Petersen Rodney W, Tabrizi Sepehr N, Garland Suzanne, Quinlivan Julie A
Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Vic. 3054, Australia.
Sex Health. 2007 Jun;4(2):133-6. doi: 10.1071/sh06050.
Chlamydia trachomatis is a major public health issue, with notifications of this sexually transmitted disease continuing to rise in Australia. Women attending colposcopy clinics are referred for treatment of cervical abnormalities often associated with human papilloma virus (HPV) infection. There is evidence that women who have acquired one sexually transmitted infection, such as HPV, are at higher risk of acquiring another. Women attending colposcopy clinics may therefore be at risk of undiagnosed infection with C. trachomatis.
To determine the prevalence of C. trachomatis in women attending a public metropolitan colposcopy clinic in Victoria.
A cross-sectional study was performed. Institutional ethics committee approval and informed consent were obtained. Consecutive women attending the colposcopy clinic completed a questionnaire and had a swab collected from the endocervix for analysis by polymerase chain reaction for C. trachomatis. Positive screens were treated in accordance with best practice. Data were analysed with Minitab Version 2004 (Minitab Inc, State College, PA, USA).
Of 581 women approached to participate in the trial, consent was obtained from 568 women (98%) and final outcome data was available on 560 women (99%). The overall rate of chlamydial infection was 2.1% (95% CI 1.5-2.7%). However, in women aged 25 years or less the rate was 5.8% (95% CI 3.8-7.8%) and in women over 25 years it was only 0.9% (95% CI 0.4-1.4%). Apart from age, no other demographic factor was significantly associated with chlamydial infection.
Although the prevalence of chlamydial infection in the colposcopy clinic population as a whole does not warrant a policy for routine screening, screening directed at women aged 25 years or less would gain the greatest yields in terms of cost efficacy. Such a policy should be implemented as standard practice.
沙眼衣原体是一个重大的公共卫生问题，在澳大利亚，这种性传播疾病的报告病例数持续上升。前往阴道镜检查诊所就诊的女性常因与人乳头瘤病毒（HPV）感染相关的宫颈异常而被转诊接受治疗。有证据表明，感染过一种性传播感染（如HPV）的女性感染另一种性传播感染的风险更高。因此，前往阴道镜检查诊所就诊的女性可能存在未被诊断出的沙眼衣原体感染风险。
确定在维多利亚州一家公立大都市阴道镜检查诊所就诊的女性中沙眼衣原体的感染率。
进行了一项横断面研究。获得了机构伦理委员会的批准并取得了知情同意。连续前往阴道镜检查诊所就诊的女性填写了一份问卷，并采集了宫颈拭子，通过聚合酶链反应分析沙眼衣原体。筛查呈阳性者按照最佳实践进行治疗。使用Minitab 2004版软件（美国宾夕法尼亚州州立学院的Minitab公司）对数据进行分析。
在邀请参与试验的581名女性中，568名女性（98%）获得了同意，560名女性（99%）有最终结果数据。衣原体感染的总体发生率为2.1%（95%可信区间1.5 - 2.7%）。然而，25岁及以下女性的感染率为5.8%（95%可信区间3.8 - 7.8%），25岁以上女性的感染率仅为0.9%（95%可信区间0.4 - 1.4%）。除年龄外，没有其他人口统计学因素与衣原体感染显著相关。
尽管总体而言，阴道镜检查诊所人群中衣原体感染率并不足以支持开展常规筛查政策，但针对25岁及以下女性进行筛查在成本效益方面将获得最大收益。应将这种政策作为标准做法实施。
