Comments from Expert Advisory Committee
- Chlamydia, caused by Chlamydia trachomatis, is the commonest STI reported in Ireland with almost half of cases diagnosed in those aged between 15 and 24 years
- Frequently asymptomatic in both males and females. Symptoms in males include dysuria and a urethral discharge. Symptoms in women include vaginal discharge, intermenstrual bleeding, post coital bleeding
- Infection can lead to epididymo-orchitis in males.
- Can lead to pelvic inflammatory disease (PID) in females. PID is associated with an increased risk of tubal factor infertility, ectopic pregnancy and chronic pelvic pain
- Diagnosis using NAAT (nucleic acid amplification technique, eg PCR, polymerase chain reaction) is the current diagnostic gold standard. This is frequently combined with a gonorrhoea NAAT in the same test
- Diagnosis can be made on first void urine in males and vulvovaginal or endocervical swab in females. Vulvovaginal swabs can be provider or self-taken.
- In sexually active men who have sex with men (MSM), three site CT testing (first void urine, pharyngeal and rectal sites ) is recommended.
- Test of cure is not routinely required but is suggested in pregnancy and in women with an intrauterine device. If doing a test of cure, wait until at least 3 weeks post completion of treatment
- Individuals diagnosed with chlamydia should be offered testing for other STIs including HIV, Hepatitis B, syphilis and gonorrhoea.
- Hepatitis C testing should be considered part of routine sexual health screening in the following circumstances: People who are HIV positive; Commercial sex workers; PWID Patients who inject drugs ; If indicated by the clinical history e.g. unexplained jaundice; When other risk factors for HCV are present, for example MSM. The full set of recommendations around HCV testing are available in the national HCV screening guidelines.
- Sexual partners in the preceding 6 months should be informed of the need for testing and patients should be encouraged to inform their sexual partners
- Chlamydia is a notifiable disease. The complete list of notifiable diseases and information on the notification process is available from HPSC. http://www.hpsc.ie/NotifiableDiseases/
Treatment of uncomplicated anogenital Chlamydia is outlined in the table below.
Reviewed December 2019