High prevalence of Chlamydia trachomatis infections in adolescent females not having pelvic examinations: Utility of PCR-based urine screening in urban adolescent clinic setting

Oh, M. Kim; Richey, Charity M.; Pate, Mitchell S.; Brown, Pernell; Hook, Edward W.

doi:10.1016/s1054-139x(96)00311-4

Cited by 30 publications

(13 citation statements)

References 23 publications

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“…This rate is comparable to rates of asymptomatic infection among previously examined sexually active populations. [8][9][10][11][12][13][14][15] Urine-based screening was easy to integrate into emergency department service delivery and was well accepted by the emergency department client population.…”

Section: Discussionmentioning

confidence: 99%

“…[9][10][11][12][13] More than 40% of participants reported a history of STIs, which proved to be a significant risk marker for current infection. Because asymptomatic infection may persist over long periods, number of sex partners in the previous year was a more sensitive marker for infection than number of partners in the previous 3 months.…”

Section: Discussionmentioning

confidence: 99%

“…6,7 Previous screening studies have demonstrated high prevalence rates of asymptomatic chlamydial infection in family planning centers, adolescent health facilities, detention centers, school-and community-based clinics, and military settings. [8][9][10][11][12][13][14][15] The emergency department represents another health care access site for identifying persons with asymptomatic STIs. Many persons at risk for STIs use emergency departments as a primary source of health care.…”

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confidence: 99%

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Emergency department screening for asymptomatic sexually transmitted infections

Todd

Haase²,

Stoner³

2001

Am J Public Health

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OBJECTIVES: This study assessed the prevalence and correlates of asymptomatic genital tract infection with Neisseria gonorrhoeae and Chlamydia trachomatis among emergency department patients. METHODS: Individuals seeking emergency department evaluation for nongenitourinary complaints provided urine samples for N gonorrhoeae and C trachomatis testing by ligase chain reaction and completed a sociodemographic and behavioral questionnaire. RESULTS: Asymptomatic N gonorrhoeae or C trachomatis was found in 9.7% of persons tested. Correlates of C trachomatis infection included younger age, residence in high-morbidity zip code areas, previous history of N gonorrhoeae or C trachomatis, and number of sex partners in the past year. CONCLUSIONS: Urine-based screening of asymptomatic emergency department patients detected significant numbers of N gonorrhoeae and C trachomatis infections. Targeted screening programs may contribute to community-level prevention and control of sexually transmitted infections.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Emergency department screening for asymptomatic sexually transmitted infections

Todd

Haase²,

Stoner³

2001

Am J Public Health

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“…10,25,26,42 for whom all prior test results (Ն1) were negative during the study period. OR indicates odds ratio; CI, confidence interval; STD, sexually transmitted disease; and ellipses, data not applicable.…”

Section: -41mentioning

confidence: 99%

Incident <EMPH TYPE="ITAL">Chlamydia trachomatis</EMPH> Infections Among Inner-city Adolescent Females

Burstein

Gaydos²,

Diener‐West

et al. 1998

JAMA

249

129

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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.

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“…Urine and self-collected samples represent easy and noninvasive techniques compared to the usual cervical swabbing, which necessitates vaginal speculum insertion and a gynecologic examination. In a study, as many as 60% of chlamydia-infected adolescents would have been missed if the urine screening program had not been in place, because they refused the gynecologic examination (14). In addition, specimens may be collected in nontraditional medical settings, such as community centers and schools, and eventually at home (6,11,15,17).…”

mentioning

confidence: 99%

Evaluation of a Modified Sanitary Napkin as a Sample Self-Collection Device for the Detection of Genital Chlamydial Infection in Women

Alary¹,

Poulin²,

Bouchard³

et al. 2001

J Clin Microbiol

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A modified sanitary napkin was compared with endocervical swab and urine specimens for the detection of urogenital Chlamydia trachomatis infection. Endocervical swabs and/or first-catch urine were collected from 510 women at medical or community settings in Quebec City. Participants were also asked to wear a modified sanitary napkin (Ezy-Detek) during 4 consecutive hours and to bring it back to the clinic or mail it to the laboratory. Endocervical and urine specimens were tested using the Cobas Amplicor CT/NG assay (Roche Diagnostic Systems) according to the manufacturer's instructions, as were specimens collected with the napkin after adequate preparation. If the PCR test result was positive on the endocervical sample or on any two samples, a woman was considered to be infected. PCR testing results on paired samples were identical for 493 Chlamydia trachomatis infection is the most frequently reported sexually transmitted disease in the industrialized countries. The association of this infection with transmission of human immunodeficiency virus infection, pelvic inflammatory disease, infertility, ectopic pregnancy, and chronic pelvic pain (10, 20, 30) constitutes a major public health concern. Because most infected women have no specific symptoms or are asymptomatic, screening programs represent one of the main approaches to control this infection (20,21).The current literature provides very good information on the value of gene amplification techniques, such as PCR or ligase chain reaction, for the detection of C. trachomatis in the lower genital tracts of women. Both technologies have been evaluated in depth using endocervical swab or urine samples. With a specificity higher than 98%, the sensitivity of PCR on either cervical specimens or urine samples varies from 80.0 to 100% (4,12,18,19,27,28).More recently, detection of chlamydial infection by these techniques has also been assessed on secretions recovered from vaginal introitus collected by clinicians or patients themselves (2,5,9,15,16,22,26,31,33) or from vaginal tampons (13,(23)(24)(25). Urine and self-collected samples represent easy and noninvasive techniques compared to the usual cervical swabbing, which necessitates vaginal speculum insertion and a gynecologic examination. In a study, as many as 60% of chlamydia-infected adolescents would have been missed if the urine screening program had not been in place, because they refused the gynecologic examination (14). In addition, specimens may be collected in nontraditional medical settings, such as community centers and schools, and eventually at home (6,11,15,17). Although these methods have been shown to be relatively easy to use and sensitive for the detection of C. trachomatis, some women failed to collect adequate specimens or did not feel at ease with the technique (2,16,31). The objective of the present study was to evaluate a modified sanitary napkin (Ezy-Detek [EDI] Inc., Sillery, Canada) as a specimen self-collection device for detection of chlamydial infection in women. Results of PCR tests ...

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High prevalence of Chlamydia trachomatis infections in adolescent females not having pelvic examinations: Utility of PCR-based urine screening in urban adolescent clinic setting

Cited by 30 publications

References 23 publications

Emergency department screening for asymptomatic sexually transmitted infections

Emergency department screening for asymptomatic sexually transmitted infections

Incident <EMPH TYPE="ITAL">Chlamydia trachomatis</EMPH> Infections Among Inner-city Adolescent Females

Evaluation of a Modified Sanitary Napkin as a Sample Self-Collection Device for the Detection of Genital Chlamydial Infection in Women

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