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Frequent screening of at-risk individuals using paper-based point-of-care diagnostics is a promising method for attenuating the spread of chlamydia and HIV. However, such diagnostics typically suffer from limited sensitivity. The authors describe a method to improve the sensitivity of the lateral-flow immunoassay (LFA), in which the target molecules are thermodynamically concentrated using aqueous two-phase systems (ATPSs) to improve the detection limit. The novel concept of sequential ATPS component resolubilization within paper for both a PEG-potassium phosphate and a UCON-50-HB-5100-potassium phosphate system was established to provide a diagnostic tool which only requires the sample to be added without any sample preparation steps. The automated ATPS phase separation and concentration of the target into the leading phase within the paper matrix can be visually demonstrated due to the use of gold nanoparticles. The importance of resolubilization order of the dehydrated polymers and salts is discussed. The designs presented improve the detection limit of a conventional LFA setup for Chlamydia trachomatis bacteria (158 μg·mL) and human immunoglobulin M (IgM) antibodies (0.31 μg·mL) to 15.8 μg·mL and 0.031 μg·mL, respectively. This is a 10-fold detection limit improvement and results are available in 15 min. Compared to other methods that improve LFA sensitivity, this particular method does not require additional equipment, reagents, or sample preparation steps as all necessary components are embedded into the initial setup. Therefore, this advancement enables a more sensitive LFA that can be operated by untrained or minimally trained personnel, significantly expanding its applicability as a point-of-care test. [ABSTRACT FROM AUTHOR]

Long-term, 32-P-labeled L cells were infected with the obligately intracellular parasite Chlamydia psittaci (strain 6 BC). At 20 h postinfection, [3-H]uridine was added, and the infected cells were sampled at intervals for incorporation of the labels into the uridine triphosphate (UTP) and cytidine triphosphate (CTP) pools of the host L cell and the uridine monophosphate (UMP) and cytidine monophosphate (CMP) in 16S ribosomal ribonucleic acid (RNA) of the parasite. The specific activity of the nucleotides was calculated from the ratio of 3-H to 32-P counts in the nucleotides. The rate of approach to equilibrium labeling of UTP and CTP in L-cell pools and UMP and CMP in 16S RNA from the exogenous uridine label was determined from the increase in the ratios of the specific activities of CTP to UTP and CMP to UMP with time. The rate of approach to equilibrium CMP:UMP labeling of the 16S RNA of C. psittaci was consistent with the rate predicted from the kinetics of labeling of the CTP and UTP pools of the host L cell. In analogous experiments, the rate of approach to equilibrium guanosine monophosphate:adenosine monophosphate labeling of 16S RNA from an exogenous [14-C]adenine label was consistent with the rate predicted from the kinetics of labeling of the purine nucleoside triphosphate pool of the host cell. These results support the concept that members of the genus Chlamydia owe their obligate intracellular mode of reproduction to a requirement for energy intermediates which is fulfilled by the host cell. In addition, evidence was obtained that the total acid-soluble purine nucleoside triphosphate pool of L cells accurately represents the precursors of L-cell 18S ribosomal RNA.

The agents of meningopneumonitis (MN) and of trachoma (TR) purified from chick embryo allantoic fluids and yolk sacs, respectively, were shown to produce CO(2) from the C(1) positions of pyruvate and glutamate, but not from the other carbon atoms. The reaction with pyruvate did not require did not require the addition of cofactors, but was stimulated to a small extent by alpha-lipoic acid and, in the case of TR, also by diphosphothiamine, and nicotinamide adenine dinucleotide (NAD). The reaction of MN with glutamate was greatly stimulated by the addition of NAD and pyruvate, and resulted in the accumulation of alanine. The reaction of TR with glutamate was also greatly enhanced by added NAD, but was not affected by added pyruvate. When eight intermediates of the citric acid cycle were added to MN cells incubated with glutamate-C(14), plus NAD and pyruvate, they reduced to varying degrees the evolution of C(14)O(2). It was shown by chromatography that the C(14) label extended to alpha-ketoglutarate and succinate, but not to fumarate and malate. A net gain in adenosine triphosphate could not be demonstrated in MN cells incubated with combined glutamate, pyruvate, oxaloacetate, and various cofactors. These results furnish additional examples of real or apparent gaps in enzyme sequences in Chlamydia.

Objectives: To compare the data quality, logistics, and cost of a self-administered sexual behavior questionnaire administered either using a computer-assisted survey instrument (CASI) or by paper and pencil in a primary care clinic. Study Design and Setting: A self-administered sexual behavior questionnaire was administered to 16-29 year olds attending general practice. Questionnaires were administered by either paper and pencil (paper) or CASI. A personal digital assistant was used to selfadminister the CASI. Results: A total of 4,491 people completed the questionnaire, with 46.9% responses via CASI and 53.2% by paper. Completion of questions was greater for CASI than for paper for sexual behavior questions: number of sexual partners [odds ratio (OR), 6.85; 95% confidence interval (CI): 3.32, 14.11] and ever having had sex with a person of the same gender (OR, 2.89; 95% CI: 1.52, 5.49). The median number of questions answered was higher for CASI than for paper (17.6 vs. 17.2; P ! 0.01). CASI was cheaper to run at $8.18 per questionnaire compared with $11.83 for paper. Conclusion: Electronic devices using CASI are a tool that can increase participants' questionnaire responses and deliver more complete data for a sexual behavior questionnaire in primary care clinics. [ABSTRACT FROM AUTHOR]

Background: Chlamydia is the most commonly reported notifiable condition in the United States. Chlamydia disproportionately impacts young women and women of color. Annual screening of sexually active women 24 years and younger is recommended., Methods: Between 2016 and 2019, we facilitated 3 learning collaboratives to increase chlamydia screening at a combined 37 family planning clinics funded by the Planned Parenthood Federation of America, the Office of Population Affairs in the Department of Health and Human Services, and the New York State Department of Health. We applied a consistent learning collaborative approach across the 3 cohorts. Participating clinics sought to improve the proportion of clients screened for chlamydia each month, implemented a standard set of recommended practices, attended virtual learning sessions, reported updates on quality improvement efforts and chlamydia screening data monthly, and provided qualitative feedback in an online final assessment., Results: Median screening rates increased by 11%, 22%, and 24% in the 3 collaboratives (P values of <0.01, 0.05, and 0.02, respectively). Increases were sustained after the collaboratives ended though the changes did not reach statistical significance. At least 75% of clinics increased screening rates in each collaborative. Clinics reported that adopting normalizing and opt-out language when counseling clients about screening was both feasible and effective, as was reducing missed opportunities for screening., Conclusions: Learning collaboratives consistently resulted in improvement across 3 cohorts and shed light on barriers and facilitators to screening in family planning settings. Public health practitioners are encouraged to draw on our results and lessons learned to promote screening.

