Herrmann B, Egger M
Department of Infectious Diseases and Clinical Microbiology, University of Uppsala, Sweden.
Sex Transm Dis. 1995 Jul-Aug;22(4):253-60. doi: 10.1097/00007435-199507000-00009.
In Uppsala County, between 1985 and 1993, examinations for Chlamydia trachomatis were being performed in a central laboratory. A change in national sexually transmitted disease legislation in 1988 encouraged screening.
To analyze trends in detection rates of genital chlamydial infections by age, sex, and clinic type, and to assess the influence of the legislation change.
This was an analysis of 119,892 tests, representing 95.4% of all specimens sampled. Eighty-six percent of the samples were cultured, 14% were examined by enzyme immunoassay.
Seventy-nine percent of specimens came from women. 7,989 positive samples were identified. Detection rates declined from 107.2 per 1,000 in 1985 to 32.3 in 1993 in women and from 183.3 to 70.7 in men. Positivity rates were highest in sexually transmitted disease and youth clinics and lowest in private practices. Among female youths, rates leveled off in later years, but the rates increased in male youths. The legislation change reduced the probability of a positive test in men but not in women.
Genital chlamydial infection generally declined. However, among youths, an increase has occurred in recent years. Continued screening and the introduction of noninvasive diagnostic methods for males is warranted, particularly in youth clinics. Selective screening may be more cost-effective in other age groups.
1985年至1993年期间，乌普萨拉县的衣原体检测在一个中央实验室进行。1988年国家性传播疾病立法的变化推动了筛查工作。
分析按年龄、性别和诊所类型划分的生殖器衣原体感染检出率趋势，并评估立法变化的影响。
这是一项对119,892次检测的分析，占所有采样标本的95.4%。86%的样本进行了培养，14%通过酶免疫测定法进行检测。
79%的标本来自女性。共识别出7,989份阳性样本。女性的检出率从1985年的每1000人107.2例降至1993年的32.3例，男性从183.3例降至70.7例。性传播疾病诊所和青少年诊所的阳性率最高，私人诊所最低。在女性青少年中，后期检出率趋于平稳，但男性青少年的检出率有所上升。立法变化降低了男性检测呈阳性的概率，但对女性没有影响。
生殖器衣原体感染总体呈下降趋势。然而，近年来青少年中的感染率有所上升。有必要继续进行筛查，并为男性引入非侵入性诊断方法，特别是在青少年诊所。在其他年龄组进行选择性筛查可能更具成本效益。
