Importance of physicians in Chlamydia trachomatis control.

Introduction: During 2002-2006, reported rates of Chlamydia (CT) increased 17.3% nationally, with 43.6% of guideline eligible females screened in 2006. Annual costs associated with CT exceed $1.88 billion. We sought to determine the importance of private medical doctors (PMDs) and hospitals as screening venues in Illinois, USA and if this varied by county Rural-Urban Continuum Code (RUCC).
Methods: A retrospective analysis of all CT cases reported in Illinois during 2002-2006. Counties were stratified by RUCC and eighteen provider types were condensed into nine venues. Venue positivity rates were derived from laboratory data.
Results: PMDs and hospitals reported 247,725 CT cases (33.1% and 25.4%, respectively). Sample positivity rates were 6.2% and 6.1%, comparable to 5.7% for family planning clinics (FPC). Distribution of cases within these venues (and STD clinics) by RUCC was highly significant (p<0.001).
Discussion: Even though screening guideline compliance is low, PMDs identify the majority of cases in Illinois and are consistently important screening venues at all levels of urbanization. As PMDs (and/or hospitals) exist in every Illinois county, it may be more efficient to augment screening rates at these venues rather than create new venues of other types which may be cost-ineffective in rural or low-prevalence areas.
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