The contribution of Chlamydia trachomatis to adverse reproductive health and the implications for control policy

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Chlamydia is one of the commonest sexually transmitted bacterial infections in Europe. Most people have no symptoms, but left untreated it can cause serious complications, including infertility. Screening programmes can identify and treat asymptomatic people and reduce long-term complications. However these programmes have costs, personal and financial, that must be balanced against their benefit. In order to do this we need to know how often complications occur after an infection. But the evidence on this is limited and based mainly on old studies that may not be relevant today. The proposed research will review current knowledge about the association between chlamydia and reproductive health and then measure this association using information collected from residents of Manitoba Province, Canada, over the last 25 years. These findings will be used to develop a mathematical model to estimate the potential impact of Chlamydia screening and to determine whether screening programmes are cost effective. Finally, interviews will be conducted with key professionals and public and patient representatives to understand the factors that influence screening policy. The research will conclude by drawing together the findings from each study to produce evidence based policy recommendations for Chlamydia screening.