To overcome shortcomings in discriminating Chlamydia pecorum strains infecting the koala (Phascolarctos cinereus) at the local level, we developed a novel genotyping scheme for this pathogen to inform koala management at a fine-scale subpopulation level. We applied this scheme to two geographically distinct koala populations in New South Wales, Australia: the Liverpool Plains and the Southern Highlands to South-west Sydney (SHSWS). Our method provides greater resolution than traditional multi-locus sequence typing, and can be used to monitor strain emergence, movement, and divergence across a range of fragmented habitats. Within the Liverpool Plains population, suspected recent introduction of a novel strain was confirmed by an absence of genetic diversity at the earliest sampling events and limited diversity at recent sampling events. Across the partially fragmented agricultural landscape of the Liverpool Plains, diversity within a widespread sequence type suggests that this degree of fragmentation may hinder but not prevent spread. In the SHSWS population, our results suggest movement of a strain from the south, where diverse strains exist, into a previously Chlamydia-free area in the north, indicating the risk of expansion towards an adjacent Chlamydia-negative koala population in South-west Sydney. In the south of the SHSWS where koala subpopulations appear segregated, we found evidence of divergent strain evolution. Our tool can be used to infer the risks of strain introduction across fragmented habitats in population management, particularly through practices such as wildlife corridor constructions and translocations., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Chlamydiosis, an infection caused by several Chlamydia species, has been reported in Nile, saltwater, and Siamese crocodiles. Despite its widespread reports in various countries, including Thailand, genetic information on Chlamydia species remains limited. This study presents a whole-genome-based characterization of Siamese crocodile-isolated Chlamydia. The results showed that Siamese crocodile Chlamydia contained a single circular chromosome with a size of 1.22-1.23 Mbp and a plasmid with a size of 7.7-8.0 kbp. A plasmid containing eight coding sequences (CDSs) was grouped in a β lineage. A chromosome sequence had approximately 1,018-1,031 CDSs. Chlamydial factors involving virulence were documented in terms of the presence of cytotoxins and several virulence factors in the chromosomes of Siamese crocodile Chlamydia. The analysis of antimicrobial resistance genes in the Chlamydia genome revealed that the most common resistance genes were associated with aminoglycosides, fluoroquinolones, macrolides, tetracyclines, and cephalosporins, with loose matching (identities between 21.12 % and 74.65 %). Phylogenetic analyses, encompassing the assessments of both whole proteome and nine taxonomic markers, revealed that Siamese crocodile Chlamydia was separated into three lineages (lineages I-III) with high bootstrapping statistic support. Interestingly, isolate 12-01 differed genetically from the others, suggesting that it is a new member of Chlamydia. The study findings indicate that Siamese crocodiles are susceptible hosts to Chlamydia, involving more than one species. This study is the first employing the highest number of whole-genome data on Siamese crocodile Chlamydia and provides better insights into pathogen genetics., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Chlamydia pecorum is a widespread veterinary chlamydial species causing endemic infections in livestock, such as ruminants and pigs, globally. However, there is limited contemporary knowledge on infecting strain diversity in various hosts. This study aimed to evaluate the genetic diversity of C. pecorum strains infecting Swiss livestock through C. pecorum genotyping and phylogenetic analyses in comparison to the global population, while also assessing chlamydial strains for plasmid carriage. A total of 263 C. pecorum positive samples from clinically healthy ruminant and pig herds (Bovines = 216, sheep = 25, pigs = 14) as well as placentae from eight C. pecorum positive ruminant abortion cases from other Swiss herds were investigated. The ompA and Multi-Locus sequence typing revealed novel C. pecorum genotypes, and bovine strains exhibited considerable genetic diversity, contrasting with lower diversity in sheep and pig strains. C. pecorum plasmid was detected in 100.0% of sheep (41/41) and pig (255/255) samples, and in 69.4% of bovine samples (150/216). In contrast, no plasmid was detected in the eight C. pecorum-positive ruminant abortion cases either representing plasmid-less strains or possibly escaping PCR detection due to autolysis of the placenta. This study supports the genetic diversity of C. pecorum strains, particularly in bovines, and identifies novel sequence types in Swiss livestock., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Nicole Borel reports financial support was provided by University of Zurich Vetsuisse Faculty. Nicole Borel reports a relationship with University of Zurich Vetsuisse Faculty that includes: funding grants. None If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Chlamydiaceae are a family of obligate intracellular bacterial pathogens that affect both humans and animals. Recently, a new species named Chlamydia (C.) buteonis was isolated from hawks. In this study, we aimed to investigate the prevalence of Chlamydiaceae in 60 falcons that underwent a routine health check at a specialized clinic in Dubai, United Arab Emirates. Using real-time PCR, we analyzed cloacal and tracheal swabs from these birds and found that 39 of them tested positive for Chlamydiaceae. Subsequent real-time PCR assays specific for C. psittaci, C. abortus, C. avium, and C. gallinacea yielded negative results, while testing positive for C. buteonis. Analysis of ompA and MLST sequences indicated a highly conserved group of strains within this set of samples, but with sequences distinct from the C. buteonis RSHA reference strains and other C. buteonis strains isolated from hawks in the United States. Two strains were further isolated by cell culture and sequenced using whole-genome sequencing, confirming the clustering of these falcon strains within the C. buteonis species, but in a separate clade from the previously identified hawk strains. We also developed a SNP-based PCR-HRM assay to distinguish between these different genotypes. Overall, our findings suggest a high prevalence of C. buteonis in falcons in Dubai and highlight the importance of monitoring this pathogen in birds of prey., Competing Interests: Declaration of Competing Interest None of the authors have any financial or personal relationships with any individuals or organizations that could inappropriately influence or bias this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Contact tracing (also known as partner notification) is a primary means of controlling infectious diseases such as tuberculosis (TB), human immunodeficiency virus (HIV), and sexually transmitted diseases (STDs). However, little work has been done to determine the optimal level of investment in contact tracing. In this paper, we present a methodology for evaluating the appropriate level of investment in contact tracing. We develop and apply a simulation model of contact tracing and the spread of an infectious disease among a network of individuals in order to evaluate the cost and effectiveness of different levels of contact tracing. We show that contact tracing is likely to have diminishing returns to scale in investment: incremental investments in contact tracing yield diminishing reductions in disease prevalence. In conjunction with a cost-effectiveness threshold, we then determine the optimal amount that should be invested in contact tracing. We first assume that the only incremental disease control is contact tracing. We then extend the analysis to consider the optimal allocation of a budget between contact tracing and screening for exogenous infection, and between contact tracing and screening for endogenous infection. We discuss how a simulation model of this type, appropriately tailored, could be used as a policy tool for determining the appropriate level of investment in contact tracing for a specific disease in a specific population. We present an example application to contact tracing for chlamydia control. [ABSTRACT FROM AUTHOR]

