Stergachis A, Scholes D, Heidrich F E, Sherer D M, Holmes K K, Stamm W E
Department of Pharmacy, School of Pharmacy, University of Washington, Seattle 98195.
Am J Epidemiol. 1993 Aug 1;138(3):143-53. doi: 10.1093/oxfordjournals.aje.a116840.
The authors used cell cultures to assess the prevalence of cervical infection caused by Chlamydia trachomatis in a population-based sample of nonpregnant women aged 15 to 34 years who attended two primary care clinics at Group Health Cooperative of Puget Sound, Seattle, Washington, between January 1, 1988, and June 30, 1989. C. trachomatis was isolated from 67 of 1,804 women (3.7%), including 13% of those who were less than 20 years of age. Seven patient characteristics were independently predictive of chlamydial infection by stepwise multivariate logistic regression analysis: being unmarried, examination showing cervical ectopy, black race, douching, nulliparity, age of 24 years or less, and intercourse with two or more partners within the preceding year. Testing all women who had a score of 5 or more (28% of women) on a weighted index based on risk factors would detect 77% of all infections with a positive predictive value of 9%. These results suggest that it should be feasible to develop a risk factor-based program to screen for cervical infection with C. trachomatis in populations where its prevalence is low.
作者利用细胞培养方法，对1988年1月1日至1989年6月30日期间在华盛顿州西雅图市普吉特海湾集团健康合作社的两家初级保健诊所就诊的15至34岁非妊娠妇女的人群样本中沙眼衣原体引起的宫颈感染患病率进行了评估。在1804名妇女中，有67人（3.7%）分离出沙眼衣原体，其中年龄小于20岁的妇女中这一比例为13%。通过逐步多变量逻辑回归分析，有七个患者特征可独立预测衣原体感染：未婚、检查显示宫颈外翻、黑人种族、冲洗阴道、未生育、年龄在24岁及以下以及前一年与两个或更多性伴侣发生性行为。对所有基于危险因素的加权指数得分在5分或以上的妇女（占妇女总数的28%）进行检测，可发现所有感染病例的77%，阳性预测值为9%。这些结果表明，在沙眼衣原体患病率较低的人群中，制定基于危险因素的方案来筛查宫颈感染应该是可行的。
