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Chlamydia testing varies with GPs' patchy knowledge

Patchy knowledge of chlamydia and its image as an urban problem are leading to dramatic variations in the frequency of testing across different practices, a Health Pro- tection Agency study has revealed.

Levels of knowledge about the infection are so low that without 'adequate investment' in training the proposed national screening rollout could flounder, the authors warn.

An audit of GPs' laboratory use found a 40-fold variation in submission of chlamydia tests according to the study, published in this month's Sexually Transmitted Infection.

Researchers studied practices in Bristol, Gloucester and Hereford and found low testing practices were 'less aware that chlamydia was usually asymptomatic, thought it was an inner-city problem and had poor knowledge of how to take diagnostic specimens'.

The RCGP sex, drugs and HIV task group has demanded that the national screening programme must be accompanied by a training programme if it is to be effective, said task group chair Dr Chris Ford, a GP in north London.

She said that, unlike HIV, chlamydia had spread into

rural areas and posed 'an enormous threat to public and individual health'.

The Government's chlamydia screening programme for England is planned to eventually involve all GPs, despite most being excluded from screening pilots because of funding restrictions.

One doctor in a low-testing rural practice told researchers: 'I am a bit sceptical of research which I always feel has come out of inner-city family planning clinics where there is a very high incidence of sexual disease.'

But Dr Catti Moss, a GP in Guilsborough, Northamptonshire, said that although rural areas might have lower chlamydia levels, testing was still worthwhile.

Dr Moss, who has worked on the RCGP sexual health handbook and is a member of the RCGP's rural GPs taskforce, said: 'GPs have some evidence that there are differences between areas but that is not a reason for complacency.'

The study also found low-testing practices did not test for chlamydia until women had reconsulted several times or when women with GU symptoms attended for family planning checks or smears.

By Cato Pedder

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