Screening Young Adults for Prevalent Chlamydial Infection in Community Settings

Abstract

METHODS-Separately for women and men, we developed three predictive models using unconditional multiple logistic regression for survey data. To account for racial/ethnic disparity in prevalence, initial models included identical predictor characteristics plus information on 1) respondent's race/ethnicity; or 2) respondent's most recent partner's race/ethnicity; or 3) no information on race/ethnicity. RESULTS-C. trachomatis diagnosis was available for 10,928 (88.6%) of the sexually experienced respondents. A combination of five characteristics for women and six characteristics for men identified approximately 80% of infections while testing ≤50% of the population. Information regarding race/ethnicity dramatically affected algorithm performance.CONCLUSION-Using race/ethnicity in any screening algorithm is problematic and controversial, but the model without race information missed many diagnoses in the minority groups. Universal screening in high prevalence regions and selective screening in low prevalence regions may be one method of reaching the affected populations while avoiding the stigma of guidelines incorporating race/ethnicity.Chlamydia trachomatis, with an estimated three million new infections each year, is the most common bacterial sexually transmitted infection (STI) in the United States (US), especially among adolescents and young adults (1). Black, Native American, and Latino women and men are disproportionately burdened with infection (2). Although predominately asymptomatic

Detection of chlamydia trachomatis by immunological methods in adult and adolescent female population in Cuiabá, Mato Grosso

“…Among the ethnic group, there was a higher number of positive cases in the mulatto group, perhaps owing to the prevalence of this phenotype in the population of Mato Grosso. However, there were no significant differences between white or black skin groups, although some authors consider the existence of differences in the prevalence of Chlamydia infection among ethnic groups (30,31) . Various methods are employed for the diagnosis of Chlamydia.…”

“…However, the diagnosis by PCR has replaced other techniques for its speed, more reliable reproducibility and, currently, low cost. The methods based on the amplification of nucleic acids have demonstrated a high positive predictive value, presenting the advantage of being usable with urethral, cervical, vaginal, and urine specimens (30,31) . Several factors can interfere with the determination of the prevalence of this STD, such as the laboratory resources available, ecology of the bacteria, the sexual behavior of population groups, therapeutic interference, among others.…”

It matters what you measure: a systematic literature review examining whether young people in poorer socioeconomic circumstances are more at risk of chlamydia

“…NHANES compared those on annual salaries above and below $20 000, and found ORs that were slightly weaker in magnitude compared with those for education (2.43 vs 3.27). These results were non-significant after adjusting for other variables 7 20. AddHealth applied a subjective measure of poverty (ability to pay utility bills) and a dichotomous measure of employment (job or no job).…”

“…Two US studies—the National Health and Nutrition Examination Survey (NHANES) and the Longitudinal Study of Adolescent Health (AddHealth)—used more than one SEC measure 7 20. In NHANES, adjusted and unadjusted prevalences were significantly higher (2.9 times and 3.3 times respectively) in those who had not graduated high school compared with those who had higher levels of education.…”

Opportunistic testing for urogenital infection with Chlamydia trachomatis in south-western Switzerland, 2012: a feasibility study

“…There were four population-based studies that included a nationally representative sample of the general adult or adolescent population in Croatia (1 study, 1 publication [81]) and the USA (3 studies, 15 publications [83][84][85][86][87][88][89][90][91][92][93][94][95][96][97]). The remaining studies enrolled participants from the general population in one or more regions of a country (four studies in Australia, 6 publications [98][99][100][101][102][103], two studies in Canada, two publications [104,105], two studies in the USA, three publications [106][107][108]), or from a specific group within the general population (e.g.…”