van Valkengoed I G, Morré S A, van den Brule A J, Meijer C J, Devillé W, Bouter L M, Boeke A J
Institute for Research in Extramural Medicine, Vrije Universiteit, Amsterdam, Netherlands.
Sex Transm Infect. 2000 Oct;76(5):375-80. doi: 10.1136/sti.76.5.375.
To develop and validate selective screening criteria for asymptomatic Chlamydia trachomatis infections in the general population.
11,505 people, aged 15-40 years, registered in 16 general practices in Amsterdam were invited to return by mail a home obtained first void urine sample and a questionnaire. Participants were randomly allocated into a development group (75%) or a validation group (25%). C trachomatis infection was determined by the ligase chain reaction. In the development group a set of criteria was identified by means of stepwise logistic regression analysis. The diagnostic accuracy (area under the ROC curve; AUC) and sensitivity, and the corresponding percentage of people selected for screening were calculated. The criteria developed in this study were applied to the validation group.
The prevalence of asymptomatic C trachomatis infections among men was found to be 2.4% (1.7-3.0), and among women 2.8% (2.2-3.4). Screening men, based on Surinam/Antillean origin and painful micturition, yielded an AUC of 0.58 (0.55-0.60). Screening women, based on Surinam/Antillean origin, new sex partner in the previous 2 months, and unmarried/not cohabiting, yielded an AUC of 0.67 (0.65-0.69). Application of the criteria for men to the validation group yielded an AUC of 0.53 (0.48-0.57); by screening 10% of the men, 15% of the cases were detected. The AUC of the criteria for women in the validation group was 0.58 (0.54-0.61); by screening 51% of the women, 63% of the cases were detected.
The prevalence of asymptomatic C trachomatis infections in Amsterdam is less than 3%. No suitable selective screening criteria for the general population could be identified.
制定并验证针对普通人群无症状沙眼衣原体感染的选择性筛查标准。
邀请在阿姆斯特丹16家普通诊所登记的11505名年龄在15至40岁之间的人通过邮件返还一份在家采集的首次晨尿样本和一份问卷。参与者被随机分为开发组（75%）或验证组（25%）。通过连接酶链反应确定沙眼衣原体感染情况。在开发组中，通过逐步逻辑回归分析确定了一组标准。计算诊断准确性（ROC曲线下面积；AUC）、敏感性以及被选作筛查对象的相应百分比。将本研究制定的标准应用于验证组。
发现男性无症状沙眼衣原体感染患病率为2.4%（1.7 - 3.0），女性为2.8%（2.2 - 3.4）。基于苏里南/安的列斯群岛血统和排尿疼痛对男性进行筛查，AUC为0.58（0.55 - 0.60）。基于苏里南/安的列斯群岛血统、过去2个月有新性伴侣以及未婚/非同居对女性进行筛查，AUC为0.67（0.65 - 0.69）。将男性标准应用于验证组，AUC为0.53（0.48 - 0.57）；通过筛查10%的男性，检测出15%的病例。验证组中女性标准的AUC为0.58（0.54 - 0.61）；通过筛查51%的女性，检测出63%的病例。
阿姆斯特丹无症状沙眼衣原体感染患病率低于3%。未找到适合普通人群的选择性筛查标准。
