Chlamydia trachomatis in the United Kingdom: a systematic review and analysis of prevalence studies

Abstract

Objectives: To undertake a systematic review to obtain estimates of genital Chlamydia trachomatis prevalence in various populations in the United Kingdom and Ireland; to determine which populations have the highest rates of infection; and to explore the most important determinants of infection. Methods: Electronic databases were searched using the keywords ''chlamydia'' and ''England,'' ''Wales,'' ''UK,'' ''Scotland,'' ''Ireland,'' or ''Britain.'' Additional unpublished data and references were solicited from experts. Studies were included in the analysis if C trachomatis prevalence was reported, and if they met inclusion criteria. Nine variables identified as potentially important descriptors of chlamydia prevalence were extracted from each study and analysed using various logistic regression models. Only studies reporting prevalence in female populations were included in the models, because there were few data from males. Results: 357 studies were identified using the search methods, 90 of which met inclusion criteria, and 19 of which contributed to the final model. The most influential variables on prevalence were age and setting of the population tested. In general practice surgeries, the under 20 year old age group had an estimated prevalence of 8.1% (95% CI 6.5 to 9.9), 20-24 year olds 5.2% (95% CI 4.3 to 6.3), 25-29 year olds 2.6% (95% CI 2.0 to 3.3), decreasing to 1.4% (95% CI 1.0 to 1.9) in those aged over 30 years. Overall, healthcare settings had higher prevalence estimates than population based studies. For example, among under 20 year olds, estimates were 17.3% (95% CI 13.6 to 21.8) in genitourinary medicine clinics, 12.6% (95% CI 6.4 to 23.2) in antenatal clinics, 12.3% (95% CI 9.8 to 15.3) in termination of pregnancy clinics, 10.7% (95% CI 8.3 to 13.8) in youth clinics, 10.0% (95% CI 8.7 to 11.5) in family planning clinics, and 8.1% (95% CI 6.5 to 9.9) in general practice, compared to 5.0% (95% CI 3.2 to 7.6) in population based studies. The type of test, specimen used, date, and location of test were not strongly associated with chlamydia prevalence. Conclusion: The chlamydia prevalence estimates by age and setting from the model may be used to inform chlamydia screening strategies. The systematic review revealed much heterogeneity in the studies identified, but with clear patterns of prevalence. It also indicated gaps in the knowledge about chlamydia prevalence in certain subgroups such as men and the general population.

Chlamydia trachomatis Load at Matched Anatomic Sites: Implications for Screening Strategies

“…The C. trachomatis positivity rate of 9.9% for the study population, which was recruited from patients at a genitourinary medicine clinic, is consistent with that reported previously for the United Kingdom (1). Although all the quantitative data for organism load analyzed in the present study were obtained with a QLCR assay, the QLCR data for a subset of samples were found to be highly correlated with corresponding QPCR results.…”

Prevalencia de Chlamydia trachomatis y Neisseria gonorrhoeae en adolescentes de colegios de la zona Sabana Centro de Cundinamarca, Colombia

“…Para N. gonorrhoeae, los estudios de población reportan prevalencias de 0,08 a 2,6 % (1,3). La variabilidad en las frecuencias está determinada por las características sociodemográficas y los hábitos sexuales de la población estudiada, así como por los métodos diagnósticos usados, entre otros factores (5).…”

Infección por Chlamydia trachomatis en pacientes de una institución de salud de Bogotá y Medellín, 2012-2015

“…A pesar de la elevada heterogeneidad en la ocurrencia de la infección, puede evidenciarse que en diversas poblaciones de comunidad general o clínicas, hasta 20% puede resultar infectado; esto corrobora la necesidad de la tamización, el diagnóstico oportuno y el tratamiento precoz, para disminuir la recurrencia de este infección y sus consecuencias clínicas; máxime al tener presente que la variabilidad en la magnitud de la infección no depende del tipo de prueba diagnóstica ni la muestra empleada 11 . …”

“…Finalmente, dicho estudio no halló diferencias según el tipo de prueba diagnóstica, muestra clínica ni año de realización 11 .…”

“…Tanto en población general del Reino Unido como en sospechosos de la infección en Bogotá, se observa una disminución gradual de la infección en la medida que aumenta la edad 11 , lo cual resulta útil para identificar a los jóvenes como un grupo de mayor riesgo para la transmisión y recurrencia de la infección. Cabe aclarar que en Medellín no se observó este gradiente, pero la frecuencia entre los 30 y 49 años fue mayor a los demás grupos etarios, permitiendo identificar el segmento de la población en mayor riesgo para la transmisión.…”