Background: Chlamydia remains the most notified bacterial sexually transmissible infection in Australia with guidelines recommending testing for re-infection at 3months post treatment. This paper aimed to determine chlamydia retesting and repeat positivity rates within 2-4months among young women in Australia, and to evaluate what factors increase or decrease the likelihood of retesting., Methods: Chlamydia retesting rates among 16-29-year-old women were analysed from Australian Collaboration for Coordinated Enhanced Sentinel Surveillance of sexually transmissible infection and bloodborne virus (ACCESS) sentinel surveillance data (n =62 sites). Among women with at least one positive test between 1 January 2018 and 31 August 2022, retesting counts and proportions within 2-4months were calculated. Logistic regression was performed to assess factors associated with retesting within 2-4months., Results: Among 8758 women who were positive before 31 August 2022 to allow time for follow up, 1423 (16.2%) were retested within 2-4months, of whom 179 (12.6%) tested positive. The odds of retesting within 2-4months were 25% lower if tested in a coronavirus disease 2019 (COVID-9) pandemic year (2020-2022) (aOR=0.75; 95% CI 0.59-0.95). Among 9140 women with a positive test before 30 November 2022, 397 (4.3%) were retested too early (within 7days to 1month) and 81 (20.4%) of those were positive., Conclusions: Chlamydia retesting rates remain low with around a sixth of women retested within 2-4months in line with guidelines. Re-infection is common with around one in eight retesting positive. An increase in retesting is required to reduce the risk of reproductive complications and onward transmission.

Chlamydia (C.) suis, a zoonotic intracellular bacterium, is described as a causative agent for conjunctivitis, particularly in nursery and fattening pigs. Chlamydiaceae are claimed to survive drying and to persist in dust. The objective of this study was to evaluate the viability of Chlamydia in dust sampled in a fattening pig farm with a high appearance of chlamydial-induced conjunctivitis. Dust was collected and stored at room temperature. To evaluate bacterial load and survival over time, quantitative PCR (Chlamydiaceae, C. suis) and isolation in cell culture were performed every week for up to 16 weeks. While qPCR results remained highly positive with consistent bacterial loads between 10 3 and 10 4 copy numbers/100 μL eluate over a period of 16 weeks and even after 40 weeks, it was not possible to isolate Chlamydia except for the initial sample. These results show only short-term viability of C. suis in dust. This is an important information regarding reduction of chlamydial loads in pig farms and risk for pigs and people to get infected via dust., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: The role of infectious agents, including Chlamydia pneumoniae (Cpn), in the development of multiple sclerosis (MS), is still a matter of major contention., Objective: This meta-analysis study aimed to assess the actual involvement of Cpn in MS development., Methods: We undertook a search of international scientific databases to identify eligible studies. We used a random-effects meta-analysis model (REM) to generate the pooled odds ratio (OR) and 95% confidence intervals (CIs). Heterogeneity was calculated using the I 2 statistic. Sensitivity and subgroup analyses were applied to assess the effects of study characteristics and socio-demographic variables on the pooled OR., Results: We identified 37 studies comprising 51 datasets that satisfied the inclusion criteria. Considering diagnostic methods for Cpn, 26 and 25 datasets used PCR- and serological-based methods, respectively. In PCR-based datasets, REM showed a significant positive association between Cpn infection and the development of MS (OR, 5.29; 95% CI, 3.12-8.97), while a non-significant positive association was achieved in serological-based datasets (OR, 1.34; 95% CI, 0.88-2.03). In subgroup analyses on PCR-based datasets, results were significant for both CSF (OR, 5.70) and serum (OR, 4.84) samples; both healthy (OR, 16.11) and hospital-based (OR, 2.88) controls; and both moderate (OR, 5.14) and high (OR, 5.48) quality studies. In serological-based datasets, only those that used CSF samples yielded significant results (OR, 3.41)., Conclusions: Our findings verify the significant positive relationship between Cpn infection and MS. We advocate prospective cohort studies with lifelong follow-ups and also experimental studies to better understand the role of Cpn in MS development., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: Sexually transmissible infections are important causes of loss of health and lives in women and infants worldwide. This paper presents the methods and results of a systematic review that focuses on the impact of antibiotic treatment for syphilis, chlamydia, and gonorrhoea during pregnancy on birth outcomes for the Lives Saved Tool (LiST)., Methods: We searched PubMed, Embase, Cochrane Libraries, Global Health and Global Index Medicus for articles available until May 23rd, 2022. The search criteria focused on the impact of treatment for the three sexually transmitted infection among pregnant women. Nearly all the articles found were non-randomized studies., Results: Treatment for pregnant women with active syphilis reduced the risk of preterm birth by 52% (95% CI = 42%-61%; 11 043 participants, 15 studies; low quality); stillbirth by 79% (95% CI = 65%-88%; 14 667 participants, eight studies; low quality); and low birth weight by 50% (95% CI = 41%-58%; 9778 participants, seven studies; moderate quality). Treatment for pregnant women with chlamydia infection reduced the risk of preterm birth by 42% (95% CI = 7%-64%; 5468 participants, seven studies; low quality) and might reduce the risk of low birth weight by 40% (95% CI = 0%-64%; 4684 participants, four studies; low quality). No studies provided data on treatment of gonorrhoea therefore no meta-analysis was conducted., Conclusions: Because few studies adjusted for potential confounding factors, the overall quality of evidence was considered low. However, given the consistent and large effects, we recommend updating the estimated effect of timely detection and treatment for syphilis on preterm birth and stillbirth in the LiST model. More research is required to ascertain the effect of antibiotic treatment for chlamydia and gonorrhoea infection in pregnancy., Competing Interests: Disclosure of interest: The authors completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and disclose no relevant interests., (Copyright © 2023 by the Journal of Global Health. All rights reserved.)

