{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T04:22:43Z","timestamp":1747196563494,"version":"3.40.5"},"reference-count":23,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2024,6,11]],"date-time":"2024-06-11T00:00:00Z","timestamp":1718064000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objectives<\/jats:title>\n<jats:p><jats:italic>Chlamydia trachomatis<\/jats:italic> (chlamydia) is one of the most reported bacterial sexually transmitted infections (STI) worldwide. Chlamydia can cause long term complications such as pelvic inflammatory disease (PID), ectopic pregnancy (EP) and tubal factor infertility (TFI). Changing testing strategies, for example reduced asymptomatic testing, influence chlamydia surveillance, highlighting the need for exploring alternative ways of monitoring chlamydia. We investigated the possibility of introducing routine surveillance of chlamydia related long term complications.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A qualitative study including 15 in-depth interviews with a purposive sample of gynaecologists, general practitioners (GP), sexual health and emergency doctors was conducted in the Netherlands in 2021\u20132022. A semi-structured interview guide focused on experiences with diagnosis and registration of PID, EP and TFI and how a change in asymptomatic chlamydia testing strategy might influence this. Interviews were transcribed and analysed using a thematic approach.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Analysis showed that gynaecologists most frequently reported diagnosing PID, EP and TFI. Other professions rarely diagnose these complications, with emergency doctors only diagnosing EP. Most respondents reported unique registration codes for PID and EP, but the coding for TFI is more ambiguous. They reflected that diagnosis and registration of PID, EP and TFI are handled differently within their professions. Most respondents acknowledged registration in diagnostic codes as a useful surveillance tool. They expressed concerns in representativeness (e.g. differences in interpretation of diagnosis criteria) and data quality for surveillance.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Patient files of gynaecologists are likely to be most complete for monitoring trends of diagnosed chlamydia related long term complications in the Netherlands. However, when establishing a chlamydia complication surveillance system, professionals should be engaged in further standardizing diagnosis and registration practices. This will improve the quality and interpretability of complication surveillance and facilitate comparison between countries.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0305279","type":"journal-article","created":{"date-parts":[[2024,6,11]],"date-time":"2024-06-11T18:26:33Z","timestamp":1718130393000},"page":"e0305279","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Investigating possibilities for surveillance of long term chlamydia complications in the Netherlands: A qualitative study"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4514-0026","authenticated-orcid":true,"given":"Elisabeth Maria","family":"den Boogert","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fleur","family":"van Aar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janneke C. M.","family":"Heijne","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,6,11]]},"reference":[{"journal-title":"Sexually transmitted infections (STIs)","year":"2019","author":"World Health Organization (WHO).","key":"pone.0305279.ref001"},{"journal-title":"NHG-Standaard Pelvic inflammatory disease (M50).","year":"2020","author":"M Bouma","key":"pone.0305279.ref002"},{"issue":"1","key":"pone.0305279.ref003","doi-asserted-by":"crossref","first-page":"1894","DOI":"10.1186\/s12889-023-16663-y","article-title":"Global burden of pelvic inflammatory disease and ectopic pregnancy from 1990 to 2019.","volume":"23","author":"D He","year":"2023","journal-title":"BMC Public Health."},{"issue":"22","key":"pone.0305279.ref004","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3310\/hta20220","article-title":"The natural history of Chlamydia trachomatis infection in women: a multi-parameter evidence synthesis","volume":"20","author":"MJ Price","year":"2016","journal-title":"Health Technol Assess"},{"issue":"4","key":"pone.0305279.ref005","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1093\/eurpub\/ckr046","article-title":"Chlamydia control activities in Europe: cross-sectional survey.","volume":"22","author":"N Low","year":"2012","journal-title":"Eur J Public Health"},{"issue":"3","key":"pone.0305279.ref006","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1093\/eurpub\/ckv196","article-title":"Changes in chlamydia control activities in Europe between 2007 and 2012: a cross-national survey.","volume":"26","author":"IV van den Broek","year":"2016","journal-title":"Eur J Public Health"},{"issue":"1","key":"pone.0305279.ref007","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1186\/s12879-022-07171-2","article-title":"Controversies and evidence on Chlamydia testing and