Criteria for selective screening of cervical Chlamydia trachomatis infections in women attending private gynecology practices

Abstract

Objective: To develop a screening strategy for Chlamydia trachomatis in private gynecology practices. Study design: Forty-six gynecologists in the greater Paris area systematically screened all consecutive female attenders during one week. Endocervical swabs were tested by enzyme immunoassay, and, if positive, was further confirmed by direct fluorescent antibody test. Results: Overall (out of 1893 women tested), the chlamydia prevalence was 0.8% (95% confidence interval: 0.32–1.2%). Among women younger than 21 years, the prevalence was 5.2% (95%, CI 0.8–9.6). Having had a new sexual partner in the last year was associated with chlamydial infection, independent of age. However, half of the infected women had not had a new partner. Conclusion: Even in this low risk population, the prevalence was high among young women. Most of these infections would probably not have been detected. We developed a strategy which would have detected 81% of chlamydia positive women by testing only one third of the patients.