Incidence Of Chlamydia Trachomatis Research Articles

Co-infection with human papillomavirus and sexually transmitted infections among Chinese individuals

ObjectivesThis study aimed to investigate the prevalence of Human Papillomavirus (HPV), Sexually Transmitted Infections (STIs) and their co-infections on different genders and ages. MethodsDifferent samples of secretions from the reproductive system were collected from 459 males and 494 females for HPV and STI detection. ResultsTotal HPV infection rate was 49.46 % for males and 48.99 % for females, and the distribution of HPV subtypes varied significantly between different genders. The infection rate of HR-HPV 52 and 31 in females was higher than that in males (p = 0.002 and 0.039, respectively). In contrast, the infection rate of LR-HPV 6 and 11 in males was higher than that in females (p = 0.01 and 0.001, respectively). Females had a significantly higher infection rate of Ureaplasma urealyticum (UU). Besides, these STIs were stratified based on age and the results indicated that the highest incidence of STIs was observed in younger patients (<20 years old). Patients with HPV infections had a higher incidence of Chlamydia trachomatis (CT) in both males and females. ConclusionsThere is a need to perform HPV, CT and UU screening among patients, and more thorough health education for younger patients is of great clinical significance to improve treatment and prognosis.

Very High Incidence of Chlamydia trachomatis, Neisseria gonorrhoeae, and Treponema pallidum among Low-Risk MSM in an Outpatient Clinic in Wroclaw, Poland in 2019-2020.

The rise in sexually transmitted infections and chemsex has led to syndemy with HIV, partly due to common routes of transmission and clustered transmissions. Despite this, barriers to STI care and PrEP still remain. We sought to determine whether MSM at low risk for HIV infection were also at low risk for other STIs. The study group was tested for HIV, HCV, and Treponema pallidum, as well as had urethral, rectal, and oropharyngeal smears performed for Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) six months apart. The control group was tested once to define the background incidence. Treponema pallidum, CT, and NG prevalence was very high at both time points and was similar to the control group. CT was especially common in the control group (20.58%) and the study group at the rectal site at the second time point (9.37%). NG dominated the oropharyngeal site (15.87%), with urethral site sparing. NG infection was associated with an increased number of partners, not condom use (OR, 1.082 [95% CI; 1.009-1.171]). Risk behavior did not change between the time points. Treponema pallidum, CT, and NG incidence was exceptionally high (12.5/100PY, 25.39/100PY, 34.92/100PY, respectively; pooled 87.5/100PY) and was comparable to other studies of high-risk MSM. Despite a lower risk for HIV acquisition, the study group was at a very high risk for other STIs, and this risk remained high throughout the study. Patients and medical professionals should be aware of syphilis, gonorrhea, and chlamydiosis transmission risks, and screening should be performed accordingly. Prophylactic programs need to be updated to specifically include lower-risk individuals.

Incident Chlamydia trachomatis Infection in a High School Population.

Simple SummaryAfter a pathogen that causes disease has been introduced in a human population, an understanding of that disease in the population depends on knowing how many people in the population have the disease (prevalence), how fast the disease spreads from one person to another within the population (incidence), and how long the disease remains in an individual once acquired (duration). Infections caused by Chlamydia trachomatis are the most common sexually transmitted bacterial infections in the world. Individuals younger than 25 are the most affected due to the patterns of their sexual activity. In most individuals, these infections do not produce symptoms. Thus, affected individuals usually are not prompted to seek care, and most cases can only be detected through screening. Screenings for chlamydia in United States schools have given an indication of how many adolescents in the population might have chlamydia. In this study, we assessed how quickly chlamydia is acquired within the adolescent population. We determined that 14–19-year-old adolescents are acquiring chlamydia at a pace of 6.6 cases per 100 person-years for boys and 11.9 cases per 100 person-years for girls. Male and female students are acquiring chlamydia within 10 and within 7 months, respectively.Prospective cohort studies of sexually transmitted infections (STIs) are logistically impractical owing to time and expenses. In schools, students are readily available for school-related follow-ups and monitoring. Capitalizing on the logistics that society already commits to ensure regular attendance of adolescents in school, a school-based STI screening in New Orleans made it possible to naturally observe the occurrence of chlamydia and to determine its incidence among 14–19-year-old adolescents. Among participants screened repeatedly, we calculated incidence rates, cumulative incidence, and incidence times. Male (n = 3820) and female (n = 3501) students were observed for 6251 and 5143 person-years, respectively, during which 415 boys and 610 girls acquired chlamydia. Incidence rates per 100 person-years were 6.6 cases for boys and 11.9 cases for girls. In multivariable analysis, the adjusted hazard ratio was 5.34 for boys and 3.68 for girls if the student tested positive for gonorrhea during follow-up, and 2.76 for boys and 1.59 for girls if at first participation the student tested positive for chlamydia, and it increased with age among boys but not among girls. In joinpoint trend analysis, the annual percentage change in the incidence rate was 6.6% for boys (95% CI: −1.2%, 15.1%) and 0.1% for girls (95% CI: −5.3%, 5.7%). Annual cumulative incidence was 5.5% among boys and 8.6% among girls. Median incidence time was 9.7 months for boys and 6.9 months for girls. Our findings can be used to refine assumptions in mathematical modeling and in cost analysis studies of C. trachomatis infection, and provide strong evidence in support of annual chlamydia screening for adolescent boys.

