Fine David, Dicker Linda, Mosure Debra, Berman Stuart
Center for Health Training, Seattle, Washington 98101-1313, USA.
Sex Transm Dis. 2008 Jan;35(1):47-52. doi: 10.1097/OLQ.0b013e31813e0c26.
Following a 9-year 60% decline, chlamydia positivity increased 46% from 1997 through 2004 among young sexually active women screened in Region X family planning clinics. The objective of this analysis was to systematically examine the influences of risk factors, changing laboratory test methods, and interclinic variability on chlamydia positivity during this period.
We analyzed data from 520,512 chlamydia tests from women aged 15 to 24 years screened in 125 family planning clinics. Multivariate logistic regression modeling was used to adjust the annual risk of chlamydia for the demographic, clinical, and sexual risk behavior characteristics associated with infection and for the increasing use of more sensitive laboratory test methods. A generalized linear mixed model was used to adjust for interclinic variability.
We found a significant 5% annual increase in the risk of chlamydia even after adjusting for risk factors including laboratory test characteristics (odds ratio 1.05, 95% confidence interval: 1.04, 1.06). Variability among the clinics where screening occurred did not account for the increase.
Based on a review of all available data, we concluded that there was a true increase in chlamydia positivity over the 8-year period.
在经历了9年60%的下降后，1997年至2004年期间，在X地区计划生育诊所接受筛查的年轻性活跃女性中，衣原体阳性率上升了46%。本分析的目的是系统研究在此期间风险因素、实验室检测方法的变化以及诊所间差异对衣原体阳性率的影响。
我们分析了在125家计划生育诊所接受筛查的15至24岁女性的520,512次衣原体检测数据。采用多变量逻辑回归模型，针对与感染相关的人口统计学、临床和性风险行为特征以及更敏感实验室检测方法使用的增加，对衣原体的年度风险进行调整。使用广义线性混合模型对诊所间差异进行调整。
即使在对包括实验室检测特征在内的风险因素进行调整后（比值比1.05，95%置信区间：1.04，1.06），我们发现衣原体风险仍以每年5%的幅度显著上升。进行筛查的诊所之间的差异并不能解释这种上升。
基于对所有可用数据的审查，我们得出结论，在这8年期间衣原体阳性率确实有所上升。
