Comparison of chlamydia control activities in England & Wales with Denmark from 2000 – 2014

Rationale
Over the last 10 years many developed countries, have increased the volume of chlamydia testing in young, sexually active people (aged 500,000 women’s experiences of chlamydia testing linked to hospital episodes of serious reproductive outcomes. We will use data from the NATSAL surveys (UK national surveys of sexual attitudes and lifestyles) to inform sexual behaviour. We will then develop a model to investigate whether the changes in coverage and diagnoses are consistent between the two countries and within countries across different geographical regions. We will explore other differences in organisation and implementation of chlamydia control to inform estimates of the programme level efficacy of the NCSP and Danish programme.

Aims & Objectives
In this project we propose to compare the chlamydia control activities in England and Wales with Denmark which are two countries which have achieved high levels of coverage over time and have similar health care provision models (ie free at the point of access, through NHS and mandatory health insurance, in UK and Denmark respectively).

Methods
We will use routine national data (PHE) and recently improved estimates of the rate of chlamydia testing and diagnosis since 2003 (NCSP). These data are limited by lack of individual follow-up. We will also use a detailed dataset from Denmark describing >500,000 women’s experiences of chlamydia testing linked to hospital episodes of serious reproductive outcomes. We will use data from the NATSAL surveys (UK national surveys of sexual attitudes and lifestyles) to inform sexual behaviour. We will then develop a model to investigate whether the changes in coverage and diagnoses are consistent between the two countries and within countries across different geographical regions. We will explore other differences in organisation and implementation of chlamydia control to inform estimates of the programme level efficacy of the NCSP and Danish programme.