Doxycycline post-exposure prophylaxis for prevention of sexually transmitted infections among Kenyan women using HIV pre-exposure prophylaxis: study protocol for an open-label randomized trial

BackgroundWomen in Africa face disproportionate risk of human immunodeficiency virus (HIV) acquisition, accounting for more than half of new infections in Africa and similarly face a disproportionate burden of sexually transmitted infections (STIs). Very high STI prevalence is being observed globally, especially among people taking pre-exposure prophylaxis (PrEP) for HIV prevention. Doxycycline post-exposure prophylaxis (dPEP) has been proposed as an STI prevention strategy to reduce chlamydia, syphilis, and possibly gonorrhea, and trials are ongoing among cisgender men who have sex with men (MSM) and transgender women who are taking PrEP in high-income settings. We designed and describe here the first open-label trial to determine the effectiveness of dPEP to reduce STI incidence among cisgender women.MethodsWe are conducting an open-label 1:1 randomized trial of dPEP versus standard of care (STI screening and treatment and risk-reduction counseling without dPEP) among 446 Kenyan women aged ≥ 18 and ≤ 30 years old women taking PrEP. Women are followed for 12 months, with quarterly STI testing, treatment, and adherence counseling. The primary trial outcome will be the combined incidence of Chlamydia trachomatis, Neisseria gonorrhoeae, and Treponema pallidum, compared between the randomized groups. We will also assess dPEP acceptability, tolerability, safety, impact on sexual behavior, adherence, and occurrence of antimicrobial resistance (AMR) in N. gonorrhoeae and C. trachomatis isolates. Finally, we will estimate cost per incident STI case and complications averted accounting for nonadherence and benefits relative AMR or side effects.DiscussionThe results of this trial may have immediate implications for the global epidemic of STIs and sexual health. If effective, dPEP could put STI prevention into women’s hands. While dPEP may be able to prevent STIs, it carries important risks that could counter its benefits; global debate about the balance of these potential risks and benefits requires data to inform policy and implementation and our study aims to fill this gap.Trial registrationClinicalTrials.gov NCT04050540.

Changes in testing and incidence of Chlamydia trachomatis and Neisseria gonorrhoeae – the possible impact of the COVID-19 pandemic in the three Scandinavian countries

Background This study aimed to investigate what impact the COVID-19 pandemic and its associated restrictions had on Chlamydia trachomatis and Neisseria gonorrhoeae infections in Sweden, Denmark and Norway, countries with very different governmental strategies for handling this pandemic. Methods Retrospective analysis of data collected via requests to Swedish regions and to health authorities in Denmark and Norway. The data were collected for the years 2018–2020 and the data from Sweden were more detailed. Results When the pandemic restrictions were installed in 2020, the number of reported chlamydia cases decreased. The decline was most pronounced in Norway 10.8% (2019: n = 28,446; 2020: n = 25,444) while it was only 3.1% in Denmark (2019: n = 35,688; 2020: n = 34,689) and 4.3% in Sweden (2019: n = 34,726; 2020: n = 33,339). Nucleic acid amplifications tests for chlamydia decreased in Sweden (10%) and Norway (18%) in 2020 compared to 2019, while in Denmark a 21% decrease was noted in April 2020 but thereafter increased to a higher level than 2019. The number of reported gonorrhoea cases decreased in Sweden (17%) and in Norway (39%) in 2020 compared to 2019, while a 21% increase was noted in Denmark. Conclusions Pandemic restrictions had an impact on the number of reported chlamydia infections in all three countries, but only temporarily and did not seem to be correlated to the restriction levels. The number of reported gonorrhoea infections in Sweden and Norway significantly decreased but not in Denmark. Pandemic restrictions appear to have had a limited effect on the spread of chlamydia and gonorrhoea.

