Division of primary care medicine, Department of Community Medicine and Primary Care, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14, Switzerland.
Swiss Med Wkly. 2010 Nov 18;140:w13126. doi: 10.4414/smw.2010.13126. eCollection 2010.
Chlamydia trachomatis infection (CTI) is the most frequent sexually transmitted infection in Switzerland and its prevalence in correctional settings is currently unknown. The aim of this study was to determine the prevalence of CTI and associated risk factors in a population of inmates aged 18-35 years.
Inmates attending the health care unit of the largest Swiss remand prison from June 2008 to May 2009 were invited to participate in this cross-sectional study. All participants completed a questionnaire and provided a first-void urine specimen for CTI testing based on a PCR assay. Univariate and multivariate logistic regression analyses were used to assess risk factors associated with CTI.
214 male and 20 female inmates agreed to participate. Overall CTI prevalence was 6.5% in men (95% CI 3.2; 9.9) and 10% (95%CI 0; 23.1) in women. None of the following possible risk factors analysed were significantly correlated to CTI: age, origin, education, religion, number of sexual partners, iv drug use, subjective health status and uro-genital symptoms.
CTI prevalence in the largest Swiss prison was two to six times higher than in the general population but similar to other European prison settings. This result should raise our awareness that this population is at particularly high risk for sexually transmitted infections and motivate a widespread surveillance of prison CT prevalence. We hesitate to consider systematic screening because evidence is still lacking in relation to the benefits of screening in males. Local cost effectiveness studies would highly contribute to a correct decision concerning implementation of screening.
沙眼衣原体感染（CTI）是瑞士最常见的性传播感染，其在惩教场所的流行情况目前尚不清楚。本研究的目的是确定在 18-35 岁的囚犯人群中 CTI 的流行情况及其相关危险因素。
2008 年 6 月至 2009 年 5 月，邀请在瑞士最大的还押监狱医疗保健单位就诊的囚犯参加这项横断面研究。所有参与者都完成了一份问卷，并提供了第一次尿液样本，用于基于 PCR 检测的 CTI 检测。使用单变量和多变量逻辑回归分析来评估与 CTI 相关的危险因素。
214 名男性和 20 名女性囚犯同意参加。男性总体 CTI 患病率为 6.5%（95%CI 3.2%；9.9%），女性为 10%（95%CI 0%；23.1%）。分析的以下可能危险因素均与 CTI 无显著相关性：年龄、原籍国、教育程度、宗教信仰、性伴侣数量、静脉吸毒、主观健康状况和泌尿生殖系统症状。
瑞士最大监狱的 CTI 患病率是普通人群的两到六倍，但与其他欧洲监狱环境相似。这一结果应该引起我们的注意，即该人群特别容易感染性传播感染，应广泛监测监狱 CT 流行情况。我们犹豫是否考虑进行系统筛查，因为目前在男性筛查的益处方面仍缺乏证据。针对实施筛查的相关成本效益研究将有助于做出正确的决策。
