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Matern Child Health J. 2007 Nov;11(6):586-94. Epub 2007 Jun 5.

Feasibility and utility of screening adolescent mothers for Chlamydia at their children's health care visits.

Author information

  • 1Department of Pediatrics, Division of Adolescent Medicine, University of Colorado Health Sciences Center, The Children's Hospital, 1056 East 19th Street, Denver, Colorado 80218, USA.

Abstract

PURPOSE:

Assess the feasibility of offering and barriers to accepting urine-based screening for Chlamydia trachomatis (CT) among asymptomatic adolescent mothers during their children's health care visits.

METHOD:

Providers were automatically cued to offer CT-screening to 13 through 21 year old mothers when they opened the child's medical record. Recording the mothers' screening decisions removed the flag for 6 months. Providers were also prompted to assess the perceived importance of CT prevention, likelihood of having CT, and the worst aspect of having CT.

RESULTS:

Mothers usually brought their children to the clinic. Hence, providers could act on 97% of the 318 flags they saw. They responded appropriately 75% of the time. Only 96 (42%) of the 229 mothers who were asked agreed to screening. The primary reasons for declining were "monogamous" and "tested within 6 months". Almost everyone said CT was a top preventive health priority, but that they would be surprised if they were infected. Mothers who agreed to screening were less likely to have a child less than 6 months of age (26.0% vs. 57.1%; P < 0.0001). They were also more likely to rate knowledge of partner infidelity (39.4% vs. 13.6%; P = 0.03) and less likely to rate medical problems (15.2% vs. 40.9%; P = 0.01) the worst aspect of having CT. None of the 21 urine samples obtained within 6 months of delivery were positive for CT. Thereafter, 5 (9.1%) of the 55 urines were positive.

CONCLUSIONS:

It is feasible and useful to screen adolescent mothers for CT at their children's health care visits. The best way to increase the efficacy and strengthen the impact of urine-based CT-screening in this setting is to initiate testing after the 6th postpartum month and heighten awareness of STD-risk among adolescent mothers.

PMID:
17549616
[PubMed - indexed for MEDLINE]
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