Penn State Milton S. Hershey Medical Center, Penn State University, Hershey, PA 17033-0850, USA.
Med Sci Sports Exerc. 2010 Apr;42(4):683-8. doi: 10.1249/MSS.0b013e3181bf53c1.
This study assessed the prevalence of Chlamydia trachomatis in the college athlete and the benefit of using the sports preparticipation examination (PPE) as a screening opportunity.
Chlamydia teaching and screening was part of the sports PPE. The 439 athletes (220 men and 219 women) answered a questionnaire and provided urine specimens. Using positive test results as an indication of prevalence, the chlamydia prevalence rate was calculated by sex and race. Using the questionnaire responses, we determined the students' accessibility to health care and the percentage of sexually active students who were ever offered chlamydial screening.
Thirteen of 439 athletes tested positive. One test was a false positive. The test positivity was 2.7%: 3.2% men and 2.2% women. In sexually active athletes, the test positivity rose to 3.8%: 4.0% men and 3.7% women. African American athletes had a higher prevalence of 9.1%: 8.9% in men and 9.5% in women, making them six times more likely to have chlamydia than Caucasian athletes (odds ratio = 6.43, 95% confidence interval = 1.58-30.55). Number of partners, contraceptive type, symptoms, and prior history of chlamydia were not statistically different between groups. Over 75% of students saw their private physicians, yet of the sexually active students, only 31% of women and 6.8% of men were ever offered chlamydial screening.
The Centers for Disease Control and Prevention and the U.S. Preventive Services Task Force guidelines recommending annual chlamydial screening for all sexually active women younger than 26 yr are not being met in the community. Taking advantage of opportunities, including the mandated sports PPE, where sexually active men and women 25 yr and younger interface with the health care system to screen for C. trachomatis, is crucial to decreasing the continued rise of chlamydial infection.
本研究评估了沙眼衣原体在大学生运动员中的流行率，并探讨了将运动前体检（PPE）作为筛查机会的益处。
沙眼衣原体教学和筛查是 PPE 的一部分。439 名运动员（220 名男性和 219 名女性）回答了一份问卷并提供了尿液样本。以阳性检测结果作为流行率的指标，按性别和种族计算沙眼衣原体的流行率。根据问卷回答，我们确定了学生获得医疗保健的机会以及接受过衣原体筛查的性活跃学生的百分比。
439 名运动员中有 13 名检测呈阳性。其中一个检测结果为假阳性。检测阳性率为 2.7%：男性为 3.2%，女性为 2.2%。在性活跃的运动员中，检测阳性率上升至 3.8%：男性为 4.0%，女性为 3.7%。非裔美国运动员的患病率较高，为 9.1%：男性为 8.9%，女性为 9.5%，感染沙眼衣原体的可能性是白种人运动员的六倍（比值比=6.43，95%置信区间=1.58-30.55）。组间的性伴侣数量、避孕类型、症状和衣原体既往史无统计学差异。超过 75%的学生看私人医生，但在性活跃的学生中，只有 31%的女性和 6.8%的男性曾接受过衣原体筛查。
疾病控制与预防中心和美国预防服务工作组建议对所有 26 岁以下有性行为的女性进行年度衣原体筛查，但这一建议在社区中并未得到落实。利用包括强制性 PPE 在内的机会，让 25 岁及以下有性行为的男性和女性与医疗保健系统接触，对衣原体进行筛查，对于降低衣原体感染的持续上升至关重要。
