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The effectiveness
of partner testing is higher when partners of C. trachomatis
infected patients are offered home sampling than when they are
offered office sampling.
Managing partners of people diagnosed
with Chlamydia trachomatis: a comparison of two partner testing
methods.
Østergaard L, Anderson B, Møller, Olesen
F, Worm A-M.
Sexually
Transmitted Infections 2003;79:358-362.
Summary:
Question
How effective is home sampling compared to sampling in a medical office
for C. trachomatis laboratory testing of the partners of people
diagnosed with C. trachomatis?
Design
This paper describes a randomized, double blind, controlled, parallel
group study conducted in four counties in Denmark to compare the
effectiveness of two partner testing strategies. Index patients were
randomized to give their partners the opportunity of home sampling or
office sampling for C. trachomatis laboratory testing.
Participants
Whenever a swab sample was found positive for C. trachomatis by the
LCx Chlamydia trachomatis test (Abbott, Chicago, IL) in a
laboratory serving four counties in Denmark, the patient, through the
healthcare provider that requested the initial test, was sent a letter
explaining the study and a questionnaire. Patients who chose to submit the
questionnaire were enrolled in the study (1300 women and 526 men).
Description of Tests and Diagnostic
Standard
Each enrolled patient was randomized to receive either home sampling kits
(637 women and 257 men) or office sampling kits (663 women and 269 men) to
be used by his/her sexual partners over the previous 12 months. Partners
in the home sampling group mailed their samples directly to the diagnostic
laboratory, while partners in the office sampling group brought the
specimen collection kit into the office of a healthcare provider to obtain
a sample. For male partners in the home sampling group, the kit contained
a 10 ml tube for collection of a first void urine sample and for female
partners the kit contained a vaginal pipette containing 5 ml of sterile
normal saline for collection of a vaginal flush sample. For the
office-sampling group, the specimen collection kit was brought to a health
care provider, who subsequently mailed the sample to the study center.
Test results were sent to the partner's address or to their physician's
address, depending on their preference.
Main Outcome Measures
The proportion of enrolled patients in each sampling group with at least
one partner tested for C. trachomatis and the proportion with at
least one partner having a C. trachomatis infection diagnosed were
determined.
Main Results
Four hundred fourteen (31.8%) of 1300 enrolled women and 148 (28.1%) of
526 enrolled men agreed to contact their partners (the recruited
patients). The characteristics of the recruited women and men in the home
sampling group (223 and 81, respectively) were not different from those of
the recruited men and women in the office-sampling group (191 and 67,
respectively). The number and proportion of enrolled women and men in each
sampling group who had at least one partner tested and at least one
partner diagnosed with C. trachomatis infection are shown in the
table. The relative effectiveness of offering home sampling to partners
compared with office sampling was 2.2 (26.1%/11.8) for women and 4.4
(14.8%/3.3%) for men.
Authors' Conclusions
More partners exposed to C. trachomatis
infection were tested and more infections were detected when partners were
given the opportunity of home sampling compared with office sampling.
Source of funding:
Danish National Board of Health, Danish Medical Research Council, Danish
Centre for Evaluation and Health Technology Assessment (DACEHTA), Aage
Bang's Fund, Helga og Peter Kornings Fond, and Pfizer Denmark A/S
For correspondence: L. Østergaard,
Research Unit Q, Department of Infectious Diseases, Skejby Sygehus, Aarhus
University Hospital, DK-8200 Aarhus N, Denmark. E-mail address: oes@sks.aaa.dk.
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