treatment in asymptomatic women and men who have sex with men: a narrative review.","volume":"22","author":"N Dukers-Muijrers","year":"2022","journal-title":"BMC Infect Dis"},{"key":"pone.0305279.ref008","doi-asserted-by":"crossref","first-page":"e4316","DOI":"10.1136\/bmj.e4316","article-title":"Effectiveness of yearly, register based screening for chlamydia in the Netherlands: controlled trial with randomised stepped wedge implementation","volume":"345","author":"IV van den Broek","year":"2012","journal-title":"Bmj"},{"issue":"9907","key":"pone.0305279.ref009","doi-asserted-by":"crossref","first-page":"1795","DOI":"10.1016\/S0140-6736(13)61947-9","article-title":"Prevalence, risk factors, and uptake of interventions for sexually transmitted infections in Britain: findings from the National Surveys of Sexual Attitudes and Lifestyles (Natsal).","volume":"382","author":"P Sonnenberg","year":"2013","journal-title":"The Lancet"},{"journal-title":"Sexually Transmitted Infections. 2021:sextrans-2021-054992","article-title":"Where to go to in chlamydia control? From infection control towards infectious disease control.","author":"JEAM van Bergen","key":"pone.0305279.ref010"},{"issue":"8","key":"pone.0305279.ref011","doi-asserted-by":"crossref","first-page":"e235","DOI":"10.1016\/S1473-3099(17)30310-9","article-title":"Sexually transmitted infections: challenges ahead","volume":"17","author":"M Unemo","year":"2017","journal-title":"The Lancet Infectious Diseases"},{"issue":"7","key":"pone.0305279.ref012","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1136\/sextrans-2011-050205","article-title":"Chlamydia infection, pelvic inflammatory disease, ectopic pregnancy and infertility: cross-national study.","volume":"87","author":"N Bender","year":"2011","journal-title":"Sex Transm Infect"},{"key":"pone.0305279.ref013","article-title":"Policy paper","author":"Public Health England","year":"2021","journal-title":"Changes to the National Chlamydia Screening Programma (NCSP)."},{"key":"pone.0305279.ref014","article-title":"Management of Chlamydia Cases in Australia (MoCCA): protocol for a non-randomised implementation and feasibility trial","author":"JL Goller","year":"2022","journal-title":"BMJ Open"},{"article-title":"NHG-Standaard Het soa-consult (M82)","year":"2023","author":"E AB","key":"pone.0305279.ref015"},{"journal-title":"Seksueel overdraagbare aandoeningen in Nederland in 2021: Rijksinstituut voor Volksgezondheid en Milieu RIVM","article-title":"Sexually transmitted infections in the Netherlands in 2021.","author":"D Van Wees","key":"pone.0305279.ref016"},{"article-title":"Healthcare in the Netherlands","year":"2016","author":"Ministry of Public Health, Welfare and Sport","key":"pone.0305279.ref017"},{"article-title":"Methodologies in Doctoral Research in Design: The Role of Research Paradigms","year":"2020","author":"V Clemente","key":"pone.0305279.ref018"},{"issue":"12 Suppl 2","key":"pone.0305279.ref019","doi-asserted-by":"crossref","first-page":"S23","DOI":"10.1093\/infdis\/jiab116","article-title":"A Review of the Challenges and Complexities in the Diagnosis, Etiology, Epidemiology, and Pathogenesis of Pelvic Inflammatory Disease","volume":"224","author":"SL Hillier","year":"2021","journal-title":"J Infect Dis"},{"volume-title":"Handbook of Research Methods in Health Social Sciences","year":"2019","author":"V Braun","key":"pone.0305279.ref020"},{"issue":"13","key":"pone.0305279.ref021","doi-asserted-by":"crossref","first-page":"1753","DOI":"10.1177\/1049732315617444","article-title":"Sample Size in Qualitative Interview Studies: Guided by Information Power.","volume":"26","author":"K Malterud","year":"2016","journal-title":"Qualitative Health Research."},{"issue":"12 Suppl 2","key":"pone.0305279.ref022","doi-asserted-by":"crossref","first-page":"S39","DOI":"10.1093\/infdis\/jiab031","article-title":"Pelvic Inflammatory Disease Due to Neisseria gonorrhoeae and Chlamydia trachomatis: Immune Evasion Mechanisms and Pathogenic Disease Pathways","volume":"224","author":"T. Darville","year":"2021","journal-title":"J Infect Dis"},{"issue":"4","key":"pone.0305279.ref023","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1136\/sti.2004.012807","article-title":"Discordance between trends in chlamydia notifications and hospital admission rates for chlamydia related diseases in New South Wales, Australia.","volume":"81","author":"MY Chen","year":"2005","journal-title":"Sex Transm Infect."}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0305279","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,11]],"date-time":"2024-06-11T18:26:47Z","timestamp":1718130407000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0305279"}},"subtitle":[],"editor":[{"given":"Jesse L.","family":"Clark","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2024,6,11]]},"references-count":23,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2024,6,11]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0305279","relation":{},"ISSN":["1932-6203"],"issn-type":[{"type":"electronic","value":"1932-6203"}],"subject":[],"published":{"date-parts":[[2024,6,11]]}}}