Novel interventions to reduce re-infection in women with chlamydia: a randomized controlled trial.

Abstract

BACKGROUND:

The aim of this study was to determine whether postal testing kits (PTKs) or patient-delivered partner therapy (PDPT) for partners of women with Chlamydia trachomatis reduce re-infection rates in women, compared with partner notification by patient referral.

METHODS:

Three hundred and thirty women testing positive for chlamydia, at clinics for genitourinary medicine, family planning and termination of pregnancy in Edinburgh, were randomized to one of three partner interventions: patient referral, PTK (partners post urine for testing) or PDPT (1 g azithromycin for partners). Women submitted urine for chlamydia testing every 3 months. The primary outcome was re-infection assessed as time to first positive result by the Cox proportional hazard regression. The proportion of partners tested or treated with each intervention was determined.

RESULTS:

Out of 330 women, 215 (65%) were retested over 12 months. There were 32 of 215 women (15%) who retested positive (7, 15 and 10 women from the patient referral, PTK and PDPT groups, respectively). There was no significant difference in re-infection between PDPT versus patient referral (HR 1.32, 95% CI 0.50-3.56), PTK versus patient referral (HR 2.35, 95% CI 0.94-5.88) or PDPT versus PTK (HR 0.55, 95% CI 0.24-1.24). There was no significant difference in the proportion of partners confirmed tested/treated between the patient referral (34%) and PTK (41%, P = 0.32) or PDPT (42%, P = 0.28) groups.

CONCLUSIONS:

PTK and PDPT do not reduce re-infection rates in women with chlamydia compared with patient referral. However, PDPT may offer other advantages such as simplicity and cost compared with patient referral.

• Authors: S T Cameron, A Glasier, G Scott, H Young, L Melvin, A Johnstone, R Elton
• Journal: Human reproduction (Oxford, England) (Hum Reprod) Vol. 24 Issue 4 Pg. 888-95 (Apr 2009) ISSN: 1460-2350 [Electronic] England
• PMID: 19136481 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Bacterial Agents
• Azithromycin

Topics

• Adolescent
• Adult
• Anti-Bacterial Agents (therapeutic use)
• Azithromycin (therapeutic use)
• Chlamydia Infections (drug therapy, prevention & control, transmission)
• Chlamydia trachomatis
• Female
• Humans
• Middle Aged
• Recurrence
• Sexual Partners
• Time Factors
• Young Adult