Eurosurveillance, Volume
13, Issue
38,
18 September 2008
The number of reported cases of Chlamydia trachomatis infections has increased in Sweden in the last decade, as in many other European countries [1]. After a temporary fall in the number of cases reported in Sweden in 2006, due to the spread of a new variant that was not detectable with some of the test methods used at the time, 2007 showed a record high of over 47,000 reported cases [2].
Chlamydia is often asymptomatic and therefore not diagnosed, which facilitates uninterrupted spread of the infection. If untreated, the infection can cause infertility in both men and women. Many diagnoses are made through opportunistic screening which mainly reaches women. Only 28% of all those tested for chlamydia in Sweden 2007 (536,484 people, positivity rate 10%) were men. It is therefore particularly important to reach more men for testing in order to find new cases.
During summer time people in general have more opportunities of finding a new sex partner, which increases the risk of getting infected with and spreading chlamydia. Consequently, the number of chlamydia cases reported in Sweden is higher in September and October compared to other months (Figure). Since 2003, the Stockholm county council has launched a yearly campaign in September in order to increase awareness of possible transmission of chlamydia infection and to encourage testing. Similar activities are also performed in other counties around the country. The campaign in Stockholm is called 'Chlamydia Monday' (Klamydiamåndag) and the main element is the opportunity of drop-in testing offered free of charge at a number of different clinics, such as youth clinics, primary health care centres and clinics for sexually transmitted diseases, on a particular Monday in September. Free condoms are also offered at this occasion to encourage condom use. Massive media advertising precedes the 'Chlamydia Monday' as a part of the campaign. Besides encouraging people to test for Chlamydia, the advertisements are also promoting condom use in order to prevent sexually transmitted infections. This year the 'Chlamydia Monday' in Stockholm happened on 15th September, with 106 clinics offering testing. How many people have been tested this year on the day has not yet been analysed.
Figure. Number of reported chlamydia cased in Sweden per month
Chlamydia testing and treatment is always free of charge in Sweden. However, the 'Chlamydia Monday' campaign increases the opportunities for testing since the clinics involved offer more drop-in hours than usual. With increased awareness and testing opportunities the campaign is aimed particularly at young men who do not seek test consultations to the same extent as young women. During the 'Chlamydia Mondays' in Stockholm county in 2006 and 2007 1,151 people (positivity rate 6,2%) and 1,480 (positivity rate 8,0%) were tested, respectively. 47% (2006) and 42% (2007) of them were men. 'Chlamydia Monday' thus seems to be an effective way of reaching both men and women for testing and keeping up the public awareness of sexually transmitted infections.
References
- Van de Laar MJ, Morré SA. Chlamydia: a major challenge for public health. Euro Surveill. 2007;12(10):pii=735. Available from: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=735
- Ripa T, Nilsson P. A variant of Chlamydia trachomatis with deletion in cryptic plasmid: implications for use of PCR diagnostic tests. Euro Surveill. 2006;11(45):pii=3076. Available from: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=3076