Farley Thomas A, Cohen Deborah A, Elkins Whitney
Louisiana Office of Public Health, and the Department of Community Health Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
Prev Med. 2003 Apr;36(4):502-9. doi: 10.1016/s0091-7435(02)00058-0.
The United States has the highest prevalence of sexually transmitted diseases in the developed world. Control strategies should address the most frequent reasons why curable sexually transmitted diseases are not treated.
We approached 1,631 persons ages 18-29 in various sites and offered them screening for gonorrhea and chlamydial infection and surveys regarding past genitourinary symptoms. For those with past symptoms we abstracted medical records or conducted additional interviews. From these data we estimated the total number of persons who had gonorrhea or chlamydial infections in the previous year, the proportion treated, and the primary reasons for nontreatment.
The prevalence of gonorrhea was 2.3% and that of chlamydial infection was 10.1%. We estimate that 45 and 77% of all cases of gonorrhea and chlamydial infection, respectively, were never symptomatic and that 86 and 95% of untreated cases of gonorrhea and chlamydial infection, respectively, were untreated because they were never symptomatic. The remaining 14 and 5% of untreated cases of gonorrhea and chlamydia, respectively, were not treated because persons did not receive medical care for symptoms.
The primary reason that gonorrhea and chlamydial infections are untreated is that infected persons never have symptoms. The most effective method to control these sexually transmitted diseases is routine screening at high-volume sites.
在发达国家中，美国性传播疾病的患病率最高。控制策略应针对可治愈性传播疾病未得到治疗的最常见原因。
我们在不同场所接触了1631名年龄在18至29岁之间的人，为他们提供淋病和衣原体感染筛查以及关于过去泌尿生殖系统症状的调查。对于有过去症状的人，我们提取了医疗记录或进行了额外访谈。根据这些数据，我们估计了上一年患有淋病或衣原体感染的总人数、接受治疗的比例以及未治疗的主要原因。
淋病患病率为2.3%，衣原体感染患病率为10.1%。我们估计，所有淋病和衣原体感染病例中，分别有45%和77%从未有过症状，而未治疗的淋病和衣原体感染病例中，分别有86%和95%未接受治疗是因为他们从未有过症状。其余未治疗的淋病和衣原体病例分别有14%和5%未接受治疗是因为人们没有因症状而接受医疗护理。
淋病和衣原体感染未得到治疗的主要原因是感染者从未出现症状。控制这些性传播疾病的最有效方法是在人流量大的场所进行常规筛查。
