Abstract
Chlamydia trachomatis (CT) infections are not reportable in Germany and limited data on prevalence are available. CT screening has been offered free of charge to pregnant women since 1995 and to all women under 25 years since 2008. For symptomatic women and men, diagnostic testing is covered by statutory health insurance. We describe the establishment of a nationwide, laboratory-based, voluntary sentinel that electronically collects information on all performed CT tests with test results, test reason and patient information. The sentinel represents one third of all performed CT tests in Germany. In the period from 2008 to 2014, 3,877,588 CT tests were reported, 93% in women. Women aged 20–24 years and men aged 25–29 years were the most frequently tested age groups. The overall proportion of positive tests (PPT) among women was 3.9% and among men 11.0%. The highest PPT among women was in the age groups 15–19 (6.8%) and 20–24 years (5.9%), and among men in the age groups 20–24 (19.2%), 15–19 (15.4%) and 25–29 years (14.8%). The PPT for CT was high among women and men younger than 25 years. Prevention is urgently needed. Monitoring of CT infection in Germany should be continued.
Highlights
Infections with Chlamydia trachomatis (CT) rank among the most frequent sexually transmitted infections (STI) in Europe and worldwide [1,2]
Sixty-seven per cent of the diagnosed CT infections were among women, many of them working as sex workers who attended the free-of-charge local municipality counselling clinics
Of the 60 laboratories selected for recruitment, 24 agreed to participate and have been reporting data to the CT laboratory sentinel
Summary
Infections with Chlamydia trachomatis (CT) rank among the most frequent sexually transmitted infections (STI) in Europe and worldwide [1,2]. According to European data, the most affected age groups are women aged 15–24 years and men aged 20–24 years [2,3].The CT infection may be asymptomatic and can, if not detected and treated, result in complications such as pelvic inflammatory disease, chronic abdominal pain, ectopic pregnancy, tubal sterility, a higher risk of adverse pregnancy outcomes for women and of epididymitis for men [3,4,5,6,7,8,9,10]. In population-wide studies in Germany performed between 2003 and 2006, we observed a prevalence of up to 4.5% among women aged 17–19 years and 4.9% among men aged 25–29 years [12,13,14]. Sixty-seven per cent of the diagnosed CT infections were among women, many of them working as sex workers who attended the free-of-charge local municipality counselling clinics. The median age of infected women was 25 years and of men 31 years [15,16]
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