Screening for Neisseria Gonorrhoea within a Chlamydia Screening Programme in England: results from the first 18 months Sara Lavelle Chlamydia Screening Programme Lead Liverpool, South Sefton and Knowsley Chlamydia Screening Programme, UK

Background National Chlamydia Screening Programme Opportunıstıc screenıng for men and women aged under 25 years Chlamydia screening using Transcription Mediated Amplification (TMA)

Consıderatıons Lack of data to identify prevalence of Neisseria Gonorrhoea (NG) within the community Ability to offer dual testing at no extra cost

Objectives Of Screening For NG To identify prevalence within a population screened for Chlamydia Trachomatis (CT) To monitor confirmatory microscopy, culture and partner findings following reactive TMA gonorrhoea screening tests

Methods All clients accepting CT Screening offered screening for NG Use of urine, endocervical and vulvovaginal swabs Clients with reactive TMA NG tests referred to Genito-Urinary Medicine Department

Screening Period All clients tested for NG between June 2004 and December 2005 were monitored Those who were TMA reactive for NG were referred to GUM and microscopy and culture results obtained if possible

Results (1) clients (16415 women and 2200 men) screened for CT (93%) of clients (15470 women and 1908 men) also accepted screening for NG 184 (1%) of clients (158 women and 26 men) had reactive TMA NG tests NG prevalence of 1% for women and 1.4% for men

Results (2) 26 TMA NG reactive men of which 15(57%) also tested positive for CT 158 TMA NG reactive women of which 74(47%) also tested positive for CT CT prevalence in opportunistically screened population was 12.5% for women and 13.5% for men

Comparison Of TMA And Culture Supportive evidence of positive NG diagnosis was found for 116 (88%) of 131 women and 14 (93%) of 15 men In one instance, NG was detected by TMA from a vulvovaginal swab, but culture was positive for pharyngeal swab only

Conclusions (1) Screening for NG in a chlamydia screening programme is acceptable to clients Screening for NG using TMA offers a method of non-invasive screening within community settings

Conclusions (2) Study adds to evidence to support TMA testing for NG as an accurate method There were more NG reactive tests within the chlamydia negative population – single screening may have offered false reassurance Culture remains essential to obtain resistance profiles