{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T11:29:21Z","timestamp":1750159761974,"version":"3.37.3"},"reference-count":15,"publisher":"Royal College of General Practitioners","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BJGP Open"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Genital and anorectal <jats:italic>Chlamydia trachomatis<\/jats:italic> (CT) frequently present together in sexually transmitted infection (STI) clinics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To investigate the prevalence of co-occurrent genital and anorectal chlamydia infection, and to study whether sexual behaviour is associated with anorectal infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design &amp; setting<\/jats:title><jats:p>A cross-sectional study in general practices in the north of the Netherlands.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Women attending general practice with an indication for genital chlamydia testing were included and asked to complete a structured questionnaire on sexual behaviour. Anorectal infection prevalence was compared according to testing indications: standard versus experimental (based on questionnaire answers). Variables associated with anorectal chlamydia were analysed by univariate and multivariate logistic regression analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Data could be analysed for 497 of 515 women included. Overall, 17.8% (<jats:italic>n<\/jats:italic> = 87\/490) were positive for CT; of these, 72.4% (<jats:italic>n<\/jats:italic> = 63\/87) had co-occurrent genital and anorectal infection, 13.8% (<jats:italic>n<\/jats:italic> = 12\/87) had genital infection only, and 12.6% (<jats:italic>n<\/jats:italic> = 11\/87) had anorectal infection only. Rectal infection was missed in 69.3% of cases using the standard indication alone, while adding the sexual history still missed 20.0%. Age was the only variable significantly associated with anorectal infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The prevalence of anorectal disease is high among women who visit their GP with an indication for genital CT testing. Many anorectal infections are missed despite taking comprehensive sexual histories, meaning that standard treatment of genital infection with azithromycin may result in rectal persistence. Performing anorectal testing in all women with an indication for genital CT testing is, therefore, recommended.<\/jats:p><\/jats:sec>","DOI":"10.3399\/bjgpo.2021.0223","type":"journal-article","created":{"date-parts":[[2022,3,10]],"date-time":"2022-03-10T11:30:13Z","timestamp":1646911813000},"page":"BJGPO.2021.0223","source":"Crossref","is-referenced-by-count":1,"title":["High rates of anorectal chlamydia in women: a cross-sectional study in general practice"],"prefix":"10.3399","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7409-0369","authenticated-orcid":false,"given":"Elisabeth","family":"AB","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dirk","family":"Luijt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alewijn","family":"Ott","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5005-9324","authenticated-orcid":false,"given":"Janny H","family":"Dekker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1987","published-online":{"date-parts":[[2022,3,10]]},"reference":[{"key":"2022092817501047000_6.3.BJGPO.2021.0223.1","unstructured":"World Health Organization (2018) Report on global sexually transmitted infection surveillance, 2018. accessed. https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/277258\/9789241565691-eng.pdf?ua=1. 14 Mar 2022."},{"issue":"9","key":"2022092817501047000_6.3.BJGPO.2021.0223.2","first-page":"450","article-title":"Dutch general practitioners society guideline on STI-consultation (first revision)] NHG-standaard het soa-consult (eerste herziening) (in Dutch","author":"Van Bergen","year":"2013","journal-title":"Huisarts Wet"},{"key":"2022092817501047000_6.3.BJGPO.2021.0223.3","unstructured":"Nederlandse Vereniging voor Dermatologie en Venereologie (NVDV) (2018) [Sexual transmitted diseases \u2014 multidisciplinary guideline 2018] Seksueel overdraagbare aandoeningen \u2014 multidisciplinaire richtlijn 2018 (in Dutch). accessed. https:\/\/www.soaaids.nl\/files\/2019-07\/multidisciplinair-richtlijn-soa-2018-update-2019.pdf. 15 Mar 2022."},{"key":"2022092817501047000_6.3.BJGPO.2021.0223.4","unstructured":"British Association for Sexual Health and HIV (BASHH) Clinical Effectiveness Group (2015) 2015 BASHH CEG guidance on tests for sexually transmitted infections. accessed. https:\/\/www.bashhguidelines.org\/media\/1084\/sti-testing-tables-2015-dec-update-4.pdf. 15 Mar 2022."},{"key":"2022092817501047000_6.3.BJGPO.2021.0223.5","unstructured":"CDC (2015) Sexually Transmitted Diseases Treatment Guidelines 2021, Chlamydial Infections. accessed. https:\/\/www.cdc.gov\/std\/treatment-guidelines\/chlamydia.htm. 17 Jun 2022."},{"key":"2022092817501047000_6.3.BJGPO.2021.0223.6","unstructured":"World Health Organization (2016) WHO guidelines for the treatment of Chlamydia trachomatis. accessed. https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/246165\/9789241549714-eng.pdf. 15 Mar 2022."},{"key":"2022092817501047000_6.3.BJGPO.2021.0223.7","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2017-053161"},{"key":"2022092817501047000_6.3.BJGPO.2021.0223.8","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2018-053950"},{"key":"2022092817501047000_6.3.BJGPO.2021.0223.9","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-14-274"},{"key":"#cr-split#-2022092817501047000_6.3.BJGPO.2021.0223.10.1","unstructured":"British Association for Sexual Health and HIV (BASHH) Clinical Effectiveness Group (2018) Update on the treatment of Chlamydia trachomatis"},{"key":"#cr-split#-2022092817501047000_6.3.BJGPO.2021.0223.10.2","unstructured":"(CT) infection. accessed. https:\/\/www.bashhguidelines.org\/media\/1191\/update-on-the-treatment-of-chlamydia-trachomatis-infection-final-16-9-18.pdf. 15 Mar 2022."},{"key":"2022092817501047000_6.3.BJGPO.2021.0223.11","unstructured":"NHS (2021) Chlamydia. accessed. https:\/\/www.nhs.uk\/conditions\/chlamydia. 15 Mar 2022."},{"key":"2022092817501047000_6.3.BJGPO.2021.0223.12","unstructured":"Staritsky LE Aar van F Visser M Coul Op de ELM et al (2019) Sexually transmitted infections in the Netherlands in 2019. accessed. https:\/\/www.rivm.nl\/publicaties\/sexually-transmitted-infections-in-netherlands-in-2019. 15 Mar 2022."},{"key":"2022092817501047000_6.3.BJGPO.2021.0223.13","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2018-053678"},{"key":"2022092817501047000_6.3.BJGPO.2021.0223.14","unstructured":"Mitchell H Allen H Sonubi T Kuyumdzhieva G et al (2020) Sexually transmitted infections and screening for chlamydia in England, 2019. 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