Hirsl-Hećej Vlasta, Pustisek Nives, Sikanić-Dugić Nives, Domljan Luka Mislav, Kani Dubravka
Department of Reproductive Health, Children's Hospital Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia.
Coll Antropol. 2006 Dec;30 Suppl 2:131-7.
The study was undertaken to determine the prevalence of chlamydial genital infection in sexually active, urban adolescent females 15-19 years; to identify behavioral, demographic, and clinical factors associated with chlamydial infections; and to develop criteria for potential screening strategies. 500 adolescent women, median age 17.7 years, who visited gynecological outpatient clinic in Children's Hospital Zagreb for different reasons were enrolled in this study. Gynecological exam, colposcopy, detection of chlamydial infection by the rapid direct immunoassay of endocervical swab (Clearview Chlamydia-Unipath), endocervical cytological examination--Papanicolaou smear, and questionnaire to obtain demographic, social, behavioral and presence of symptoms data were performed. Positive Chlamydia trachomatis test were found in 16.4% of participants, cytologic cervical abnormalities--cervical intraepithelial neoplasia (CIN I-CIN III) were found in 25.2% and cytological signs of Human papilloma virus were found in 11.4%. Stepwise multivariate logistic regression analysis identified five factors associated with infection: the age of menarche < or =13 years, > or =4 lifetime sexual partners, non-use of contraception (rare or never), cervical friability, and abnormal Papanicolaou test. Urban adolescent sexually active women are at high risk for chlamydial infection and other sexually transmitted diseases including HIV infection. Association between chlamydial genital infection and risk-taking sexual and contraceptive behavior was found. Routine Chlamydia trachomatis testing for this population is recommended as well as implementation of school based sexual health education because of their risk-taking sexual behavior.
开展这项研究是为了确定15 - 19岁有性活动的城市青少年女性衣原体生殖器感染的患病率；识别与衣原体感染相关的行为、人口统计学和临床因素；并制定潜在筛查策略的标准。500名年龄中位数为17.7岁、因不同原因前往萨格勒布儿童医院妇科门诊就诊的青少年女性被纳入本研究。进行了妇科检查、阴道镜检查、通过宫颈拭子快速直接免疫测定法（Clearview Chlamydia - Unipath）检测衣原体感染、宫颈细胞学检查——巴氏涂片检查，以及通过问卷获取人口统计学、社会、行为和症状数据。16.4%的参与者沙眼衣原体检测呈阳性，25.2%发现宫颈细胞学异常——宫颈上皮内瘤变（CIN I - CIN III），11.4%发现人乳头瘤病毒的细胞学迹象。逐步多因素逻辑回归分析确定了与感染相关的五个因素：月经初潮年龄≤13岁、终生性伴侣≥4个、不使用避孕措施（很少或从不）、宫颈脆性增加以及巴氏试验异常。城市有性活动的青少年女性感染衣原体以及包括艾滋病毒感染在内的其他性传播疾病的风险很高。发现了衣原体生殖器感染与冒险的性行为和避孕行为之间的关联。由于该人群存在冒险的性行为，建议对其进行常规沙眼衣原体检测，并开展以学校为基础的性健康教育。