The authors investigate speculations on the possible overlapping of information on chlamydia screening published in research papers entitled "Sexually Transmitted Infections" and "The Journal of Family Planning and Reproductive Health Care" in Great Britain. They presented the inquiry to the Committee on Publication Ethics (COPE). COPE explained that the event took place due to misconception among authors and editors during the publication process.

Physcion, a natural anthraquinone derivative, has been reported to exert remarkable antibacterial activities against Staphylococcus aureus,Staphylococcus epidermidis and Pseudomonas aeruginosa. However, it is not fully illustrated as anti-Chlamydia substance. In the present study, minimum inhibitory concentration(MIC)values for physcion against Chlamydia psittaci(C.psittaci) 6BC, C.psittaci SBL and C.psittaci HJ were 128 μg/mL,256 μg/mL and 128 μg/mL while minimum bactericidal concentration (MBC) values were 256 μg/mL,512 μg/mL and 256 μg/mL,respectively. Moreover, Chlamydial adhesion to Hela 229 cells was blocked in a dose-dependent manner and RB-to-EB differentiation was inhibited by physcion from 28 to 48 hpi.Post treatment,upregulation of LC3-II was in a dose-dependent manner, indicating physcion activated autophagy and bacterial clearance.To validate clinical efficacy,49 SPF chickens aged 21days were divided into 5 groups and infected intra-laryngeally with 0.2 mL of 1 × 10 7 IFU/mL C.psittaci 6 BCE.Three days later, birds received orally with serial doses of physcion (4 mg/kg to 9 mg/kg), or 3 mg/kg of doxycycline for 6 days.Chickens with difficulty in breathing were alleviated significantly with increasing concentrations of physicon.Postmortem,lesions of air sacs were reduced significantly in a dose-dependent manner.More importantly,birds with 9 mg/kg of physcion could alleviate lesions of air sacs and lungs, and reduce bacterial loads in spleens, which was comparable to doxycycline treatment. Based on above evidences, physcion is a promising cost-effective natural drug by blocking Chlamydial adhesions to host cells, RB-to-EB differentiation and activating bacterial autophagy and it will be a good alternative to doxycycline combating virulent C.psittaci infection, contributing to eradication of Chlamydial transmission from animals to human beings., Competing Interests: Declaration of Competing Interest We declare that we have no competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

(1) Problem: The increasing incidence and prevalence of infectious diseases in Indigenous Australians (Aboriginal groups and Torres Strait Islanders) are concerning. Indigenous Australians experience the burden of infectious diseases disproportionately when compared to non-Indigenous Australians. (2) Aim: Our report aims to describe how to apply Strengths-Based Nursing (SBN) to ameliorate the impact of the most common infectious diseases in Indigenous Australians. Specifically, we aim to describe how nurses can use SBN to partner with Indigenous Australian communities to remediate, control, and mollify the impact of the most common infectious diseases encountered by them using their limited resources. (3) Methods: Meticulous PubMed, Google Scholar, and web searches were conducted pertaining to Strengths-Based Nursing and common infectious diseases in Indigenous Australians. (4) Findings: The two groups of infectious diseases considered are sexually transmitted infections (STIs) and infectious skin diseases (including parasitic infestations). The prevalence of these infectious diseases in Indigenous Australians is deliberated on, with data when possible, or known trends and impacts. Finally, existing, evidence-based, prudent, and possible SBN approaches are discussed towards tackling these infectious diseases judiciously with available local resources, in conjunction with the support of impacted people, their families, and their communities. (5) Discussion and Conclusion: The SBN approach is a relatively new perspective/approach to clinical and nursing care. In contradistinction to the commonly utilised medical model, SBN pits strengths against deficits, available resources against professional judgment, solutions against unavailable items, and collaborations against hierarchy. In light of the current situation/data, several SBN approaches to combat STIs and skin infections in Indigenous Australians were identified and discussed for the first time in the "Results" section of this paper. [ABSTRACT FROM AUTHOR]

The authors revisit the events and problems that arose concerning the publication of a study of chlamydia screening in Great Britain in 2000. The research was funded by the Department of Health (DH) and aimed at screening for chlamydia. However, a problem arose when the bodies involved in the research agreed to publish the results in two separate papers.

Nowadays, the mathematical modeling of infectious diseases is a big trend worldwide. The mathematical models help us to forecast future outbreaks of diseases in the presence of present data. In this article, we represent a model of the transmission of Chlamydia in the United States by using data from 1989 to 2019. In the formulation of the model, we used integer and fractional derivatives. Several graphs are plotted for the various possible cases of the given parameters. The aim of this paper is to justify how the mathematical models in terms of fractional derivatives have more degree of freedom to explore disease dynamics for a particular data set and capture memory effects. The separate parameter estimation for each value of the fractional order increases the novelty of this work. The use of a real-data set of Chlamydia in the United States makes this study more visible and important to the literature. [ABSTRACT FROM AUTHOR]

Editors of "Sexually Transmitted Infections" wish to bring to the attention of readers of the journal the significant overlap between articles entitled "Who has Chlamydia? The prevalence of genital tract Chlamydia trachomatis within Portsmouth and South East Hampshire, UK" which was previously published in the Journal of Family Planning and Reproductive Health Care. The paper published in Sexually Transmitted infections was written and submitted for publication according to a publication strategy agreed by the Department of Health's Steering Committee for the national chlamydia screening pilot, that the first publications from the pilot should be based on a combined analysis of results from the two sites taking part in the pilot.

