Chlamydia trachomatis and non-gonococcal urethritis

Chlamydial infection is the commonest treatable sexually transmitted infection (STI) in the western world. Untreated or recurrent Chlamydia infection can have significant long-term complications including infertility in women. Reduction in prevalence of chlamydia is considered possible if offers and uptake of chlamydia tests are increased. Nucleic acid amplification techniques with improved sensitivity and high specificity have made diagnosis much more reliable. These tests are also licensed for less invasive, patient-taken sampling. This combined with the simplification of treatment options (azithromycin 1 g) means non-genitourinary medicine settings are well placed to test and treat individuals for chlamydia. This is in line with the goals of the National Chlamydia Screening Programme whose aim is for all sexually active men and women under 25 years of age to be aware of chlamydia, its effects, and have access to services providing screening, prevention and treatment. Testing for chlamydia also provides an opportunity to offer screening for other STIs as well as to offer advice to those engaging in high-risk sexual behaviour. Non-gonococcal urethritis (NGU) continues to cause morbidity in men. Although NGU is usually sexually transmitted, it can occur within a stable relationship. In at least 30% of cases no micro-organism is detected. Although diagnosis and management is best undertaken in a specialist sexual health centre, it can be managed successfully in a non-specialist setting.