英国康沃尔郡 2003-2009 年的衣原体筛查、复检和重复诊断。

Chlamydia screening, retesting and repeat diagnoses in Cornwall, UK 2003-2009.

机构信息

School of Social and Community Medicine, University of Bristol, Bristol, UK.

出版信息

Sex Transm Infect. 2013 Feb;89(1):70-5. doi: 10.1136/sextrans-2012-050696. Epub 2012 Sep 28.

DOI:10.1136/sextrans-2012-050696

PMID:23024225

Abstract

OBJECTIVES

This study aims to describe the patterns of testing and retesting for chlamydia in Cornwall during the first 5 years of the National Chlamydia Screening Programme. We evaluate the factors associated with retesting and estimate the incidence of chlamydia diagnosis and repeat diagnosis.

STUDY DESIGN

Secondary database analysis.

SELECTION CRITERIA

men and women tested for chlamydia between March 2003 and January 2009 in Cornwall, aged ≥12 years and ≤25 years at the first test. The factors associated with retesting in those with at least one known test result and at least 14 days follow-up time were analysed using Cox regression and the incidence of diagnosis and repeat diagnosis were calculated.

RESULTS

The final dataset consisted of 71 066 records from 49 941 individuals; of whom 59.0% were female and 75.4% were only tested once. There were 48 375 individuals with at least one known test result (negative or positive) and at least 14 days follow-up, included in the Cox regression analysis. Factors associated with testing more than once were (adjusted HR, 95% CI): being female (2.24; 2.14 to 2.34) and initially testing positive (1.43; 1.35 to 1.51). The positivity at first episode declined from 13.2% (1077 cases) in 2003/2004 to 5.8% (843 cases) in 2008/2009. The incidence of diagnosis at the second test was 5.9 per 100 person years in those testing negative at the first test compared with 18.1 per 100 person years in those initially positive.

DISCUSSION

Most individuals in this analysis were tested only once, but the testing volume and proportion of repeat tests were highest at the end of the study period. As the testing rate stabilises to 30% coverage, maintaining retesting rates in those previously tested and especially in those previously diagnosed with chlamydia will be necessary for the sustainability of the screening programme.

CONCLUSIONS

A key feature of the next 5 years of the screening programme will be to maintain screening and rescreening.

摘要

目的

本研究旨在描述康沃尔郡国家衣原体筛查计划实施前 5 年衣原体检测和复查的模式。我们评估了与复查相关的因素，并估计了衣原体诊断和重复诊断的发生率。

研究设计

二次数据库分析。

选择标准

2003 年 3 月至 2009 年 1 月期间年龄在 12 岁及以上且≤25 岁的在康沃尔郡接受过衣原体检测的男性和女性。对至少有一次已知检测结果且至少有 14 天随访时间的患者，采用 Cox 回归分析与复查相关的因素，并计算诊断和重复诊断的发生率。

结果

最终数据集由来自 49941 名个体的 71066 份记录组成；其中 59.0%为女性，75.4%仅检测过一次。有 48375 名个体至少有一次已知的检测结果（阴性或阳性）且至少有 14 天的随访时间，包括在 Cox 回归分析中。与多次检测相关的因素为（调整后的 HR，95%CI）：女性（2.24；2.14 至 2.34）和初次检测阳性（1.43；1.35 至 1.51）。首次发病时的阳性率从 2003/2004 年的 13.2%（1077 例）下降至 2008/2009 年的 5.8%（843 例）。首次检测阴性的个体在第二次检测时的诊断发生率为每 100 人年 5.9 例，而首次检测阳性的个体的诊断发生率为每 100 人年 18.1 例。