The 'Australian Sexually Transmitted Infection (STI) Management Guidelines For Use In Primary Care' (www.sti.guidelines.org.au) provide evidence-based, up-to-date guidance targeted at use in primary care settings. A major review of the guidelines was undertaken in 2020-22. All content was reviewed and updated by a multi-disciplinary group of clinical and non-clinical experts, and assessed for appropriateness of recommendations for key affected populations and organisational and jurisdictional suitability. The guidelines are divided into six main sections: (1) standard asymptomatic check-up; (2) sexual history; (3) contact tracing; (4) STIs and infections associated with sex; (5) STI syndromes; and (6) populations and situations. This paper highlights important aspects of the guidelines and provides the rationale for significant changes made during this major review process. [ABSTRACT FROM AUTHOR]

Chlamydia trachomatis infections may occur in multiple organs, including the lungs, lymph nodes, peritoneal cavity, and genitourinary systems. This disease results in significant ascites, the swelling of lymph nodes, and elevated tumor markers (CA125), sometimes mimicking an ovarian malignancy. At our hospital, we often perform examination laparoscopic surgery in cases of suspected gynecologic cancers before initial treatment. In this paper, we report the case of a 19-year-old woman who came to our hospital because of an ovarian tumor and ascites. There was no history of sexual intercourse (self-reported). We suspected ovarian cancer from image inspections, so we performed laparoscopic surgery for diagnosis. The final pathological diagnosis was acute-to-chronic inflammation of the bilateral fallopian tubes, and a cytologic examination of the ascites was negative for malignant cells. The C. trachomatis antigen was positive on vaginal examination after the operation. Based on this result, we diagnosed this patient with C. trachomatis infection. Chlamydia peritonitis should be a differential diagnosis for cancer peritonitis in juvenile patients with abnormal ascites. Exploratory laparoscopy should help confirm the pathological diagnosis. [ABSTRACT FROM AUTHOR]

Chlamydia psittaci is an established zoonotic agent causing respiratory disease in humans. An infection often remains asymptomatic but can also result in flu-like illness, pneumonia or even multi-organ failure. This paper describes three patients, hospitalised at AZ Sint-Lucas Hospital, with atypical pneumonia who were diagnosed with C. psittaci after an in-depth anamnesis and laboratory investigation in the midst of the COVID pandemic. All three infections were confirmed with PCR and serology, whereas viable bacteria were only present for one patient. Genotyping revealed the presence of genotype B for patient 1 and 2 whereas ompA genotyping was unsuccessful for patient 3. This case report demonstrates the importance of a thorough patient history as close contact with birds is one of the main risk factors to contract the pathogen. Once exposure to birds has been confirmed, a diagnosis by a combination of PCR and serology is essential in order to initiate a treatment with the proper antibiotics. As psittacosis is still an underestimated and underdiagnosed disease, communication between laboratory, clinicians and bird fanciers is encouraged. [ABSTRACT FROM AUTHOR]

To prepare for the development of the 2021 Centers for Disease Control and Prevention (CDC) sexually transmitted infections treatment guidelines, the CDC convened a committee of expert consultants in June 2019 to discuss recent abstracts and published literature on the epidemiology, diagnosis, and management of sexually transmitted infections.This paper summarizes the key questions, evidence, and recommendations for the diagnosis and management of uncomplicated Chlamydia trachomatis (CT) infections in adolescents and adults that were reviewed and discussed for consideration in developing the guidelines. The evidence reviewed mostly focused on efficacy of doxycycline and azithromycin for urogenital, rectal, and oropharyngeal CT infection, CT risk factors in women, performance of CT nucleic acid amplification tests on self-collected meatal specimens in men, and performance of newer CT point-of-care tests. [ABSTRACT FROM AUTHOR]

An amendment to this paper has been published and can be accessed via a link at the top of the paper. [ABSTRACT FROM AUTHOR]

In this paper, we are concerned with the global behavior of a multi-group SIR epidemic model with age structure. A similar model was studied in [T. Kuniya, J. Wang, and H. Inaba, Discrete Contin. Dyn. Syst. Ser. B, 21 (2016), pp. 3515--3550] under some restrictive assumptions. In this paper, we weaken some of these assumptions for the purpose of application, and show that the global behavior of our model is completely determined by the basic reproduction number \scrR 0: if \scrR 0 < 1, then the disease-free equilibrium is globally attractive, whereas if \scrR 0 > 1, then the endemic equilibrium is globally attractive. The proofs are done by constructing suitable Lyapunov functions for total trajectories in compact attractors. In the application, we consider the chlamydia epidemic in Japan in 2015, and compare the estimation results of \scrR 0 in four special cases of our model: a homogeneous model, an age-independent two-sex model, an age-dependent onesex model, and an age-dependent two-sex model. In conclusion, we see that \scrR 0 for the chlamydia epidemic in Japan in 2015 is in the range 1.0148--1.0535, and the introduction of the age structure has more influence on the value of \scrR 0 than that of the two-group structure. [ABSTRACT FROM AUTHOR]

Objective To assess the effectiveness of electronic patient records (EPRs) in facilitating multiple, rapid measurements of treatment and partner notification (PN) outcomes for chlamydia and gonorrhoea. Methods In two sexual health clinics, the proportion of patients with chlamydia and gonorrhoea who had been treated within 4 weeks of diagnosis was measured, and also the proportion where at least one of their partners had been treated. These outcomes were measured monthly for 6 months, and changes in recording practice were instituted when necessary. Results It took 8 h to capture and analyse the data for 89 patients in month 1. The health advisers subsequently entered data into searchable fields to facilitate better data capture. As a result, by month 6 it took only 1.5 h to measure these outcomes using an electronic search. It had previously taken 2 days to perform the same analysis using paper records. In month 1, successful treatment was recorded in 26/27 (96%) patients with gonorrhoea and 57/61 (93%) with chlamydia, and there was successful PN for gonorrhoea and chlamydia patients in 19/27 (70%) and 39/61 (64%). By month 6, the recorded outcomes were 30/31 (97%) and 81/86 (94%), respectively, for successful treatment and 28/31 (90%) and 74/86 (86%) for successful PN, respectively. Conclusions Frequent rapid clinical outcome monitoring is easily attained using EPRs as long as the data are entered into searchable fields. Treatment and PN success for chlamydia and gonorrhoea with this method are well above national targets, which may be attributable to both the use of EPRs and better data capture. [ABSTRACT FROM PUBLISHER]