Predicting Chlamydia Trachomatis Infection in a Mining Community in Western Ghana

Chlamydia Trachomatis (CT) infection among females in a mining community in Western Ghana is a major medical issue. Screening using laboratory test results have been the usual control and prevention of STI globally but have been found to have its own limitations due to delay in test results leading to further transmission of genital infections. Consequently, a statistical model is formulated to predict the incidence of Chlamydia Trachomatis (CT) infection among females in the community. The model used a Modified Univariate Normal Discriminant Function, a Logistic Regression Model and specific symptoms associated with Chlamydial infection as part of the explanatory variables. Samples were taken from 186 patients consisting of 40 males and 146 females from two hospitals in the Tarkwa Nsuaem Municipality, a mining community in Western Ghana. The model was validated using a sensitivity analysis test and Apparent Error Rate (APER). The model predicted decreasing infection rate of patients with increasing age. The most reported and significant symptoms among the female patients diagnosed was vaginal discharge, (p<0.05). The study predicted a patient as positive or infected with Chlamydial, if the result of the model evaluated gave a positive value, otherwise the patient was declared free of infection. Further analysis of the proposed Statistical Chlamydia Trachomatis (SCT) model gave a sensitivity of 84% which was consistent with other research findings like the rapid point of care (POC) diagnostic test for Chlamydial infection with sensitivity range of 55–85% for high prevalence populations. The study observed that young females in mining communities are at risk of acquiring Chlamydial T infection if presenting with vaginal discharge. Identifying these risk factors associated with Chlamydial infection among young women in the mining communities would help inform health care officials the rate of infection in the Municipality, and accordingly mount public educational health campaign in the Municipality aimed at minimizing the spread of chlamydial infections and any other STI.

Incident gonorrhoea and chlamydia among a prospective cohort of men who have sex with men in Kisumu, Kenya

ObjectiveSTIs disproportionately affect men who have sex with men (MSM) in sub-Saharan Africa. We identified factors associated with incident Chlamydiatrachomatis (CT) and Neisseriagonorrhoeae (NG) infections among MSM in the Anza...

Incidence of Chlamydia trachomatis detected by PCR in women’s endocervical samples in Lages, Santa Catarina, Brazil

ABSTRACT Introduction: Chlamydia trachomatis is one of the major causative agents of sexually transmitted infections (STI) in men and women, but the greatest impact of infection occurs in the reproductive system of women, causing, among other problems, infertility. Objective: To estimate the incidence of C. trachomatis detected by the polymerase chain reaction (PCR) technique in endocervical samples from women in Lages, Santa Catarina, Brazil. Methods: A descriptive, quantitative, cross-sectional study was conducted from May to November 2017. Endocervical cell samples were collected from 126 women that receive medical assistance at three primary healthcare units and one gynecology clinic in the city. The samples of endocervical material were evaluated for the diagnosis of C. trachomatis by the PCR technique. Prior to sample collection, a Cancer Information System (SISCAN) standard questionnaire was answered by the participants. Fisher's exact test and chi-square test were used to evaluate the association between infection and the variables of the questionnaire. Results: From the 126 endocervical samples analyzed, 39.7% were positive for C. trachomatis. The average age of the participants was 31.7 years old. From the 118 women who did not show changes in the cervix, 43 were positive for C. trachomatis, which reinforces the asymptomatic character of the infection. There was no significant association between endocervical infection by C. trachomatis and age, use of contraceptive pill, time of last pap test and signs of STI. Conclusion: The incidence of C. trachomatis infection in the endocervical samples from these women can be considered high, which emphasizes the importance of measures designed to clarify and prevent this important STI.

