Home-sampling as a tool in the context of Chlamydia trachomatis partner notification: a randomized controlled trial.

Chlamydia trachomatis is the most common known bacterial cause of sexually transmitted infection (STI) (1, 2) and an important cause of infertility in women and possibly in men (3, 4). Following a remarkable decrease in reported cases of C. trachomatis, there was a 10–15% annual increase in cases reported to the Swedish Centre of Communicable Disease Control between 1997 and 2005 (5). Increase in the incidence of chlamydia have also been reported in many other countries (6). In Sweden, partner notification of chlamydia-infected individuals is mandatory under legislation passed in 1988 and 2004 (7). One possible reason for this increase in Sweden could be that partner notification may not be fully effective in preventing transmission. The aim of the present study was to evaluate whether home-sampling could decrease the delay between the time when partner tracing starts (i.e. the meeting between the index patient and a counsellor) and the date of testing (sampling) of sexual partners, compared with conventional testing of partners at a clinic. MATERIALS AND METHODS This Swedish multicentre study included sexually transmitted disease (STD) clinics in 3 towns (Norrköping, Motala and Väs-tervik), and all C. trachomatis-infected individuals presenting between October 2006 and July 2007 were eligible and were invited to enrol in the study. The primary index patient, i.e. the first individual diagnosed with C. trachomatis in a new sexual network, was randomized to either a conventional partner notification mode (in which the partners were asked either by the index patient or by the counsellor to attend a clinic for C. trachomatis testing) or to a mode in which a test kit for home self-sampling was posted to them by the counsellor or distributed via the index patient. When sexual partners infected with C. trachomatis became index patients, they were assigned to the same study branch as the primary index patient. At the STD clinics an informed consent was given to the partner tracer. Written information about the study was sent with the letter requiring the partner to be tested for C. tracho-matis at a clinic, according to the law, if the index person was randomized or assigned to the conventional clinic-testing study branch. Current sexual partners who were prescribed antibiotics were excluded from participation. Sampling of female partners was carried out via combined first-catch urine (FCU) and vaginal samples. Sampling of male partners was via FCU. The sampling date was taken as the end-point. The Kaplan–Meier …