Abstract
Infections with Chlamydia trachomatis (CT) can lead to severe sequelae; however, they are not notifiable in Germany. We tested urine samples from participants of KiGGS (German Health Interview and Examination Survey for Children and Adolescents) for CT infections and linked the results to demographic and behavioural data from 1,925 participants (girls aged 15-17 years and boys aged 16-17 years) to determine a representative prevalence of CT infection in adolescents in Germany and to assess associated risk factors. Prevalence of CT infection was 2.2% (95% CI: 1.4-3.5) in girls and 0.2% (95% CI: 0.1-0.7) in boys. CT infection in girls was associated with higher use of alcohol, marijuana and cigarettes, lower social status, oral contraceptive use, pregnancy, repeated lower abdominal pain and higher rates of doctors' consultations within the preceding three months and consultation of gynaecologists within the last 12 months. In multiple logistic regression, we identified two predictors for CT infection: marijuana consumption often or several times within the last 12 months (F(1,164)=7.56; p<0.05) and general health status less than 'very good' (F(1,164)=3.83; p=0.052). Given our findings, we recommend enhancing sex education before sexual debut and promoting safe sex practices regardless of the contraceptive method used. Well-informed consumption of alcohol should be promoted, the risky behaviour of people intoxicated through consumption of marijuana highlighted and doctors' awareness of CT screening enhanced.
Highlights
Infections with Chlamydia trachomatis (CT) are the most frequently reported urogenital, bacterial sexually transmitted infections (STIs) worldwide
In our study presented here, we retrospectively tested urine samples from 1,925 KiGGS participants for CT infection and linked the results to the participants’ demographic and behavioural data to determine a representative prevalence of CT infection in adolescents in Germany and to assess associated risk factors
We have previously reported the results of a random sample of 12–17 year-old KiGGS participants that was tested for CT in pools of four [18]
Summary
Infections with Chlamydia trachomatis (CT) are the most frequently reported urogenital, bacterial sexually transmitted infections (STIs) worldwide. Latest figures (2005) from the World Health Organization (WHO) show that there were an estimated 101.5 million new cases per year of CT infection among adults aged 15 to 49 years [1]. In Europe, prevalence of CT infection among unscreened asymptomatic women ranges between 1.7% and 17% [2], with sexually active women and men under the age of 20 years and 25 years respectively being most affected. CT infections are asymptomatic in up to 90% of women and more than 50% of men [3]. Chlamydial infections can cause infertility in men and women and according to WHO, 10–15% of women with untreated infections develop symptomatic pelvic inflammatory disease or other severe sequelae such as infertility or extrauterine pregnancies [4]. The effect of screening programmes and intensified testing, CT persistence and natural history of CT infections are still under debate [5,6,7,8,9,10]
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