Time series analysis and forecasting of chlamydia trachomatis incidence using surveillance data from 2008 to 2019 in Shenzhen, China

Abstract Chlamydia trachomatis (CT) infection has been a major public health threat globally. Monitoring and prediction of CT epidemic status and trends are important for programme planning, allocating resources and assessing impact; however, such activities are limited in China. In this study, we aimed to apply a seasonal autoregressive integrated moving average (SARIMA) model to predict the incidence of CT infection in Shenzhen city, China. The monthly incidence of CT between January 2008 and June 2019 in Shenzhen was used to fit and validate the SARIMA model. A seasonal fluctuation and a slightly increasing pattern of a long-term trend were revealed in the time series of CT incidence. The monthly CT incidence ranged from 4.80/100 000 to 21.56/100 000. The mean absolute percentage error value of the optimal model was 8.08%. The SARIMA model could be applied to effectively predict the short-term CT incidence in Shenzhen and provide support for the development of interventions for disease control and prevention.

Prophylaxis for ophthalmia neonatorum in Brazil: A snapshot using a multi-professional national survey.

Brazil is a large country with an elevated incidence of Chlamydiatrachomatis (CT) and Neisseriagonorrhoeae (NG) during pregnancy and variable access to health care. The objective of the study was to identify ophthalmia neonatorum prophylaxis practices in the country. A prospective multidisciplinary survey was conducted using a closed social media group. Fifteen questions were developed after literature review. Specific content included categorization of respondents and practices such as type of medication, age at administration, occurrence of clinical and/or chemical conjunctivitis and microbiology identification. Questions were multiple choice, but some allowed written response. A total of 1.015 professionals responded, representing 24 states (92%) and 181 cities; mainly neonatologists (64%) and general pediatricians (21%). 96% of respondents reported performing prophylaxis at their institutions, mostly at birth or <1 h of life (99%), and regardless the mode of delivery (73%). Frequently used medications are: 1% silver nitrate (64%), 2.5% povidone iodine (18%) or 10% silver vitelinate (12%), with some regional variations. Occurrence of chemical conjunctivitis was stated by 58% of the respondents and microbiology identification was unusual. Ophthalmia neonatorum prophylaxis Brazil is almost universal and mainly performed by the use of anti-septic medications, with some regional variability. However, identification and treatment of CT and NG in both parents and newborns is not accomplished.

Chlamydia trachomatis screening in preterm labor: A systematic review and meta-analysis

ObjectiveSpontaneous preterm labor (PTL) is responsible for approximately half of all preterm births with intrauterine infection being an important risk factor for PTL. Chlamydia trachomatis infections have been associated with preterm prelabor rupture of membranes (P-PROM) and preterm birth, but its impact on PTL has not previously been specified. The aim of this study was to evaluate the overall prevalence of Chlamydia trachomatis infections in pregnant women with threatened PTL compared to those not in threatened PTL. Study designA literature search was performed in electronic databases using combinations of: “Chlamydia”, “vaginal cervical infection” and “preterm labor.” Cohort and case-controlled studies examining threatened PTL and Chlamydia trachomatis infection demonstrated by culture or NAAT methods at time of diagnosis of threatened labor. The Meta-analyses of Observational Studies in Epidemiology (MOOSE) guidelines for reporting of observational studies for systematic reviews was used. Bias was assessed with the Methodological Index for Non-Randomized Studies (MINORS) score. Meta-analysis was performed using a random effects model. ResultsFour studies were identified. A total of 591 women were included, 309 in the threatened PTL, and 282 controls not in threatened PTL. Women presenting in PTL had an increased risk of screening positive for Chlamydia trachomatis compared to the control group (27/308 (9%) vs 3/282 (1%); OR 7.74, 95% CI 2.64–22.71). ConclusionsThe incidence of Chlamydia trachomatis in women with threatened PTL is approximately 9%, and significantly increased compared to asymptomatic controls. Women with threatened PTL should be considered for screening for Chlamydia trachomatis.

