Satterwhite Catherine Lindsey, Newman Daniel, Collins Dayne, Torrone Elizabeth
a Division of STD Prevention, National Center for HIV, Viral Hepatitis , STD, and Tuberculosis Prevention, Centers for Disease Control and Prevention , Atlanta , Georgia , USA.
Women Health. 2014;54(8):712-25. doi: 10.1080/03630242.2014.932890.
An estimated 2.9 million new chlamydia infections occur in the United States each year. Among women, chlamydia can lead to serious adverse outcomes, including pelvic inflammatory disease and infertility. Chlamydia prevalence is highest among females aged 15-19 years. Despite long-standing recommendations directed at young, sexually active females, screening remains sub-optimal. Juvenile detention centers (JDCs) are uniquely situated to screen and treat high-risk adolescents. From 2009-2011, performance measure data on chlamydia screening coverage (proportion of eligible females screened) and positivity (proportion of females tested who were positive) were available from 126 geographically-dispersed JDCs in the United States. These facilities reported screening 55.2% of females entering the facilities (149,923), with a facility-specific median of 66.4% (range: 0-100%). Almost half (44.4%) of facilities had screening coverage levels of 75-100%. This screening resulted in the detection of 12,305 chlamydial infections, for an overall positivity of 14.7% (facility-specific median = 14.9%, range: 0-36.9%). In linear regression analysis, chlamydia positivity was inversely associated with screening coverage: as coverage increased, positivity decreased. The burden of chlamydia in JDCs is substantial; facilities should continue to deliver recommended chlamydia screening and treatment to females and identify mechanisms to increase coverage.
据估计，美国每年有290万例新的衣原体感染病例。在女性中，衣原体感染可导致严重的不良后果，包括盆腔炎和不孕症。衣原体感染率在15至19岁的女性中最高。尽管长期以来一直建议对年轻的性活跃女性进行筛查，但筛查情况仍不尽人意。少年拘留中心（JDCs）在筛查和治疗高危青少年方面具有独特的优势。2009年至2011年期间，美国126个分布在不同地理位置的少年拘留中心提供了衣原体筛查覆盖率（符合筛查条件的女性中接受筛查的比例）和阳性率（接受检测的女性中呈阳性的比例）的绩效衡量数据。这些机构报告称，对进入机构的55.2%的女性进行了筛查（149,923人），各机构的中位数为66.4%（范围：0至100%）。近一半（44.4%）的机构筛查覆盖率在75%至100%之间。此次筛查共检测出12,305例衣原体感染病例，总体阳性率为14.7%（各机构中位数为14.9%，范围：0至36.9%）。在线性回归分析中，衣原体阳性率与筛查覆盖率呈负相关：随着覆盖率的提高，阳性率下降。少年拘留中心的衣原体感染负担相当大；各机构应继续为女性提供推荐的衣原体筛查和治疗，并找出提高覆盖率的方法。
