Chlamydia Screening‐Yes, but of Whom, When, by Whom, and with What?

Abstract

The importance of screening programs in reducing the prevalence of genital chlamydial infections is stressed by the fact that the majority of infected persons are more or less asymptomatic. The use of oral contraceptives may mask infections affecting the upper genital tract. This imposes selective screening and rescreening of women with a history of pelvic inflammatory disease. The recent knowledge that vaginal introital samples will provide a detection rate equal to or even higher than that of cervical samples collected in the same women opens up the possibility of screening women in health units lacking a gynecological examination chair. It also opens up the possibility of outpatient screening programs, for example, home sampling and mailing samples to laboratories that will perform analyses. The use of nucleic acid-based assays means increased sensitivity and specificity compared with earlier used techniques such as ELISA. These former methods can also be used in low-prevalence populations with acceptable positive predictable value, but may be misleading if used in post-therapy check-ups because the antigen may persist in microbiologically cured cases.

Neonatal Chlamydial Infections

“…[31] The rate of chlamydial infecstrategy. [11,43,47] A review of the cost effectiveness of screening tions among infants who received silver nitrate was 92.5% higher reported that screening of asymptomatic women under 30 years of than among those assigned to receive povidone-iodine; the rate age was cost effective at prevalence rates of more than 3%.…”

“…[43] In developing couna historical control group, the rate of transmission of chlamydial tries this is frequently not possible. The cost of screening and infection was reduced by 63% with silver nitrate and 77% with treatment of infected carriers must be weighed up against the cost tetracycline (table I).…”

“…[40] In contrast, Bell et al [41] in a Therefore, primary prevention of neonatal infections through precomparative study of silver nitrate, erythromycin, and no eye natal screening, treatment of infected mothers and their sexual prophylaxis in US infants reported the rate of non-gonococcal partner(s), and active follow-up may be an important strateconjunctivitis to be lower in the silver nitrate and erythromycin gy. [10,43,44] The efficacy of maternal screening depends on the groups versus no treatment. However, no distinction between incidence of chlamydial carriage, the availability of diagnostic chlamydial conjunctivitis and infection with other bacteria was facilities, and the availability of therapy.…”