ABO blood group and incidence of Chlamydia trachomatis, Trichomonas vaginalis infections among child bearing women in Kirkuk Province

ABO blood group and incidence of Chlamydia trachomatis, Trichomonas vaginalis infections among child bearing women in Kirkuk Province

Incidence of Chlamydia trachomatis and Trichomonas Vaginalis Genital Infections among Non-Pregnant Women in Al - Najaf Province

Background: Trichomonas vaginalis infections are greatly connected with the Existence of other STIs (gonorrhea, chlamydia, and Human Immunodeficiency Virus). Aims of study: To investigate the infection rate of Chlamydia trachomatis and Trichomonas vaginalis in women who attended to Al-Zahraa Hospital for Maternity and Children in Al- Najaf city. Methods: A cross-sectional study conducted on 86 women was attended to Al-Zahraa Hospital for Maternity and Children in Al- Najaf city at period between Aprils to September 2018. Cervical samples were taken from women suffering from cervicitis or cervical erosion to detect the Chlamydia trachomatis and Trichomonas vaginalis. Results: the results show there was 50 positive samples with Chlamydia trachomatis (58.2%) and 36 sample negative (41.8%) and showed there was 24 positive samples with Trichomonas vaginalis (27.9) % and negative was 62 (72.1) % with significant difference (P ≤ 0.05) between positive and negative patients. There was no associated between these microorganisms and use contraceptive or none, mode of delivery and time of the menstrual cycle. Conclusion: This study concludes high percentage of Chlamydia trachomatis with intermediate percentage of Trichomonas vaginalis among women in Al- Najaf city. No significant effect between these organisms and the variables in this study may be indicate the ability of them to spread in any case and required the accurately diagnosed and treated. Recommendation: As a result, the present study recommends the epidemiological study of migratory diseases periodically and increasing the awareness procedures for the damage of these diseases and their risks.

Polymerase chain reaction chlamydia trachomatis examination in nonspecific genital infection patients

Introduction: Nonspecific genital infection (NSGI) is an inflammation of urethra, rectum, or cervix that caused by nonspecific bacteria. Chlamydia trachomatis is known as the most causal organism of NSGI, usually mild (mucopurulent discharge) or asymptomatic, and if untreated it can cause serious complication such as pelvic inflammatory disease that leads to infertility in women. The diagnosis of Chlamydia trachomatis needs an advanced method, such as polymerase chain reaction (PCR). PCR has high sensitivity and specificity, and endocervical swab is specimen of choice that also has high sensitivity and specificity to diagnose Chlamydia trachomatis. Method: This research aims to evaluate if Chlamydia trachomatis is the most causal organism of NSGI by PCR Chlamydia trachomatis using 201bp primers. Results: Eighteen NSGI married patients who came to outpatient clinic were evaluated from endocervical swab. The result demonstrated that 16,67% from eighteen NSGI patient positive Chlamydia trachomatis. Conclusion: The low incidence of Chlamydia trachomatis in low risk population such in this study need further study, the cause of NSGI needs to be known certainly so the exact treatment can be given.

Chlamydia trachomatis screening in urine among asymptomatic men attending an STI clinic in Paris: a cross-sectional study

BackgroundThe incidence of Chlamydia trachomatis (Ct) urethritis has been increasing for the past 10 years. There is little data regarding the screening of Ct infection in asymptomatic men in France, despite the national recommendation to screen at-risk asymptomatic men under 30 attending Sexually Transmitted Infections (STI) clinics. Recent data from the French surveillance network Rénachla show indeed that systematic screening is still focused on women. The objective of our study was to determine the prevalence and risk factors for Ct infection in asymptomatic men under 30 attending an STI clinic located in Paris, France.MethodsWe performed a cross-sectional study between April 4, and December 31, 2016 in the database of the software DIAMM Client V8 used in our STI clinic. We extracted the demographic characteristics, sexual behavior and result of STI screening of all asymptomatic men who had consulted and given their consent for the use of their personal data. Those data were collected in usual care through a standardized questionnaire filled in during an appointment with a trained physician. STI screening was performed using PCR kit CT/NG Abbott Realtime® on first void urines. For MSM, a rectal swab was also collected. Risk factors for Ct infection were analyzed by univariate and multivariate modeling using STATA software 8.2.ResultsAmong 872 men who had attended the clinic, 647 were included and 37 (5.7, 95% CI 4.2 to 7.8) were positive for Ct in urine. In univariate analysis, men who had unprotected sex in the last 6 weeks (OR 2.40 (95%CI 1.16 to 4.94), p = 0.02), and those who had an infected partner (OR 7.6 (95%CI 3.03 to 20), p = 0.0001) were more likely to be infected. In the multivariate analysis having an infected partner was the only risk factor (OR 11.1(95% CI 3.7 to 33.3), p = 0.0001) that remained significant.ConclusionPrevalence of Ct infection is high among asymptomatic men of 30 years or less attending our urban STI clinic especially among those with an infected partner. The Ct screening among this population associated with partner notification, as recommended by the French national guidelines, should be more widely implemented.

