sensitive assays. The proportion of the population infected with chlamydia is not known.

The Department of Human Services convened a multidisciplinary group to consider a range of issues relating to chlamydia and develop a comprehensive strategy for the control of the infection in Victoria. This document sets out the strategy and addresses issues such as screening, surveillance, testing and diagnosis, clinical management and education and prevention strategies. The key recommendations include:

• Sentinel surveillance to enable estimation of the prevalence and incidence of chlamydial infection in Victoria and trends in disease over time.
• Targeted screening of people in high risk groups for chlamydial infection.
• Increased awareness of health care professionals of chlamydia, its management and notification requirements.
• Increased awareness of the community, in particular the target groups, of the significance of chlamydial infection.
• Strengthening of partner notification processes for each case of chlamydia.

Contents

Disclaimer

Acknowledgments
Foreword
Introduction
Departmental Working Parties

Part A: Disease Burden

• Clinical Features
  • Presentation in Women
  • Presentation in Men
  • Presentation in Infants
    
• Epidemiology
  • Prevalence
  • Epidemiology in Victoria
  • Demographic Factors
  • Risk Factors
  • Association between Chlamydia and HIV
  • Immunity
    
• Economic burden

Part B: Reducing the Burden

• National and International Context
  • International Recommendations for the Control of Chlamydia
  • National Initiatives
  • State Initiatives
    
• Laboratory Diagnosis
  • Test Performance
  • Quality Control and Quality Assurance
  • Cost of Tests
  • Tests of Cure
  • Implications of Test Results
  • Recommendations
    
• Screening
  • Options for Screening
  • Screening Recommendations
  • Clinical Indications for Testing
    
• Clinical Management of Patients
  • Goals
  • Key Strategies
  • Treatment of Chlamydial Infection
  • Education
  • Follow-Up Visits
  • Partner Notification (Contact Tracing)
  • Goals of Partner Notification
  • Options for Tracing Partners
  • Strategies for Improving Partner Notification
    
• Surveillance
  • Definition
  • Strategies for Improving Surveillance
  • Detecting New Cases
  • Estimating Prevalence
    
• Prevention and Education
  • Background
  • Data Requirements
  • Specific Strategies for Reducing the Transmission of Chlamydia
  • Settings for Prevention and Education

Evaluation
Research

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Chlamydia Strategy - 2001-2004 (1mb, pdf)