Division of STD Prevention, CDC, 1600 Clifton Road, Mailstop E-02, Atlanta, GA 30333, USA.
Sex Transm Dis. 2011 Nov;38(11):989-94. doi: 10.1097/OLQ.0b013e318225f7d7.
Annual chlamydia screening is recommended for all sexually active women aged <25 years. Substantial limitations exist in ascertaining chlamydia trends. Reported case rates have increased likely due to increased screening and improved test technology. Other data suggest that prevalence has decreased.
Data from the Infertility Prevention Project (IPP), a national chlamydia screening program, were used to assess trends in chlamydia positivity from 2004 to 2008 among women aged 15 to 24 years who were tested in family planning clinics reporting data to IPP. Using the clinic as the unit of analysis, a correlated, longitudinal data analysis with a random intercept was conducted among clinics reporting ≥3 years of data during the analysis timeframe. Sensitivity analyses were performed to address the impact of various clinic participation levels in addition to the assessment of various correlation structures.
Over 5 million chlamydia tests were reported to IPP family planning clinics from 2004 to 2008. A majority of tests were conducted among white women (clinic-specific mean: 63.2%, interquartile range: 37.6%-91.5%); the clinic-specific mean percent of tests conducted among black women was 17.9% (interquartile range: 0.8%-25.7%). Overall chlamydia positivity from 2004 to 2008 was 7.0%. The odds ratio associated with a single year change (1.00; 95% confidence interval: 0.99, 1.00) suggested that chlamydia positivity did not change from 2004 to 2008, after controlling for clinic-specific population factors (age, race, test usage, and geography).
Findings support previous analyses suggesting that chlamydia prevalence is not increasing despite apparent increasing rates based on case reports.
建议所有年龄<25 岁的有性生活的女性每年进行衣原体筛查。在确定衣原体趋势方面存在很大的局限性。报告的病例率增加可能是由于筛查增加和检测技术改进所致。其他数据表明，流行率有所下降。
本研究使用全国衣原体筛查计划-不孕预防项目（IPP）的数据，评估了 2004 年至 2008 年期间在向 IPP 报告数据的计划生育诊所接受衣原体筛查的年龄在 15 至 24 岁的女性中衣原体阳性率的趋势。以诊所为分析单位，对报告分析期间至少 3 年数据的诊所进行了具有随机截距的相关纵向数据分析。进行了敏感性分析，以解决各种诊所参与水平的影响，以及对各种相关结构的评估。
2004 年至 2008 年期间，IPP 计划生育诊所报告了超过 500 万例衣原体检测。大多数检测是在白人女性中进行的（诊所特定平均：63.2%，四分位间距：37.6%-91.5%）；诊所特定平均黑人女性接受检测的比例为 17.9%（四分位间距：0.8%-25.7%）。2004 年至 2008 年期间，衣原体阳性率总体为 7.0%。与单一年份变化相关的比值比（1.00；95%置信区间：0.99，1.00）表明，在控制了诊所特定的人口因素（年龄、种族、检测使用和地理位置）后，衣原体阳性率并未从 2004 年至 2008 年发生变化。
研究结果支持先前的分析结果，即尽管基于病例报告的衣原体发病率似乎在增加，但实际上流行率并未增加。
