RT Journal Article SR Electronic T1 High rates of anorectal chlamydia in women: a cross-sectional study in general practice JF BJGP Open JO BJGP Open FD Royal College of General Practitioners SP BJGPO.2021.0223 DO 10.3399/BJGPO.2021.0223 VO 6 IS 3 A1 Elisabeth AB A1 Dirk Luijt A1 Alewijn Ott A1 Janny H Dekker YR 2022 UL http://bjgpopen.org/content/6/3/BJGPO.2021.0223.abstract AB Background Genital and anorectal Chlamydia trachomatis (CT) frequently present together in sexually transmitted infection (STI) clinics.Aim To investigate the prevalence of co-occurrent genital and anorectal chlamydia infection, and to study whether sexual behaviour is associated with anorectal infection.Design & setting A cross-sectional study in general practices in the north of the Netherlands.Method Women attending general practice with an indication for genital chlamydia testing were included and asked to complete a structured questionnaire on sexual behaviour. Anorectal infection prevalence was compared according to testing indications: standard versus experimental (based on questionnaire answers). Variables associated with anorectal chlamydia were analysed by univariate and multivariate logistic regression analyses.Results Data could be analysed for 497 of 515 women included. Overall, 17.8% (n = 87/490) were positive for CT; of these, 72.4% (n = 63/87) had co-occurrent genital and anorectal infection, 13.8% (n = 12/87) had genital infection only, and 12.6% (n = 11/87) had anorectal infection only. Rectal infection was missed in 69.3% of cases using the standard indication alone, while adding the sexual history still missed 20.0%. Age was the only variable significantly associated with anorectal infection.Conclusion The prevalence of anorectal disease is high among women who visit their GP with an indication for genital CT testing. Many anorectal infections are missed despite taking comprehensive sexual histories, meaning that standard treatment of genital infection with azithromycin may result in rectal persistence. Performing anorectal testing in all women with an indication for genital CT testing is, therefore, recommended.