Objective: To review systematically and critically, evidence used to derive estimates of costs and cost effectiveness of chlamydia screening. Methods: Systematic review. A search of 11 electronic bibliographic databases from the earliest date available to August 2004 using keywords including chlamydia, pelvic inflammatory disease, economic evaluation, and cost. We included studies of chlamydia screening in males and/or females over 14 years, including studies of diagnostic tests, contact tracing, and treatment as part of a screening programme. Outcomes included cases of chlamydia identified and major outcomes averted. We assessed methodological quality and the modelling approach used. Results: Of 713 identified papers we included 57 formal economic evaluations and two cost studies. Most studies found chlamydia screening to be cost effective, partner notification to be an effective adjunct, and testing with nucleic acid amplification tests, and treatment with azithromycin to be cost effective. Methodological problems limited the validity of these findings: most studies used static models that are inappropriate for infectious diseases; restricted outcomes were used as a basis for policy recommendations; and high estimates of the probability of chlamydia associated complications might have overestimated cost effectiveness. Two high quality dynamic modelling studies found opportunistic screening to be cost effective but poor reporting or uncertainty about complication rates make interpretation difficult. Conclusion: The inappropriate use of static models to study interventions to prevent a communicable disease means that uncertainty remains about whether chlamydia screening programmes are cost effective or not. The results of this review can be used by health service managers in the allocation of resources, and health economists and other researchers who are considering further research in this area. [ABSTRACT FROM AUTHOR]

Background Prevalence of sexually transmissible infections (STIs) has been associated with availability of alcohol. This paper investigates potential associations between prevalent cases of chlamydia in young people in Australia and the availability of alcohol within their local area, defined as postcode of residence. Methods Alcohol availability was determined at the postcode level using liquor licensing data, classified as total number of licences, number of 'take-away' licences and number of licenses by population. Participant data were drawn from a survey targeting Australians aged 16-29years in rural and regional Australia, capturing demographic details including postcode of residence, indicators of sexual behaviour including condom use and chlamydia test results. Mixed-effects logistic regression was used to examine potential associations between first, alcohol availability and chlamydia, and second, between condom use and chlamydia. Results We found little evidence of associations between alcohol availability and chlamydia in either unadjusted or adjusted models. After adjusting for alcohol availability, we observed significant associations between inconsistent condom use and chlamydia prevalence, whether alcohol availability was measured as total number (adjusted odds ratio (AOR) 2.20; 95% confidence interval (CI) 1.20, 3.70), number of take-away licenses (AOR 2.19; 95% CI1.30, 3.69) or licenses per 1000 population (AOR 2.19; 95% CI 1.30, 3.68). Conclusion Little evidence of association between alcohol availability and chlamydia at the postcode level was found. Further research is required to determine appropriate measures of 'local area' and how characteristics thereof may impact on sexual health. [ABSTRACT FROM AUTHOR]

Trachoma is a devastating neglected tropical disease caused by Chlamydia trachomatis and the leading global cause of infectious blindness. Although antibiotic treatment against trachoma is efficient (SAFE strategy), additional affordable therapeutic strategies are of high interest. Water-filtered infrared A and visible light (wIRA/VIS) irradiation has proven to reduce chlamydial infectivity in vitro and ex vivo. The aim of this study was to evaluate whether wIRA/VIS can reduce chlamydial infection load and/or ocular pathology in vivo, in a guinea pig model of inclusion conjunctivitis. Guinea pigs were infected with 1 × 10 6 inclusion-forming units/eye of Chlamydia caviae via the ocular conjunctiva on day 0. In infected animals, wIRA/VIS irradiation (2100 W/m 2 ) was applied on day 2 (single treatment) and on days 2 and 4 (double treatment) post-infection (pi). wIRA/VIS reduced the clinical pathology score on days 7 and 14 pi and the conjunctival chlamydial load on days 2, 4, 7, and 14 pi in comparison with C. caviae-infected, not irradiated, controls. Furthermore, numbers of chlamydial inclusions were decreased in wIRA/VIS treated C. caviae-infected guinea pigs on day 21 pi compared to C. caviae-infected, non-irradiated, controls. Double treatment with wIRA/VIS (days 2 and 4 pi) was more efficient than a single treatment on day 2 pi. wIRA/VIS treatment did neither induce macroscopic nor histologic changes in ocular tissues. Our results indicate that wIRA/VIS shows promising efficacy to reduce chlamydial infectivity in vivo without causing irradiation related pathologies in the follow-up period. wIRA/VIS irradiation is a promising approach to reduce trachoma transmission and pathology of ocular chlamydial infection., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Background Pelvic inflammatory disease (PID) is under-diagnosed globally, particularly in primary care, and if untreated may cause reproductive complications. This paper investigates PID diagnosis by Australian general practitioners (GPs) and barriers to their conducting a pelvic examination.Methods: An online survey investigating Australian GPs' chlamydia management, including PID diagnosis, was conducted in 2019. From 323 respondents, 85.8% (n = 277) answered multiple-choice questions about PID and 74.6% (n = 241) answered a free-text question about barriers to conducting pelvic examinations. Using multivariable logistic regression, we identified factors associated with conducting pelvic examinations. Barriers to performing pelvic examinations were explored using thematic analysis.Results: Most GPs indicated that they routinely ask female patients with a sexually transmissible infection about PID symptoms, including pelvic pain (86.2%), abnormal vaginal discharge (95.3%), abnormal vaginal bleeding (89.5%), and dyspareunia (79.6%). Over half reported routinely conducting speculum (69.0%) and bimanual pelvic (55.3%) examinations for women reporting pelvic pain. Female GPs were more likely to perform speculum [adjusted odds ratio (AOR) 4.6; 95%CI: 2.6-8.2] and bimanual pelvic examinations (AOR 3.7; 95%CI: 2.1-6.5). GPs with additional sexual health training were more likely to routinely perform speculum (AOR 2.2; 95%CI: 1.1-4.2) and bimanual pelvic examinations (AOR 2.1; 95%CI: 1.2-3.7). Barriers to pelvic examinations were patient unwillingness and/or refusal, GP gender, patient health-related factors, time pressures, and GP reluctance.Conclusion: Although GPs typically ask about PID symptoms when managing patients with chlamydia, they are not consistently able or willing to perform pelvic examinations to support a diagnosis, potentially reducing capacity to diagnose PID. [ABSTRACT FROM AUTHOR]

This paper provides an overview of the current knowledge of chlamydiae. These intracellular microorganisms belonging to the Chlamydiaceae family are widely distributed throughout the world. Constant development of culture-independent approaches for characterisation of microbial genomes enables new discoveries in the field of Chlamydia. The number of new taxa is continuously increasing as well as the range of hosts. New species and genotypes are constantly being discovered, particularly new avian and reptilian agents, which are discussed in this article. Interestingly, wild animals are the main hosts for new Chlamydia species including different species of bird, turtle and snake. The availability of next-generation sequencing opens up a new prospect for research and leads to deeper knowledge of these interesting microorganisms about which much is still to discover. [ABSTRACT FROM AUTHOR]

