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Fam Plann Perspect. 1987 Nov-Dec;19(6):252-6.

Selective screening for Chlamydia trachomatis infection in nonurban family planning clinics in Wisconsin.

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1
Acute and Communicable Disease Epidemiology Section, Wisconsin Division of Health.

Abstract

To determine the prevalence of, and identify risk factors for, Chlamydia trachomatis infection, we studied 380 women attending four Wisconsin family planning clinics in October 1985. The patients completed self-administered sexual history questionnaires, were examined by nurse clinicians and had specimens taken for direct fluorescent antibody (DFA) testing for C. trachomatis. Of 335 women with adequate specimens, 10.7 percent had positive DFA tests. Selective screening criteria were developed based on the following risk factors for C. trachomatis: Age less than 20 years and recent exposure to either a new sexual partner or a partner with more than one partner; a partner with symptoms of urethritis; a diagnosis of cervicitis; and inflammatory changes on Pap smear. Thirty-six percent of patients met one or more of these screening criteria, and the criteria had a sensitivity of 72 percent.

PIP:

In October 1985, clinicians took an endocervical sample from all women (at least 335) who attended family planning clinics in Wausau, Manitowoc, Eau Claire, and Superior in Wisconsin to determine prevalence and risk factors for chlamydial infection among rural midwestern women. Laboratory staff used the direct fluorescent antibody test for Chlamydia trachomatis. Each patient completed a questionnaire on her clinical and sexual history. 36 (10.7%) had a chlamydial infection. Women who came to the clinic because of a possible sexually transmitted disease or gynecologic infection (11.4%) were just as likely to have a chlamydial infection as were those who came for a routine exam (11.7%). Thus a women's reason for visiting a clinic was not predictive of chlamydial infection. This finding indicated that clinicians should determine the presence of risk factors even in women who come for a routine exam. Further it also indicated that women who visited the clinic with genitourinary symptoms did not necessarily mean a chlamydial infection. Sexual exposure risk factors included a new sexual partner within 3 months before the exam (p=.05; relative risk [RR]=2), a partner with 1 partner within 3 months before the exam (p=.007; RR=3.2), and a partner with signs or symptoms of urethritis within 30 days before the exam (p=.0004; R=14.4). Of all women with C. trachomatis, 40% had mucopurulent discharge and 8.9% did not have it (p=.0001; RR=4.5). Moreover, 26.5% had a friable cervix compared to 8% without a friable cervix (p=.0001; Rr=3.3). Chlamydial infection was also significantly associated with inflammatory changes on the most recent Pap smear (p=.0001; Rr=5.2). Further women 20 years were 2.4 times more likely to have a chlamydial infection than those 20 years old (p=.02). 36% fulfilled at least 1 of the screening criteria. Criteria sensitivity was 72%.

PMID:
3436412
[Indexed for MEDLINE]
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