Redmond Shelagh M, Alexander-Kisslig Karin, Woodhall Sarah C, van den Broek Ingrid V F, van Bergen Jan, Ward Helen, Uusküla Anneli, Herrmann Björn, Andersen Berit, Götz Hannelore M, Sfetcu Otilia, Low Nicola
Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, CH-3012, Bern, Switzerland.
HIV & STI Department, National Centre for Infectious Disease Surveillance and Control, Public Health England, 61 Colindale Avenue, London, NW9 5EQ, United Kingdom.
PLoS One. 2015 Jan 23;10(1):e0115753. doi: 10.1371/journal.pone.0115753. eCollection 2015.
Accurate information about the prevalence of Chlamydia trachomatis is needed to assess national prevention and control measures.
We systematically reviewed population-based cross-sectional studies that estimated chlamydia prevalence in European Union/European Economic Area (EU/EEA) Member States and non-European high income countries from January 1990 to August 2012. We examined results in forest plots, explored heterogeneity using the I² statistic, and conducted random effects meta-analysis if appropriate. Meta-regression was used to examine the relationship between study characteristics and chlamydia prevalence estimates.
We included 25 population-based studies from 11 EU/EEA countries and 14 studies from five other high income countries. Four EU/EEA Member States reported on nationally representative surveys of sexually experienced adults aged 18-26 years (response rates 52-71%). In women, chlamydia point prevalence estimates ranged from 3.0-5.3%; the pooled average of these estimates was 3.6% (95% CI 2.4, 4.8, I² 0%). In men, estimates ranged from 2.4-7.3% (pooled average 3.5%; 95% CI 1.9, 5.2, I² 27%). Estimates in EU/EEA Member States were statistically consistent with those in other high income countries (I² 0% for women, 6% for men). There was statistical evidence of an association between survey response rate and estimated chlamydia prevalence; estimates were higher in surveys with lower response rates, (p = 0.003 in women, 0.018 in men).
Population-based surveys that estimate chlamydia prevalence are at risk of participation bias owing to low response rates. Estimates obtained in nationally representative samples of the general population of EU/EEA Member States are similar to estimates from other high income countries.
需要有关沙眼衣原体流行率的准确信息来评估国家预防和控制措施。
我们系统回顾了1990年1月至2012年8月期间在欧盟/欧洲经济区（EU/EEA）成员国和非欧洲高收入国家进行的基于人群的横断面研究，这些研究估计了衣原体流行率。我们在森林图中检查结果，使用I²统计量探索异质性，并在适当情况下进行随机效应荟萃分析。荟萃回归用于检查研究特征与衣原体流行率估计值之间的关系。
我们纳入了来自11个欧盟/欧洲经济区国家的25项基于人群的研究和来自其他五个高收入国家的14项研究。四个欧盟/欧洲经济区成员国报告了对18 - 26岁有性经历成年人的全国代表性调查（回复率52 - 71%）。在女性中，衣原体点流行率估计值范围为3.0 - 5.3%；这些估计值的合并平均值为3.6%（95% CI 2.4, 4.8，I² 0%）。在男性中，估计值范围为2.4 - 7.3%（合并平均值3.5%；95% CI 1.9, 5.2，I² 27%）。欧盟/欧洲经济区成员国的估计值与其他高收入国家的估计值在统计学上一致（女性I² 0%，男性I² 6%）。有统计学证据表明调查回复率与估计的衣原体流行率之间存在关联；回复率较低的调查中估计值较高（女性p = 0.003，男性p = 0.018）。
由于回复率低，基于人群的估计衣原体流行率的调查存在参与偏倚风险。在欧盟/欧洲经济区成员国一般人群的全国代表性样本中获得的估计值与其他高收入国家的估计值相似。