Deconvolution of bulk transcriptomics data from mixed cell populations is vital to identify the cellular mechanism of complex diseases. Existing deconvolution approaches can be divided into two major groups: supervised and unsupervised methods. Supervised deconvolution methods use cell type-specific prior information including cell proportions, reference cell type-specific gene signatures, or marker genes for each cell type, which may not be available in practice. Unsupervised methods, such as non-negative matrix factorization (NMF) and Convex Analysis of Mixtures (CAM), in contrast, completely disregard prior information and thus are not efficient for data with partial cell type-specific information. In this paper, we propose a semi-supervised deconvolution method, semi-CAM, that extends CAM by utilizing marker information from partial cell types. Analysis of simulation and two benchmark data have demonstrated that semi-CAM outperforms CAM by yielding more accurate cell proportion estimations when markers from partial/all cell types are available. In addition, when markers from all cell types are available, semi-CAM achieves better or similar accuracy compared to the supervised method using signature genes, CIBERSORT, and the marker-based supervised methods semi-NMF and DSA. Furthermore, analysis of human chlamydia-infection data with bulk expression profiles from six cell types and prior marker information of only three cell types suggests that semi-CAM achieves more accurate cell proportion estimations than CAM. [ABSTRACT FROM AUTHOR]

Background In Australia, men who have sex with men (MSM) have high rates sexually transmissible infections (STIs) and sex-on-premises venue (SOPV) patrons are at risk. This paper assesses Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT), syphilis and HIV prevalence in men tested at Australian SOPVs and describes testing services.Methods: EMBASE, Medline, PubMed and international conference proceedings were searched for articles reporting on-site SOPV testing between 1 January 2000 and 31 January 2017. Meta-analysis calculated pooled prevalence estimates of STIs by anatomical site.Results: Twelve cross-sectional studies were identified. Most (8/12) were local sexual health clinics (SHC) outreach services. Participants' mean age was 41.1 years (95% confidence interval (CI) 37.0-43.3; range 17 to 84 years). Testing included CT and NG (9/12), HIV (8/12) and syphilis (5/12). CT and NG prevalence overall summary estimates were 3.4% (95% CI 1.9-5.2%, I2 = 88.7%, P < 0.01) and 1.3% (95% CI 0.7-2.2%, I2 = 75.5%, P < 0.01) respectively. CT and NG prevalence was highest in the ano-rectum and oro-pharynx respectively. The HIV and syphilis pooled estimates were 2.3% (95% CI 1.6-2.9%, I2 = 93.1%, P < 0.01) and 3.2% (95% CI 1.8-4.6%, I2 = 72.8%, P < 0.01) respectively. Participation rate varied.Conclusion: This review examines HIV and STI testing in Australian SOPVs before HIV pre-exposure prophylaxis (PrEP). Findings indicate a high prevalence of STIs. PrEP use and resultant condomless sex may influence STI prevalence. Further research is required to determine the effect of PrEP on the STI prevalence among SOPV patrons. [ABSTRACT FROM AUTHOR]

This paper includes the first transmission electron microscopical (TEM) study of the tegument of a member of the basal digenean family Aporocotylidae. Scanning electron microscopical investigations of the fish blood fluke Aporocotyle simplex show that each boss on the lateral body surface bears 12–15 simple, uniform spines which extend from 0.5–2.7 μm above the surface of the boss. TEM observations revealed that these spines reach deep beneath the distal cytoplasm of the tegument for much of their length (9–12 μm) and are surrounded by a complex of diagonal muscles in each boss. This is the first record of any digenean with so-called 'sunken' spines. The results suggest that aporocotylid spines arise from within the sarcoplasm of the boss diagonal muscles. The sunken cell bodies (perikarya) of the tegument are connected to the distal cytoplasm via ducts (specialised processes lined by microtubules); this in contrast to other digeneans studied, where they are connected via non-specialised cytoplasmic processes. Within the distal cytoplasm, the tegumental ducts of A. simplex are surrounded by invaginations of the basal membrane and release their cytoplasmic inclusions into the distal cytoplasm. These apparently unique morphological features of the tegument, especially the deep origin of the spines, may represent useful characteristics for understanding aporocotylid relationships, especially in view of the known variation in the spine patterns of aporocotylids. [ABSTRACT FROM AUTHOR]

Background: Sydney Sexual Health Centre (SSHC) partnered with a large sex-on-premises venue, South Eastern Sydney Local Health District HIV and Related Programs Unit and AIDS Council of NSW (ACON) to develop and implement a community-based sexually transmissible infection (STI) screening model co-located in a sex-on-premises venue. This paper describes the process, the outcomes and examines the cost of this model. Methods: A retrospective cross-sectional study of gay and bisexual men (GBM) attending a STI testing service co-located in a sex-on-premises venue in Sydney city between the 1 November 2012 and 31 May 2014. Results: A total of 402 patrons had 499 testing episodes in the study period. Testing patrons were a median of 39.5 years of age, 221 (55%) were born overseas, 85 (21%) spoke a language other than English at home and 54 (13%) had a STI at first testing. A total of 105 (26%) testing patrons had never tested for a STI before. Of the 297 (74%) who had been tested before, 83 (21%) had not been tested within the last 12 months. A total of 77 STIs were detected in 63 people over 499 testing episodes, giving a STI positivity rate of 15% in the testing episodes. The prevalence of rectal chlamydia was the highest at 8% followed by pharyngeal gonorrhoea at 3%. A total of 97% of testing patrons were successfully relayed their results via their preferred methods within a median of 7.5 days. Conclusion: This paper highlights that offering STI screening in a community-based setting was an effective and low-cost alternative to traditional testing services. [ABSTRACT FROM AUTHOR]

