Department of Clinical Investigation, Madigan Army Medical Center, Tacoma, Washington.
Department of Obstetrics and Gynecology, Madigan Army Medical Center, Tacoma, Washington.
Semin Reprod Med. 2018 Nov;36(6):340-350. doi: 10.1055/s-0039-1678752. Epub 2019 Apr 19.
is the most common sexually transmitted bacterial infection in the United States. Within the U.S. military, the age- and race-adjusted chlamydia infection rates among female service members are consistently higher than civilian rates, with a 20% annual acquisition rate among young active-duty women. The sequelae of chlamydia disproportionately impact women in terms of severity and cost. Untreated chlamydia progresses to pelvic inflammatory disease in 40% of cases, and is a leading cause of fallopian tube damage and pelvic adhesive disease resulting in ectopic pregnancy, tubal infertility, and acute and chronic pelvic pain. Tubal infertility is among the leading indications for fertilization (IVF) nationally and rates among couples undergoing IVF at military treatment centers are double the national average. Collectively, chlamydia infection represents a significant resource burden to the military health care system and, in view of the serious gynecologic health sequelae, a significant threat to the readiness of servicewomen. In this review, we discuss the gynecologic impact of chlamydia infection within the military, the critical gaps for research funding, and opportunities for intervention.
在美国，它是最常见的性传播细菌感染。在美国军队中，女性军人的衣原体感染率（按年龄和种族调整）一直高于平民，年轻现役女性的年获得率为 20%。衣原体感染的后遗症在严重程度和费用方面对女性的影响不成比例。未经治疗的衣原体感染在 40%的病例中会发展为盆腔炎，是导致输卵管损伤和盆腔粘连性疾病的主要原因，进而导致异位妊娠、输卵管不孕以及急性和慢性盆腔疼痛。输卵管不孕是全国范围内进行体外受精（IVF）的主要指征之一，在军事治疗中心接受 IVF 的夫妇的比例是全国平均水平的两倍。总的来说，衣原体感染对军队医疗保健系统造成了重大的资源负担，鉴于严重的妇科健康后遗症，对女兵的战备状态也构成了重大威胁。在这篇综述中，我们讨论了衣原体感染对军队中女性的妇科影响、研究资金的关键差距以及干预的机会。
