Long‐term trends of Chlamydia trachomatis in a clinic population at the Royal Women's Hospital, Melbourne

Abstract

Background Chlamydia trachomatis (C. trachomatis) prevalence has been reported to be increasing. Whether this is a true increase over time or confounded by increases in testing and/or use of more sensitive assays is to be determined. Materials and Methods One laboratory service has been detecting C. trachomatis for the past 30 years within the Royal Women's Hospital Melbourne. We conducted a retrospective audit of records over the period 1986–2016 from a clinic population routinely offered chlamydia screening. These were women presenting for family planning advice (termination of pregnancy, intrauterine device insertion or considered at high risk), who underwent chlamydia testing in the context of various diagnostic assays used over this time period. Assays utilised included culture, enzyme immunoassay (EIA), DNA probe, and nucleic acid amplification testing (NAAT). Non‐parametric test for trend was used to determine significant differences between prevalence estimates across ordered groups. Least squares regression was conducted to describe a linear trend matching known data points. Results Overall, there was no significant change for chlamydia prevalence which was 2.2%, in the 30‐year study period (P = 0.7). Over time diagnostic assays changed from culture, to EIA, DNA probe, to the more sensitive NAAT. The bulk of the positives were in women under 25 years of age (57%). Conclusion Chlamydia prevalence has been stable over 30 years, remaining a problem in young women. Screening for those at risk needs underscoring in a national sexual health program.

Prevalencia de Chlamydia trachomatis en la población femenina asintomática atendida en los servicios de citología cervical de tres instituciones prestadoras de servicios de salud en Medellín, Colombia

“…Si bien en este estudio el 83 % de las participantes tenía una edad superior a los 25 años, se encontró una tendencia a la disminución de la infección por C. trachomatis a medida que aumentaba la edad, situación también observada en otros lugares del mundo, por lo que se considera que la infección por C. trachomatis es dependiente de la edad, siendo más común en mujeres sexualmente activas menores de 25 años 20 , 21 . La tendencia a la disminución de la infección a medida que aumenta la edad podría explicarse por una reducción del número de nuevas parejas sexuales, la presencia de factores biológicos protectores para el desarrollo de la infección y promotores de una rápida resolución 2 .…”