Weekly variations in feelings of trust predict incident STI within a prospective cohort of adolescent women from a US city

ObjectivesFeelings of intimacy, perceptions of partner concurrency (PPC) and perceptions of risk for an STD (PRSTD) are meaningful and dynamic attributes of adolescent sexual relationships. Our objective was to examine...

Pharmacy-level barriers to implementing expedited partner therapy in Baltimore, Maryland

Addressing record high rates of Chlamydia trachomatis incidence in the United States requires the utilization of effective strategies, such as expedited partner therapy, to reduce reinfection and further transmission. Expedited partner therapy, which can be given as a prescription or medication, is a strategy to treat the sexual partners of index patients diagnosed with a sexually transmitted infection without prior medical evaluation of the partners. There are multiple steps in the prescription-expedited partner therapy cascade, and we sought to identify pharmacy-level barriers to implementing prescription-expedited partner therapy for Chlamydia trachomatis treatment. We used spatial analysis and ArcGIS, a geographic information system, to map and assess geospatial access to pharmacies within Baltimore, MD, neighborhoods with the highest rates of Chlamydia trachomatis (1180.25-4255.31 per 100,000 persons). Expedited partner therapy knowledge and practices were collected via a telephone survey of pharmacists employed at retail pharmacies located in these same neighborhoods. Cost of antibiotic medication in US dollars wascollected. Census tracts with the highest Chlamydia trachomatis incidence rates had lower median pharmacy density than other census tracts (26.9 per 100,000 vs 31.4 per 100,000, P < .001). We identified 25 pharmacy deserts. Areas defined as pharmacy deserts had larger proportions of black and Hispanic or Latino populations compared with non-Hispanic whites (93.1% vs 6.3%, P < .001) and trended toward higher median Chlamydia trachomatis incidence rates (1170.0 per 100,000 vs 1094.5 per 100,000, P= .110) than non-pharmacy desert areas. Of the 52 pharmacies identified, 96% (50 of 52) responded to our survey. Less than a fifth of pharmacists (18%, 9 of 50) were aware of expedited partner therapy for Chlamydia trachomatis. Most pharmacists (59%, 27 of 46) confirmed they would fill an expedited partner therapy prescription. The cost of a single dose of azithromycin (1 g) ranged from 5.00 to 39.99 US dollars (median, 30 US dollars). Limited geographic access to pharmacies, lack of pharmacist awareness of expedited partner therapy, and wide variation in expedited partner therapy medication cost are potential barriers to implementing prescription-expedited partner therapy. Although most Baltimore pharmacists were unaware of expedited partner therapy, they were generally receptive to learning about and filling expedited partner therapy prescriptions. This finding suggests the need for wide dissemination of educational material targeted to pharmacists. In areas with limited geographic access to pharmacies, expedited partner therapy strategies that do not depend on partners physically accessing a pharmacy merit consideration.

Chlamydia trachomatis Incidence Using Self-Reports and Serology by Gender, Age Period, and Sexual Behavior in a Birth Cohort.

Although understanding chlamydia incidence assists prevention and control, analyses based on diagnosed infections may distort the findings. Therefore, we determined incidence and examined risks in a birth cohort based on self-reports and serology. Self-reported chlamydia and behavior data were collected from a cohort born in New Zealand in 1972/3 on several occasions to age 38 years. Sera drawn at ages 26, 32, and 38 years were tested for antibodies to Chlamydia trachomatis Pgp3 antigen using a recently developed assay, more sensitive in women (82.9%) than men (54.4%). Chlamydia incidence by age period (first coitus to age 26, 26-32, and 32-38 years) was calculated combining self-reports and serostatus and risk factors investigated by Poisson regression. By age 38 years, 32.7% of women and 20.9% of men had seroconverted or self-reported a diagnosis. The highest incidence rate was to age 26, 32.7 and 18.4 years per 1000 person-years for women and men, respectively. Incidence rates increased substantially with increasing number of sexual partners. After adjusting age period incidence rates for partner numbers, a relationship with age was not detected until 32 to 38 years, and then only for women. Chlamydia was common in this cohort by age 38, despite the moderate incidence rates by age period. The strongest risk factor for incident infection was the number of sexual partners. Age, up to 32 years, was not an independent factor after accounting for partner numbers, and then only for women. Behavior is more important than age when considering prevention strategies.

