Risk factors for Chlamydia trachomatis infection in adolescents: results from a representative population-based survey in Germany, 2003–2006

Abstract

Infections with Chlamydia trachomatis (CT) can lead to severe sequelae; however, they are not notifiable in Germany. We tested urine samples from participants of KiGGS (German Health Interview and Examination Survey for Children and Adolescents) for CT infections and linked the results to demographic and behavioural data from 1,925 participants (girls aged 15-17 years and boys aged 16-17 years) to determine a representative prevalence of CT infection in adolescents in Germany and to assess associated risk factors. Prevalence of CT infection was 2.2% (95% CI: 1.4-3.5) in girls and 0.2% (95% CI: 0.1-0.7) in boys. CT infection in girls was associated with higher use of alcohol, marijuana and cigarettes, lower social status, oral contraceptive use, pregnancy, repeated lower abdominal pain and higher rates of doctors' consultations within the preceding three months and consultation of gynaecologists within the last 12 months. In multiple logistic regression, we identified two predictors for CT infection: marijuana consumption often or several times within the last 12 months (F(1,164)=7.56; p<0.05) and general health status less than 'very good' (F(1,164)=3.83; p=0.052). Given our findings, we recommend enhancing sex education before sexual debut and promoting safe sex practices regardless of the contraceptive method used. Well-informed consumption of alcohol should be promoted, the risky behaviour of people intoxicated through consumption of marijuana highlighted and doctors' awareness of CT screening enhanced.

Prevalence of Chlamydia trachomatis infection in women, heterosexual men and MSM visiting HIV counselling institutions in North Rhine-Westphalia, Germany - should Chlamydia testing be scaled up?

“…In a German population-based survey conducted among adolescents (2003–2006), the prevalence of Chlamydia infection was 2.2 % (95 % CI: 1.4–3.5) in girls aged 15–17 years and 0.2 % (95 % CI: 0.1–0.7) in boys aged 16–17 years [5]. …”

Screening Adolescents for Sexually Transmitted Infections in the Pediatric Emergency Department

“…17 Furthermore, other studies have demonstrated that high risk social behaviors, such as violence exposure and substance use, are associated with STIs. 18,19 The main objective was to determine the prevalence of CT and GC infections in our studied population. In addition, we sought to clarify whether certain health care-seeking patterns, high-risk sexual behaviors, high-risk social behaviors, and conditions such as abuse, depression, and SI were associated with a positive screen for STIs.…”

Analysis of Public Policies for Sexuality Education in Germany and The Netherlands

“…For example, in a U.S. study of sexually experienced 15-to 24-year-old females, 7.1% were found to be positive for chlamydia (Forhan et al, 2009). This compares with the findings of a population-based, representative sample of females the same age in Germany who had a prevalence rate of 2.2% (Haar et al, 2013) and the findings of a Netherlands study of pregnant women under 30 years old who had a 1.9% prevalence rate (Pereboom et al, 2014). Although teens in the United States and Europe have similar levels of sexual activity, teens in Germany and The Netherlands are much more likely to use contraceptives and, therefore, have substantially lower pregnancy and STI rates (Santelli, Sandfort, & Orr, 2005).…”