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Chlamydia is an important sexually transmitted infection in young people. Rates have been rising steadily over the past decade. Treatment is available and easy to take without many side effects. And young people are rightly worried about chlamydia. The complications, although perhaps not life threatening, can be devastating in later life. Try to explain to a couple in their 30s that they can't have children because of a previous undiagnosed chlamydia infection.
We can look for more and more evidence and do more and more research, all costing a lot of money and delaying any disease control project for many more years. I have been involved in the chlamydia screening project in Lambeth for nearly two years. Currently we are screening high numbers of young people, male and female, and our detection rate for chlamydia is above 10%. Practices are paid a small incentive when they manage to screen 10% of young people on their list. Many practices do so, and many do even better. Articles such as the one written by Low do not help the cause: they only create confusion and feed scepticism.1
We need optimism. Simple measures would increase the screening target, and yes, it would be easy to change screening from being opportunistic to proactive. Very simple; make it a quality and outcomes framework. Change the specimen request forms, integrate requests for chlamydia screening with the usual generic pathology forms. This would save a lot of hassle and increase the compliance of clinicians. Yes, chlamydia screening is expensive, but young people are worth it.
Competing interests: None declared.