Incident Chlamydia trachomatis Infections Among Inner-city Adolescent Females
1998
Context.—Adolescents are at highest risk for infection with Chlamydia trachomatis, an important preventable cause of pelvic inflammatory
disease and subsequent tubal factor infertility in US women. Current guidelines
for delivery of adolescent primary care services recommend yearly chlamydia
screening for those adolescent females considered to be at risk.Objectives.—To describe the epidemiology of prevalent and incident chlamydia infection
among adolescent females to assess the appropriate interval for chlamydia
screening and to define risk factors that would identify adolescent females
to target for screening.Design.—Prospective longitudinal study.Patients.—A consecutive sample of 3202 sexually active females 12 through 19 years
old making 5360 patient visits over a 33-month period, January 1994 through
September 1996.Setting.—Baltimore, Md, family planning, sexually transmitted disease, and school-based
clinics.Intervention.—Testing for C trachomatis by polymerase chain
reaction.Main Outcome Measures.—Prevalence and incidence of C trachomatis infections;
predictors of positive test result for C trachomatis.Results.—Chlamydia infection was found in 771 first visits (24.1%) and 299 repeat
visits (13.9%); 933 adolescent females (29.1%) had at least 1 positive test
result. Females who were 14 years old had the highest age-specific chlamydia
prevalence rate (63 [27.5%] of 229 cases; P=.01).
The chlamydia incidence rate was 28.0 cases per 1000 person-months (95% confidence
interval, 24.9-31.5 cases). The median time was 7.2 months to a first positive
chlamydia test result and 6.3 months to a repeat positive test result among
those with repeat visits. Independent predictors of chlamydia infection—reason
for clinic visit, clinic type, prior sexually transmitted diseases, multiple
or new partners, or inconsistent condom use—failed to identify a subset
of adolescent females with the majority of infections.Conclusions.—A high prevalence and incidence of C trachomatis
infection were found among adolescent females. We, therefore, recommend screening
all sexually active adolescent females for chlamydia infection every 6 months,
regardless of symptoms, prior infections, condom use, or multiple partner
risks.
Keywords:
- Correction
- Source
- Cite
- Save
- Machine Reading By IdeaReader
52
References
281
Citations
NaN
KQI