Chlamydia prevention and management in Australia: reducing the burden of disease

call for innovative Chlamydia trachomatis (hereafter referred to as chlamydia) screening programs to reduce the high rates of notifications in Australia at the time, chlamydia remains as the country’s most notified bacterial sexually transmissible infection (STI). From 2014 to 2018, the overall number and rate of chlamydia notifications rose by 21% and 15% respectively.2 Most new chlamydia infections are occurring among young people aged 15– 29 years, and in 2019, women aged 15– 24 years old recorded higher notification rates per 100 000 population compared with similarly aged men. An important exception is that notification rates appear to be falling in women under 25 years old,3 for whom chlamydia testing rates have plateaued and positivity among those tested is declining.4 In addition to people with female reproductive organs and young people aged 15– 29 years, chlamydia is also disproportionately high among Aboriginal and Torres Strait Islander people, people living in remote and very remote areas, those with greater socioeconomic disadvantage,5 and among gay and bisexual men.6 People who are pregnant are also a priority population, where chlamydia infection is associated with miscarriage, stillbirth, preterm birth, low birth weight, and postpartum infections in the mother and/or newborn.7,8 Once treated, an individual may become reinfected, contributing to further potential transmission and increasing the risk of morbidity in the form of pelvic inflammatory disease (PID), ectopic pregnancies, infertility, and chronic pelvic pain.9 Chlamydia remains a significant public health issue in Australia, with the search for novel prevention and management strategies ongoing.