Vuylsteke B, Vandenbruaene M, Vandenbalcke P, Van Dyck E, Laga M
Institute of Tropical Medicine, Antwerp, Belgium.
Sex Transm Infect. 1999 Jun;75(3):152-5. doi: 10.1136/sti.75.3.152.
To determine prevalence and risk factors of Chlamydia trachomatis among female secondary school students and to develop potential selective screening strategies.
A cross sectional survey was conducted in the 17 school medical centres in Antwerp municipality, Belgium. All female students of forms 5 or 6, who were due for their medical check up during the school year 1996-7, were invited to participate. A self administered questionnaire on general and sexual behaviour, and a first void urine sample were collected. The urine specimen was tested for C trachomatis with ligase chain reaction assay, and positive tests were confirmed with polymerase chain reaction assays.
2784 female students participated in the study. Their median age was 17, and 52% of them reported having sexual intercourse at least once. The prevalence of C trachomatis among sexually active women was 1.4%. Factors significantly associated with infection in multivariate analysis were number of lifetime partners, genital complaints of partner, type of secondary school, and a history of pregnancy. Selective screening of those women who are at highest risk for infection would have detected 90% of all infections, and require testing of 14% to 18% of the population.
The prevalence of C trachomatis was relatively low among female secondary school students in Antwerp, but unsafe sex practices were evident because of the high number of unplanned pregnancies. Selective screening strategies with a high sensitivity can be proposed, but should be assessed for acceptability, feasibility, and cost.
确定比利时安特卫普市中学女生沙眼衣原体的患病率及危险因素，并制定潜在的选择性筛查策略。
在比利时安特卫普市的17个学校医疗中心进行了一项横断面调查。邀请了所有在1996 - 1997学年应进行体检的5或6年级女生参加。收集了一份关于一般行为和性行为的自填问卷以及首次晨尿样本。尿液标本采用连接酶链反应检测沙眼衣原体，阳性检测结果用聚合酶链反应检测进行确认。
2784名女生参与了研究。她们的年龄中位数为17岁，其中52%的女生报告至少有过一次性行为。性活跃女性中沙眼衣原体的患病率为1.4%。多因素分析中与感染显著相关的因素有终身性伴侣数量、性伴侣的生殖器不适、中学类型以及怀孕史。对感染风险最高的女性进行选择性筛查可检测出所有感染病例的90%，且需要对14%至18%的人群进行检测。
安特卫普市中学女生中沙眼衣原体的患病率相对较低，但由于意外怀孕数量较多，不安全的性行为较为明显。可以提出具有高灵敏度的选择性筛查策略，但应评估其可接受性、可行性和成本。
