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PLoS One. 2015 Jan 23;10(1):e0115753. doi: 10.1371/journal.pone.0115753. eCollection 2015.

Genital chlamydia prevalence in Europe and non-European high income countries: systematic review and meta-analysis.

Author information

1
Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, CH-3012, Bern, Switzerland.
2
HIV & STI Department, National Centre for Infectious Disease Surveillance and Control, Public Health England, 61 Colindale Avenue, London, NW9 5EQ, United Kingdom.
3
Unit of Epidemiology and Surveillance, RIVM/Centre for Infectious Disease Control Netherlands, PO Box 1, 3720 BA, Bilthoven, Netherlands.
4
University of Amsterdam, 1012 WX Amsterdam, Netherlands and STI AIDS Netherlands, Keizersgracht 390, 1016 GB, Amsterdam, Netherlands.
5
Infectious Diseases Epidemiology, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, London, W2 1PG, United Kingdom.
6
Department of Public Health, University of Tartu, Ravila 19, 50411, Tartu, Estonia.
7
Department of Clinical Microbiology, Uppsala University Hospital, SE-751 85, Uppsala, Sweden.
8
Department of Public Health Interventions, Randers Hospital, Skovlyvej, 8900, Randers, Denmark.
9
Department of Infectious Disease Control, Municipal Public Health Service Rotterdam-Rijnmond, PO Box 70032, 3000 LP, Rotterdam, Netherlands.
10
European Centre for Disease Prevention and Control (ECDC), Tomtebodavägen 11 A, 17183, Stockholm, Sweden.

Abstract

BACKGROUND:

Accurate information about the prevalence of Chlamydia trachomatis is needed to assess national prevention and control measures.

METHODS:

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.

RESULTS:

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).

CONCLUSIONS:

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.

PMID:
25615574
PMCID:
PMC4304822
DOI:
10.1371/journal.pone.0115753
[Indexed for MEDLINE]
Free PMC Article

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