Improving Chlamydia Screening in Women Presenting with Genitourinary Symptoms to the Walk-in-Clinic

Background: Chlamydia trachomatis (CT) cases continue to rise annually. CT is more prevalent than ever, reaching its highest number of cases reported (over 1.75 million) in 2018 (CDC, 2019b). The highest infection rates occur in women aged 20-24 years, followed by females aged 15-19 years (USPSTF, 2014). In addition, according to the CDC over 97% of all reported CT cases in females were aged 15-44 years (2019a). Studies by Brown et al. (2018) and Myers et al. (2017) indicate the need to improve CT screening, which is suboptimal. Studies by Mian et al. (2017), Shipman et al. (2018), Yoo and Vangrafeiland (2018), Ouellette et al. (2017), and Jackson et al. (2015) highlight that misdiagnosis can occur for a urinary tract infection (UTI) or vaginal infection, when it was a sexually transmitted infection (STI). As walk-in-clinics and urgent cares are being utilized more frequently for patient health care needs due to convenience and faster service, there are likely missed opportunities for CT screenings in this target patient population. Females who present to a walk-in-clinic with genitourinary (GU) symptoms, are sexually active or engaged in high-risk sexual behaviors, should be screened for CT.

Purpose: The purpose of this study was to evaluate implementation of a screening protocol for females at risk for CT through provider and staff education. The focus of this study was on females who presented to a walk-in-clinic, who were at highest risk based on age group (aged 18 years and older), were sexually active or engaged in high-risk sexual behaviors, and were experiencing GU symptoms.