Prevention of Pelvic Inflammatory Disease by Screening for Cervical Chlamydial Infection

Scholes, Delia; Stergachis, Andy; Heidrich, Fred E.; Andrilla, Holly; Holmes, King K.; Stamm, Walter E.

doi:10.1056/nejm199605233342103

Cited by 758 publications

(330 citation statements)

References 18 publications

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“…15 Niettemin hebben twee interventiestudies aangetoond dat screening op CT-infectie en behandeling van de gevonden (veelal asymptomatische) CT-infecties leidt tot vermindering van het aantal gevallen van PID. 17,18 De relatie tussen CT-infectie en cervixkanker en CT-infectie en mannelijke infertiliteit is nog niet definitief vastgesteld en blijft vooralsnog omstreden. Bij mannen kan een CT-infectie in 1-4% van de gevallen aanleiding geven tot opstijgende infecties zoals epididymitis.…”

Section: Er Moet Een Detecteerbare Asymptomatische Of Vroegsymptomatiunclassified

“…Er zijn twee RCT's verricht: één in de VS onder vrouwen met een verhoogd risico op infectie, de andere onder scholieren in Denemarken (selectieve populatiescreening). 17,18 Beide studies tonen aan dat (systematische) CT-screening een reductie van het risico op PID van omstreeks 50% bewerkstelligt. Er is echter enige kritiek op de kwaliteit van beide studies.…”

Section: Rct'sunclassified

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Screening op urogenitale Chlamydia trachomatis-infecties: de stand van zaken

Bergen¹

2009

BIJB

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SamenvattingInfectie met Chlamydia trachomatis (CT) is de meest frequent voorkomende bacteriële soa in Nederland. CT-infecties zijn een belangrijke oorzaak van ontstekingen in het kleine bekken, infertiliteit, buitenbaarmoederlijke zwangerschap en chronische buikpijn bij vrouwen. Zeventig procent van de infecties bij vrouwen en 50% bij mannen verloopt zonder specifieke symptomen. Huidige testmethoden middels amplificatietechnieken maken een screeningsprogramma via thuis verzamelde monsters mogelijk. In 2008 is gestart met een proefimplementatie om meer inzicht te krijgen in haalbaarheid, effectiviteit en impact.Kernpunten 1 Naar schatting vinden jaarlijks 60.000Chlamydia-infecties plaats in Nederland. 2 Actieve opsporing en vroege behandeling leveren voordelen op voor het individu (voorkómen van complicaties) en voor de volksgezondheid (voorkómen van verdere verspreiding). 3 Onderzoek van (thuis) zelf afgenomen monsters is betrouwbaar en maakt screening mogelijk zonder noodzaak tot lichamelijk onderzoek. 4 In 2008 is gestart met een proefimplementatie van Chlamydia-screening in Amsterdam, Rotterdam en Zuid-Limburg. 5 De bewijskracht voor effectiviteit en impact van een nationaal screeningsprogramma moet nog worden uitgebreid alvorens landelijke toepassing kan plaatsvinden.

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Section: Er Moet Een Detecteerbare Asymptomatische Of Vroegsymptomatiunclassified

Section: Rct'sunclassified

Screening op urogenitale Chlamydia trachomatis-infecties: de stand van zaken

Bergen¹

2009

BIJB

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“…The major aims of C. trachomatis screening are to reduce morbidity by early detection and treatment of lower genital tract infection as well as to decrease prevalence of this infection and consequently reduce their transmission [19]. Randomized controlled trial conducted in the USA demonstrated that selective C. trachomatis screening reduced the incidence of PID by 56% after 1 year of follow up [20]. In addition, for every 83 women screened, one case of PID is prevented [21].…”

Section: Introductionmentioning

confidence: 99%

Screenning of <i>Chlamydia trachomatis</i> Infection among Women Attending Outpatient Clinic of Infertility

Lavorato¹,

Moço²,

Martín³

et al. 2015

OJOG

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Objective: The goal of this study was to determine the prevalence of C. trachomatis in women diagnosed with infertility attending the Outpatient Clinic of Infertility from Botucatu Medical School, UNESP, Brazil. Patients and Methods: This molecular study enrolled a total of 112 women. Among these patients, 62 presented primary infertility while 50 presented secondary infertility. The criteria for eligibility included women who were: reproductive-aged; no prior report of seroconversion for HIV; no antibiotic or vaginal cream used in the preceding 30 days; and abstinence from sexual intercourse for 72 hours before the visit. The women were submitted to a gynecological examination and cervical samples were collected with an endocervical cytobrush for molecular analysis of C. trachomatis. Results: The prevalence of chlamydial infection was 8% with similar prevalence between primary (8.1%) and secondary (8.0%) infertility. Conclusion: Considering the asymptomatic nature of chlamydial infection and its association with tubal factor infertility, there is a pressing need to incorporate the screening of C. trachomatis infection as part of the routine investigation for infertility. The early diagnostic by screening can minimize complications and reduce Public Health costs with Assisted Reproductive Technology.

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“…5 The predominance of asymptomatic infection in conjunction with endemic levels of disease creates an environment whereby proactive screening is not only vital for improving health status but also represents a cost-effective measure. 6,7 …”

Section: Introductionmentioning

confidence: 99%

'Yes wee can' - a nurse-driven asymptomatic screening program for chlamydia and gonorrhoea in a remote emergency department

Mossenson¹,

Algie

Olding

et al. 2012

Sex. Health

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Abstract. Background: A nurse-driven, urine-based screening program for Neisseria gonorrhoeae and Chlamyida trachomatis was conducted in a remote emergency department targeting asymptomatic youth. Methods: Individuals who presented to the Emergency Department with non-genitourinary complaints between the ages of 16 and 34 were offered free opportunistic urinary testing for gonorrhoea and chlamydia. Results: In total, 178 eligible patients were offered screening, 65% consented for testing and 14 patients (12%) returned positive results, with 10 diagnoses of chlamydia, 9 of gonorrhoea and 5 with both. Discussion: Emergency departments are an underutilised interface between difficult to reach at risk youth populations and public health services.

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Prevention of Pelvic Inflammatory Disease by Screening for Cervical Chlamydial Infection

Abstract: A strategy of identifying, testing, and treating women at increased risk for cervical chlamydial infection was associated with a reduced incidence of pelvic inflammatory disease.

Cited by 758 publications

References 18 publications

Screening op urogenitale Chlamydia trachomatis-infecties: de stand van zaken

Screening op urogenitale Chlamydia trachomatis-infecties: de stand van zaken

Screenning of <i>Chlamydia trachomatis</i> Infection among Women Attending Outpatient Clinic of Infertility

'Yes wee can' - a nurse-driven asymptomatic screening program for chlamydia and gonorrhoea in a remote emergency department

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Prevention of Pelvic Inflammatory Disease by Screening for Cervical Chlamydial Infection

Abstract: A strategy of identifying, testing, and treating women at increased risk for cervical chlamydial infection was associated with a reduced incidence of pelvic inflammatory disease.

Cited by 758 publications

References 18 publications

Screening op urogenitale Chlamydia trachomatis-infecties: de stand van zaken

Screening op urogenitale Chlamydia trachomatis-infecties: de stand van zaken

Screenning of &lt;i&gt;Chlamydia trachomatis&lt;/i&gt; Infection among Women Attending Outpatient Clinic of Infertility

'Yes wee can' - a nurse-driven asymptomatic screening program for chlamydia and gonorrhoea in a remote emergency department

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Screenning of <i>Chlamydia trachomatis</i> Infection among Women Attending Outpatient Clinic of Infertility