Background: Loss to follow-up in randomised controlled trials reduces statistical power and increases the potential for bias. Almost half of all trials fail to achieve their follow-up target. Statistical methods have been described for handling losses to follow-up and systematic reviews have identified interventions that increase follow-up. However, there is little guidance on how to develop practical follow-up procedures. This paper describes the development of follow-up procedures in a pilot randomised controlled trial of a sexual health intervention that required participants to provide and return questionnaires and chlamydia test samples in the post. We identified effective methods to increase follow-up from systematic reviews. We developed and tested prototype procedures to identify barriers to follow-up completion. We asked trial participants about their views on our follow-up procedures and revised the methods accordingly.Results: We identified 17 strategies to increase follow-up and employed all but five. We found that some postal test kits do not fit through letterboxes and that that the test instructions were complicated. After identifying the appropriate sized test kit and simplifying the instructions, we obtained user opinions. Users wanted kits to be sent in coloured envelopes (so that they could identify them easily), with simple instructions and questionnaires and wanted to be notified before we sent the kits. We achieved 92 % (183/200) overall follow-up for the postal questionnaire at 1 month and 82 % (163/200) at 12 months. We achieved 86 % (171/200) overall follow-up for the postal chlamydia test at 3 months and 80 % (160/200) at 12 months.Conclusions: By using established methods to increase follow-up, testing prototype procedures and seeking user opinions, we achieved higher follow-up than previous sexual health trials. However, it is not possible to determine if the increase in response was due to our follow-up procedures.Trial Registration: Current Controlled Trials ISRCTN02304709 Date of registration: 27 March 2013. [ABSTRACT FROM AUTHOR]

Background: Patient-delivered partner therapy (PDPT) involves providing a prescription or medication to a patient diagnosed with chlamydia to pass to their sexual partner/s. Barriers to PDPT include uncertainty about its integration into clinical practice and permissibility. In Victoria, Australia, the Department of Health provides clinical guidance for PDPT (updated in 2022). We explored health practitioner views on the usefulness of the updated guidance for providing PDPT. Methods: We conducted an online survey (12 December 2022 to 2 May 2023) of health practitioners who primarily work in Victoria and can prescribe to treat chlamydia. The survey displayed excerpts from the guidance, and asked closed and free-text questions about its ability to address barriers to PDPT. Quantitative data were descriptively analysed, complemented by conventional content analysis of qualitative data. Results: Of a total of 49 respondents (66.7% general practitioners), 74.5% were aware of PDPT, and 66.7% had previously offered PDPT. After viewing excerpts of the guidance, >80% agreed it could support them to identify patients eligible/ineligible for PDPT, and 66.7% indicated they would be comfortable to offer PDPT. The guidance was viewed as helpful to address some barriers, including complicated documentation (87.7%) and medico-legal concerns (66.7%). Qualitative data highlighted medico-legal concerns by a minority of respondents. Some raised concerns that the guidance recommended prescribing azithromycin, despite doxycycline being first-line chlamydia treatment. Conclusions: The guidance was largely viewed as supportive for PDPT decision-making. There is scope for further refinements and clarifications, and wider dissemination of the guidance. Patient-delivered partner therapy (PDPT) involves providing a prescription or medication to a patient with chlamydia to pass to their sexual partner/s, but clinicians have expressed uncertainty about its permissibility and integration into practice. We surveyed clinician perspectives on updated health authority guidance for PDPT; finding they largely viewed it as supportive for PDPT decision-making and addressed some practical barriers. Low awareness of the updated guidance, and medico-legal concerns, for some, highlight scope for further dissemination and clarification of PDPT permissibility. [ABSTRACT FROM AUTHOR]

Background: The general practice out-of-hours (GPOOH) service is under pressure to treat more patients in less time, while reducing referrals and minimising diagnostic errors. Point-of-care (POC) testing involves rapid clinical tests that can be used to generate results during the consultation, and has the potential to facilitate managing these competing demands safely. Aim: To describe current availability of POC tests in GPOOH in Scotland, and identify barriers, enablers, benefits, and drawbacks to its use. Design & setting: Cross-sectional mixed-methods study, which surveyed opinions of clinicians working in the GPOOH service in NHS Scotland. Method: An electronic questionnaire was developed, designed, piloted, and distributed to clinicians, which had closed questions and areas for free text. Results: In total, 142 responses were received. Urine dipstick testing (99.2%), pregnancy tests (98.5%), oxygen saturation (97.7%), and blood glucose testing (93.9%), were the only POC tests commonly available in GPOOH in NHS Scotland. There was strongest support for the provision of POC tests, particularly C-reactive protein (CRP; 79.4%), strep A (76.0%), and D-dimer (75.2%). Responders felt that POC tests would improve confidence (92.3%) and safety (89.8%) surrounding clinical decision making, improve patient satisfaction (80.6%), and reduce hospital and secondary care referrals (77.5%). Barriers to POC test use were availability of the test kits and machines (94.5%), training requirements on how to use the machine (71.1%) and interpret results (56.3%), and time to do the test (62.0%). Conclusion: Few POC tests are in regular use in GPOOH in Scotland. GPOOH clinicians are supportive of using POC testing. They identified a number of benefits to its use, with very few drawbacks. Increased provision of POC testing in GPOOH in NHS Scotland should be considered urgently. [ABSTRACT FROM AUTHOR]

Objectives: Chlamydia trachomatis (chlamydia) is one of the most reported bacterial sexually transmitted infections (STI) worldwide. Chlamydia can cause long term complications such as pelvic inflammatory disease (PID), ectopic pregnancy (EP) and tubal factor infertility (TFI). Changing testing strategies, for example reduced asymptomatic testing, influence chlamydia surveillance, highlighting the need for exploring alternative ways of monitoring chlamydia. We investigated the possibility of introducing routine surveillance of chlamydia related long term complications. Methods: A qualitative study including 15 in-depth interviews with a purposive sample of gynaecologists, general practitioners (GP), sexual health and emergency doctors was conducted in the Netherlands in 2021–2022. A semi-structured interview guide focused on experiences with diagnosis and registration of PID, EP and TFI and how a change in asymptomatic chlamydia testing strategy might influence this. Interviews were transcribed and analysed using a thematic approach. Results: Analysis showed that gynaecologists most frequently reported diagnosing PID, EP and TFI. Other professions rarely diagnose these complications, with emergency doctors only diagnosing EP. Most respondents reported unique registration codes for PID and EP, but the coding for TFI is more ambiguous. They reflected that diagnosis and registration of PID, EP and TFI are handled differently within their professions. Most respondents acknowledged registration in diagnostic codes as a useful surveillance tool. They expressed concerns in representativeness (e.g. differences in interpretation of diagnosis criteria) and data quality for surveillance. Conclusions: Patient files of gynaecologists are likely to be most complete for monitoring trends of diagnosed chlamydia related long term complications in the Netherlands. However, when establishing a chlamydia complication surveillance system, professionals should be engaged in further standardizing diagnosis and registration practices. This will improve the quality and interpretability of complication surveillance and facilitate comparison between countries. [ABSTRACT FROM AUTHOR]