Évaluation des pratiques, en médecine générale, concernant le diagnostic et le dépistage des infections génito-urinaires à Chlamydia Trachomatis, vers l'élargissement du dépistage organisé à la médecine générale

Abstract : Introduction: Chlamydia trachomatis (Ct), the most common sexually transmitted infection in industrialized countries, is a public health problem because of its complications (high genital infections, infertility) in women and its growing incidence favoured by its predominantly asymptomatic nature. The French screening program since 2003 targets young people in dedicated centers. The recommendations provided for the extension to general practitioners but the feasibility remains to be studied. Method: Descriptive study in which 109 GPs randomly selected in the Bouches-du-Rhône department were interviewed through a questionnaire sent by email aiming to: evaluate their practices of diagnosis of Ct infections, study the impact of the main brakes and factors favouring screening, as well as to get their opinion on their inclusion in future recommendations. Results: 49.5% of the doctors showed satisfactory knowledge of the pathology, those who declared having a competence or an attraction for the gynecology in their practice had the best notions (p = 0,028 OR 3,947 IC95 [1,140; 13,660]). 74.3% knew the age group of highest prevalence (under 25 years for women and 30 years for men), An installation time greater than 10 years would be associated with a better identification of the ages most concerned by Ct infection (p = 0.03 OR 2.938 IC95 [1.099, 7.855]). 22.9% chose diagnostic methods according to the recommendations, the attraction for gynecology conferred a benefit (p = 0.032 OR 3.738 IC95 [1.121, 12.460]). The women said they were looking for more infection (p = 0.014 OR 2.992 IC95 [1.253, 7.142]). Doctors cited the difficulty of thinking about looking for infection during an unspecified consultation, cultural taboos and the intrusive aspect as barriers to possible screening. 97% of physicians were in favour of involvement in targeted screening organized in general practice. Conclusion: These results show that general practitioners could be future competent actors of a targeted screening organized in primary care.
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Eric Payraudeau. Évaluation des pratiques, en médecine générale, concernant le diagnostic et le dépistage des infections génito-urinaires à Chlamydia Trachomatis, vers l'élargissement du dépistage organisé à la médecine générale. Sciences du Vivant [q-bio]. 2018. ⟨dumas-02086423⟩

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