Prevalence and epidemiologic correlates of chlamydia trachomatis in rural and urban populations

Article Abstract:

Chlamydia trachomatis, the most common sexually transmitted bacteria, can be present without causing symptoms. Chronic or untreated infections can cause swelling in the fallopian tubes, which can lead to infertility. An increase in the number of ectopic pregnancies, in which the fertilized embryo becomes implanted outside of the uterus, has been attributed to chronic chlamydia infections. Since current screening procedures are too expensive to perform routinely, the identification of women at risk becomes an important prescreening tool. To be able to use these risk factors reliably to predict which women should be screened, the incidence of infection in both metropolitan and rural clinics must be established. Family planning clinics in both types of region screened a total of 889 women. There was no difference in the number of cases diagnosed between rural and metropolitan clinics. Women who were younger than 25 years old, taking birth control pills, with a history of gonorrhea, an abnormal or large amount of vaginal discharge, or with a structurally abnormal cervix were at a higher risk for chlamydia infections. Age, abnormal discharge, contraceptive method and gonorrhea infection were the four factors involving risk among women living in the urban areas. Abnormal and excess vaginal discharge and cervical abnormalities were factors predicting risk in the rural populations. Other studies to identify risk factors concluded that the number of sexual partners was a factor, but this was not so in this study. Of the women with a previous negative test result, 12.4 percent were positive one year later. One out of 10 women initially testing positive were negative at follow-up, and therefore screening and treatment were effective. In light of the potential consequences of an undiagnosed chlamydial infection, it is suggested that all women under 25 be screened. (Consumer Summary produced by Reliance Medical Information, Inc.)

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Chlamydia trachomatis infection in women attending urban midwestern family planning and community health clinics: risk factors, selective screening, and evaluation of non-culture techniques

Article Abstract:

Infection due to Chlamydia trachomatis (CT) is the most commonly reported notifiable disease in Wisconsin. This organism is a cause of pelvic inflammatory disease, urethritis, and cervicitis. These diseases are frequently only mildly symptomatic or asymptomatic. Many risk factors are known, and include younger age, increased sexual exposure, cervicitis, and the use of contraceptive methods that act without physical barriers. Direct fluorescent antibody (DFA) and enzyme immunoassay (EIA) tests are now used more frequently to detect this infection, replacing tissue techniques. They also have greater specificity and sensitivity than other test procedures. A project was initiated to determine risk factors and the prevalence of endocervical CT infections in women residing in the Milwaukee area. Evaluation of DFA and EIA tests, both non-culture procedures, was also included in the protocols. The study group included 849 women who were drawn from two family planning clinics and one community health center. The demographic details are described. The results showed that, on the basis of tissue culture evidence, the prevalence of CT was 12.4 percent. None of the other procedures had sufficient predictive values to suggest their usefulness in a selective screening program. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Testing

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Decreased prevalence of Chlamydia trachomatis infection associated with a selective screening program in family planning clinics in Wisconsin

Article Abstract:

A statewide screening program in Wisconsin family planning clinics may have reduced the incidence of infections caused by Chlamydia trachomatis among women. Infections caused by Chlamydia trachomatis are sexually transmitted and can cause pelvic inflammatory disease and infertility in women. Among 1,757 women who underwent testing for a Chlamydia infection between 1985 and 1990, 1,252 were treated at four rural family planning clinics and 495 were treated at an urban family clinic. Eleven percent of the women tested at the rural family planning clinics were diagnosed with a Chlamydia infection in 1985, compared with 5% of those tested in 1990. Thirteen percent of the women tested at the urban family planning clinic were diagnosed with a Chlamydia infection in 1986, compared with 7% of those tested in 1990. The reduction in Chlamydia infections was similar among women in both the low-risk and high-risk groups for sexually transmitted diseases.

Evaluation, Medical screening, Health screening

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