Can a busy abortion service cope with a screen-and-treat policy for Chlamydia trachomatis infection?

In order to determine the effectiveness of a screen-and-treat policy for Chlamydia trachomatis within a busy medical and surgical abortion service, a retrospective audit was conducted of 2058 women undergoing induced abortion over 12 months. The prevalence of C. trachomatis was 6%. Although most positive results were available before a surgical abortion (97%), only 76% were available before a medical abortion (P=0.007). This resulted in more treatment delays in the medical group (P=0.04). Although the majority of women (94% surgical and 84% medical) were seen by genitourinary medicine, only one-quarter of partners attended for contact tracing. The current screen-and-treat policy has been shown to be deficient in several areas. Of most concern are the treatment delays with medical abortion, which may be due to the faster 'processing' of women since this method is only available at ≤ 9 weeks' gestation. Such challenges to a screen-and-treat policy, are likely to become more common as medical abortion becomes more widely adopted.