Division of Clinical Epidemiology and Biostatistics, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
Sex Transm Infect. 2013 Feb;89(1):20-4. doi: 10.1136/sextrans-2011-050469. Epub 2012 Jul 6.
To describe uptake of chlamydia screening, determine rates of repeated yearly screening and investigate determinants of repeated participation in an organised school-based screening programme.
The authors analysed data from 1995 to 2005 from female and male students in up to 13 schools in New Orleans, Louisiana, USA. The authors calculated proportions of students tested among all enrolled students and among those with parental consent and the percentage of positive chlamydia tests in each school year. The authors used random effects logistic regression to examine the effect of past screening history on subsequent participation.
35 041 students were registered for at least one school year. Overall coverage was >30% in all school years. Among all students registered for 4 years, 10.6% (95% CI 9.3% to 12.0%) of women and 12.7% (95% CI 11.2% to 14.2%) of men had a test every year. Among students with parental consent for 4 years, 49.3% (95% CI 44.6% to 54.1%) of women and 59.3% (95% CI 54.5% to 64.0%) of men had a test every year. Among students registered for 2 or more years, those with a previous positive chlamydia test were less likely to have a subsequent test (female adjusted OR 0.77, 95% CI 0.67 to 0.88 and male adjusted OR 0.84, 95% CI 0.69 to 1.02). Chlamydia positivity increased over time.
High levels of uptake can be achieved in school-based chlamydia screening programmes, but repeated yearly screening is difficult to sustain over time.
描述衣原体筛查的参与情况，确定每年重复筛查的比率，并调查在有组织的学校筛查计划中反复参与的决定因素。
作者分析了美国路易斯安那州新奥尔良市多达 13 所学校的 1995 年至 2005 年期间的女性和男性学生的数据。作者计算了所有入学学生和获得家长同意的学生中接受测试的学生比例，以及每个学年阳性衣原体检测的百分比。作者使用随机效应逻辑回归来检查过去筛查史对后续参与的影响。
有 35041 名学生至少注册了一个学年。所有学年的总体覆盖率均超过 30%。在注册了 4 年的所有学生中，每年有 10.6%（95%CI9.3%至 12.0%）的女性和 12.7%（95%CI11.2%至 14.2%）的男性接受了测试。在获得家长同意的 4 年学生中，每年有 49.3%（95%CI44.6%至 54.1%）的女性和 59.3%（95%CI54.5%至 64.0%）的男性接受了测试。在注册了 2 年或以上的学生中，之前衣原体检测呈阳性的学生不太可能进行后续检测（女性调整后的比值比为 0.77，95%CI0.67 至 0.88，男性调整后的比值比为 0.84，95%CI0.69 至 1.02）。衣原体阳性率随时间增加。
在学校为基础的衣原体筛查计划中，可以实现高水平的参与率，但随着时间的推移，每年重复筛查很难维持。
