Quality Assessment of "Chlamydia trachomatis" Screening and Treatment in a Juvenile Detention Center

• NCJ Number: 222376
• Journal: Journal of Correctional Health Care Volume: 14 Issue: 2 Dated: April 2008 Pages: 99-108
• Author(s): Julia C. Frye PA-C, MMS; Lisa Wallace Ph.D.; R. Scott Chavez Ph.D., PA; David A. Luce PA-C
• Date Published: April 2008
• Length: 10 pages
• Publication Format: Article
• Publication Type: Report (Study/Research)
• Language: English
• Country: United States of America

Annotation

This study investigated the usefulness of screening asymptomatic juveniles, the feasibility of completing treatment in high turnover juvenile correction facilities, and the strengths and weaknesses of the current screening and treatment program.

Abstract

Findings showed that of the approximately 9,500 juveniles entering facilities in Illinois annually, 76 percent received screening for Chlamydia and gonorrhea. The population consisted of 85 percent African-Americans, and many of the juveniles were sexually active and engaged in high risk behaviors such as drug use. Both race and high-risk behaviors are risk factors for infection and led to a positivity rate higher than the national average. The high positivity rate also shows the importance of screening asymptomatic individuals in this population as they may not receive regular health care. The study showed the importance of a quick turnaround time between tests and treatment as well as a good relationship with the local public health department. In this study, the facility treated 75.9 percent of the juveniles, whereas the public health department treated 10.4 percent. Overall, 86.3 percent of the juveniles received treatment. Universal screening for Chlamydia is cost-effective when Chlamydia prevalence exceeds 7.7 percent, the percentage of positive test the facility treats before the inmates release is 49 percent, and patients report symptoms less than 53 percent of the time. The prevalence of Chlamydia among the females at the juvenile detention center was 20.8 percent; the detention center’s Chlamydia screening program would be more cost effective if all females entering the facility received treatment for Chlamydia without being tested. Among the male population it would be more cost effective for the detention center to provide testing rather than empiric treatment given that the prevalence rate is only 9 percent. Further research should assess the other treatment recommendations such as partner notification and patient education. Tables, figures, and references