Percentage of women 16-24 years of age who were identified as sexually active and who had at least one test for chlamydia during the measurement period.

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Report a total score, and each of the following strata:
Stratum 1: Patients age 16-20 
Stratum 2: Patients age 21-24

None

None

Chlamydia trachomatis is the most common sexually transmitted bacterial infection in the U.S., resulting in over 2.8 million new cases each year (Centers for Disease Control and Prevention 2011 - Chlamydia).  It is often known as a “silent” disease because most infected people have no symptoms and therefore are unaware they have an infection (United States Preventive Services Task Force, 2007; Centers for Disease Control and Prevention 2011- Chlamydia). Although chlamydia symptoms are usually mild or nonexistent, untreated infections can lead to serious and irreversible complications (United States Preventive Services Task Force 2007).

Women are particularly vulnerable when infected with chlamydia. Left untreated, chlamydia can cause pelvic inflammatory disease (PID), permanent damage to a woman's fallopian tubes, uterus and surrounding tissue, or Reiter Syndrome, which includes pink eye (conjunctivitis) and skin lesions affecting the lower extremities. Between 10 and 15 percent of untreated chlamydia infections result in PID, which can lead to ectopic pregnancy and infertility (Centers for Disease Control and Prevention 2011 – Chlamydia). As many as 15 percent of women with PID will become infertile (Centers for Disease Control and Prevention 2011 – Pelvic Inflammatory Disease). Additionally, pregnant women might experience premature delivery, miscarriage, low birth weight, infant mortality, or they may pass conjunctivitis or chlamydia pneumonia to their infants (United States Preventive Services Task Force, 2007; Centers for Disease Control and Prevention 2011- Chlamydia). Chlamydia is the leading cause of preventable infertility and, among other adverse pregnancy related problems, can cause preterm birth, miscarriages, infant mortality, and neonatal chlamydia infections (United States Preventive Services Task Force 2007).

Over 900,000 chlamydia infections were reported to the Centers for Disease Control and Prevention (CDC) from 50 states and the District of Columbia in 2004. Since many cases are not reported or even diagnosed, it is estimated that there are actually 2.8 million new cases of chlamydia each year (Centers for Disease Control and Prevention 2010). From 1987 through 2004, the reported rate of chlamydia infection in women increased from 78.5 cases to 485 cases per 100,000 people, though a portion of the increase in prevalence is attributed to continued expansion of chlamydia screening programs (Centers for Disease Control and Prevention 2005).

A significant proportion of sexually active individuals, both male and female, continue to go undiagnosed due to the disease's asymptomatic nature (Wilson et al. 2009). Approximately 75 percent of chlamydia infections in women and 95 percent in men are asymptomatic, resulting in delayed medical care and treatment (Centers for Disease Control and Prevention 2011 – Pelvic Inflammatory Disease). Women whose sexual partners are not screened and appropriately treated are at high risk for re-infection. Multiple chlamydia infections increase a woman’s risk of serious reproductive health complications (Centers for Disease Control and Prevention 2010).

U.S. Preventive Services Task Force (2007):
All sexually active nonpregnant young women age 24 years or younger and older women (pregnant or not) who are at increased risk should be screened for a chlamydial infection. 

The USPSTF found fair evidence that nucleic acid amplification tests (NAATs) can identify chlamydial infection in asymptomatic men and women, including asymptomatic pregnant women, with high test specificity. 

If clinicians have not concurrently screened for chlamydial infection, the CDC recommends presumptive treatment for chlamydia at the time of treatment for gonorrhea. In order to prevent recurrent transmission, partners of infected individuals should be tested and treated if infected, or treated presumptively.  

American Academy of Family Physicians (2009):
The AAFP strongly recommends screening for chlamydia infection for all sexually active non-pregnant young women aged 24 and younger and for older non-pregnant women who are at increased risk. 

The AAFP recommends screening for chlamydia infection for all pregnant women aged 24 younger and for older pregnant women who are at increased risk.

Higher score indicates better quality

Centers for Disease Control and Prevention. 2011. “Chlamydia – CDC Fact Sheet.”  http://www.cdc.gov/std/Chlamydia/STDFact-Chlamydia.htm

United States Preventive Services Task Force. 2007. Screening for chlamydia infection: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 147(2):128-34.

Wilson, T.E., M. Hogben, E.S. Malka, N. Liddon, W.M. McCormack, S.R. Rubin, M.A. Augenbraun. 2009. “A Randomized Controlled Trial for Reducing Risks for Sexually Transmitted Infections Through Enhanced Patient-Based Partner Notification.” Am J Public Health 99(S1):S104-10.

Centers for Disease Control and Prevention. 2011. “Pelvic Inflammatory Disease (PID) - CDC Fact Sheet.” http://www.cdc.gov/std/PID/STDFact-PID.htm

Centers for Disease Control and Prevention. 2010. "Sexually Transmitted Diseases (STDs): Chlamydia Treatment." http://www.cdc.gov/std/chlamydia/treatment.htm (June 6, 2011).

Centers for Disease Control and Prevention. 2005. Sexually Transmitted Disease Surveillance 2004 Supplement, Chlamydia Prevalence Monitoring Project. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention.

American Academy of Family Physicians (AAFP). 2009. Summary of recommendations for clinical preventive services. Revision 6.8. Leawood: American Academy of Family Physicians (AAFP).

None

Codes to identify sexually active women include codes for: pregnancy, sexually transmitted infections, contraceptives or contraceptive devices, and infertility treatments.

The denominator exclusion does not apply to patients who qualify for the initial patient population based on services other than the pregnancy test alone.

None

Women 16 to 24 years of age who are sexually active and who had a visit in the measurement period

Equals Initial Patient Population

Women who received a pregnancy test solely as a safety precaution before ordering an x-ray or specified medications

Women with at least one chlamydia test during the measurement period

Not applicable

None

Not applicable

Not applicable

For every patient evaluated by this measure also identify payer, race, ethnicity and sex.