Chlamydia check-up: Tracking policy shifts with a scientific swab at general practices

Abstract

Background - Chlamydia trachomatis is a common sexually transmitted disease. Since January 2025, the Dutch public health service (GGD) implemented a major policy change for sexual health centers, discontinuing the testing and treatment of asymptomatic chlamydia infections. Impact can be expected on testing behavior, incidence and chlamydia consultations at the general practitioners (GP), who have not changed their policy. Aim - To create an overview of current chlamydia consultation characteristics at the GP, including presence or absence of symptoms for persons >12 years old, and to identify associatiowith chlamydia positivediagnosDesign and setting - Retrospective observationalcohort study with medical record data extracted for person>12 years old seeking care at general practices affiliated to the Julius General Practitioners Network from 2018-2023. Method - A random sample was manually screened for reason of consultation, chlamydia-related symptoms, chlamydia diagnostics, test results, antibiotic prescriptions and other STD positivity. Characteristics were stratified for chlamydia positive and negative diagnosis. A multivariable analysis of sex, age, presence of chlamydia-related symptoms and chlamydia positive diagnosis was performed. Results - Characteristics of chlamydia consultations (n=867) include a female majority(57.1%)and median age of 28. Main reason for consultation was fear of STD (69.0% n=598), of which 10.2% of patients was chlamydia positive. Chlamydia-related symptoms were registered most for patients (36,3% n=315), of which 22.5% was chlamydia positive. Significant associations for younger age and presence of symptoms with chlamydia were found (respectively OR = 0.892, 95% CI: 0.861–0.924 and OR = 3.005, 95% CI: 1.822–4.955). Conclusion - Chlamydia presence was highest in younger people and people that reported symptoms.