Shandong Provincial Hospital for Skin Disease, Shandong University, Jinan, China.
Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, 27397 Jingshi Road, Jinan, 250022, China.
BMC Infect Dis. 2018 Oct 26;18(1):534. doi: 10.1186/s12879-018-3432-y.
A population-based study of Chlamydia trachomatis (CT) infections is essential in designing a specific control program; however, no large investigation of CT infections among the general population in mainland China has been conducted since 2000. We aimed to determine the prevalence, risk factors, and associated medical costs of CT among residents, 18-49 years of age, in Shandong, China.
From May to August 2016, a multistage probability sampling survey involving 8074 individuals was distributed. Data were collected via face-to-face interviews, followed by self-administered questionnaire surveys. First-void urines were collected and tested for CT and Neisseria gonorrhoeae (NG) using nucleic acid amplification.
The weighted prevalence of CT infection was 2.3% (95% confidence interval [CI], 1.5-3.2) in females and 2.7% (1.6-3.8) in males. Women, 30-34 years of age, had the highest prevalence of CT infections (3.5%, 2.6-4.4), while the highest prevalence of CT infections in males was in those 18-24 years of age (4.3%, 0.0-8.8). Neisseria gonorrhoeae infection had a prevalence of 0.1% (0.0-0.3) in women and 0.03% (0.0-0.1) in men. Risk factors for CT infections among females included being unmarried, divorced, or widowed (odds ratio [OR], 95% CI 3.57, 1.54-8.24) and having two or more lifetime sex partners (3.72, 1.14-12.16). Among males, first intercourse before 20 years of age (1.83, 1.10-3.02) and having two or more lifetime sex partners (1.85, 1.14-3.02) were associated with CT infections. The estimated lifetime cost of CT infections in patients 18-49 years of age in Shandong was 273 million (range, 172-374 million) China Renminbi in 2016.
This study demonstrated a high burden of CT infections among females < 35 years of age and males < 25 years of age in Shandong. Thus, a CT infection control program should focus on this population, as well as others with identified risk factors.
开展基于人群的沙眼衣原体（CT）感染研究对于制定特定的控制方案至关重要；然而，自 2000 年以来，中国尚未对普通人群中的 CT 感染进行大规模调查。本研究旨在确定中国山东省 18-49 岁居民 CT 感染的流行率、危险因素和相关医疗费用。
2016 年 5 月至 8 月，采用多阶段概率抽样调查，共纳入 8074 名研究对象。通过面对面访谈和自填问卷收集数据，并采集首次尿液标本，采用核酸扩增法检测 CT 和淋病奈瑟菌（NG）。
女性 CT 感染的加权流行率为 2.3%（95%置信区间[CI]：1.5-3.2），男性为 2.7%（1.6-3.8）。30-34 岁女性 CT 感染的流行率最高（3.5%，2.6-4.4），而 18-24 岁男性 CT 感染的流行率最高（4.3%，0.0-8.8）。女性 NG 感染的流行率为 0.1%（0.0-0.3），男性为 0.03%（0.0-0.1）。女性 CT 感染的危险因素包括未婚、离婚或丧偶（比值比[OR]，95%CI：3.57，1.54-8.24）和有两个或更多性伴侣（3.72，1.14-12.16）。男性中，20 岁以前首次性交（1.83，1.10-3.02）和有两个或更多性伴侣（1.85，1.14-3.02）与 CT 感染相关。2016 年山东省 18-49 岁患者 CT 感染的终生费用估计为 2.73 亿元（范围为 1.72-3.74 亿元）人民币。
本研究表明，山东省 35 岁以下女性和 25 岁以下男性 CT 感染负担较重。因此，CT 感染控制方案应针对这部分人群以及其他具有明确危险因素的人群。