Sergamumas lytiškai plintančiomis infekcijomis Vilniaus mieste 2009–2015 metais

Straipsnyje pateikiami 2009 – 2015 metų VšĮ Centro poliklinikoje vykdytos visuomenės sveikatos priemonės, finansuojamos Vilniaus miesto savivaldybės visuomenės sveikatos rėmimo specialiosios programos lėšomis „Lytiškai plintančių infekcijų profilaktika“ duomenys. Nustatyta, kad 2009 – 2015 m. didžioji dalis moterų (net 86,4 proc.) dėl lytiškai plintančių infekcijų atvyko pasitikrinti profilaktiškai, ir tik 13,6 proc. moterų - turėdamos simptomatiką. Atlikti tyrimai rodo, kad iki 19 m. amžiaus grupėje Mycoplasma genitalium infekcijos paplitimas yra žymiai didesnis negu 40 – 50 m. amžiaus grupėje. Didžiausias sergamumas Chlamydia trachomatis lytiškai plintančia infekcija yra 20 – 29 m. amžiuje. Vertinant atliktų tyrimų rezultatus, nustatyta, kad amžiaus grupėse 20 – 29 m. ir 30 – 39 m. Ureaplasma urealyticum infekcijos paplitimas yra rečiausias, tačiau 40 – 50 m. amžiaus grupėje – dažniausias iš visų lytiškai plintančių infekcijų tirtų tarp moterų.

The natural history of Chlamydia trachomatis infection in women: a multi-parameter evidence synthesis.

The evidence base supporting the National Chlamydia Screening Programme, initiated in 2003, has been questioned repeatedly, with little consensus on modelling assumptions, parameter values or evidence sources to be used in cost-effectiveness analyses. The purpose of this project was to assemble all available evidence on the prevalence and incidence of Chlamydia trachomatis (CT) in the UK and its sequelae, pelvic inflammatory disease (PID), ectopic pregnancy (EP) and tubal factor infertility (TFI) to review the evidence base in its entirety, assess its consistency and, if possible, arrive at a coherent set of estimates consistent with all the evidence. Evidence was identified using 'high-yield' strategies. Bayesian Multi-Parameter Evidence Synthesis models were constructed for separate subparts of the clinical and population epidemiology of CT. Where possible, different types of data sources were statistically combined to derive coherent estimates. Where evidence was inconsistent, evidence sources were re-interpreted and new estimates derived on a post-hoc basis. An internally coherent set of estimates was generated, consistent with a multifaceted evidence base, fertility surveys and routine UK statistics on PID and EP. Among the key findings were that the risk of PID (symptomatic or asymptomatic) following an untreated CT infection is 17.1% [95% credible interval (CrI) 6% to 29%] and the risk of salpingitis is 7.3% (95% CrI 2.2% to 14.0%). In women aged 16-24 years, screened at annual intervals, at best, 61% (95% CrI 55% to 67%) of CT-related PID and 22% (95% CrI 7% to 43%) of all PID could be directly prevented. For women aged 16-44 years, the proportions of PID, EP and TFI that are attributable to CT are estimated to be 20% (95% CrI 6% to 38%), 4.9% (95% CrI 1.2% to 12%) and 29% (95% CrI 9% to 56%), respectively. The prevalence of TFI in the UK in women at the end of their reproductive lives is 1.1%: this is consistent with all PID carrying a relatively high risk of reproductive damage, whether diagnosed or not. Every 1000 CT infections in women aged 16-44 years, on average, gives rise to approximately 171 episodes of PID and 73 of salpingitis, 2.0 EPs and 5.1 women with TFI at age 44 years. The study establishes a set of interpretations of the major studies and study designs, under which a coherent set of estimates can be generated. CT is a significant cause of PID and TFI. CT screening is of benefit to the individual, but detection and treatment of incident infection may be more beneficial. Women with lower abdominal pain need better advice on when to seek early medical attention to avoid risk of reproductive damage. The study provides new insights into the reproductive risks of PID and the role of CT. Further research is required on the proportions of PID, EP and TFI attributable to CT to confirm predictions made in this report, and to improve the precision of key estimates. The cost-effectiveness of screening should be re-evaluated using the findings of this report. The Medical Research Council grant G0801947.