NEW YORK (Reuters Health) - Asymptomatic Chlamydia trachomatis infections appear to be relatively common among sexually active male adolescents. Investigators in California have found that routine urine screening for C. trachomatis is an effective means of diagnosing these infections in sexually active young men.

Male infection can lead to urethritis and epididymitis, as well as transmission to female sex partners whose fertility could become compromised, Dr. Kathleen P. Tebb of the University of California, San Francisco and associates note in the October issue of the American Journal of Public Health.

They therefore determined the effectiveness of screening sexually active 14- to 18-year-old males scheduled for routine health maintenance visits at 10 clinics of a large HMO between 2001 and 2002. The five clinics assigned to the experimental intervention tested urine specimens using a leukocyte esterase analysis.

There were 1088 sexually active male adolescents who visited the intervention clinics and 1134 who visited control clinics that did not routinely screen for C. trachomatis.

The proportion of subjects screened in the intervention clinics rose from 2.6% at baseline to 48.5% after about 18 months. In the control clinics, corresponding screening rates rose from 7.0% to 9.1%. The authors report that the infection rate for the entire cohort was 3.8%.

The screening program, they conclude, "was effective in identifying a treatable condition with a moderate level of prevalence and morbidity via an accurate, acceptable, and feasible screening mechanism in a busy community clinic setting."

Am J Public Health 2005;95:1806-1810

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