Screening and treatment of Chlamydia trachomatis infections

Tubal Damage, Infertility and Tubal Ectopic Pregnancy: Chlamydia trachomatis and Other Microbial Aetiologies

“…These authors conclude that their study shows that a longer duration of the asymptomatic period results in a more pronounced impact of a screening programme (Althaus et al, 2010). The incidence of PID in untreated women infected with C. trachomatis has been reviewed and widely discussed in the literature in terms of (1) its cost-effectiveness as a screening program and (2) as a predictor of tubal damage in infertile patients (Aghaizu et al, 2008;Althaus et al, 2010;Bakken & Ghaderi 2009;den Hartog et al, 2008;Dietrich et al, 2010;Kalwij et al, 2010;Land et al, 2010;Low et al, 2009;Low & Hocking 2010;Oakeshott et al, 2010;Risser & Risser 2007;Simms & Horner 2008). In a comprehensive study that evaluated all available original research and assessed the incidence of PID following C. trachomatis infection, it was concluded that no study could adequately answer the question and that many studies either had inaccuracies, validition problems or only indirect evidence to support their reported incidences (Risser and Risser, 2007).…”

“…It has also been reported in a prospective study evaluating the sensitivity of multiple-site swab testing (cervix, urethra, vagina and Fallopian tubes) in 2,020 fertility patients over 12 months that multiple site sampling does not increase the detection rate of C. trachomatis among infertile women and in fact that routine DNA testing for C. trachomatis should be confined to cervical sampling (Dietrich et al, 2010). A review from the National Chlamydia screening programme in London has highlighted the need for Chlamydia testing to be offered routinely to young people (under 25 years) as part of an overall approach to sexual health in the community (Kalwij et al, 2010). It has been noted recently that no studies have yet published results of the effects of greater than one round of screening or indeed screening for repeat Chlamydia infections on reproductive sequelae in women following asymptomatic C. trachomatis genital infection .…”

Chlamydia trachomatis Infection and Reproductive Health Outcomes in Women

“…The most common target groups are usually sexually active young persons, especially those with frequent changes of partner, pregnant women, women seeking pregnancy termination, and those undergoing instrumentation of the uterus. Partly due to differences in the local epidemiology and burden of disease, various policies and practices are underway in several countries such as the USA, England, Denmark, Estonia, Iceland, Latvia, Norway, and Sweden, although not all of these policies are nationwide and some are implemented in specific regions only (19,34,50,57). Women are usually more willing than men to undergo diagnostic tests for STI.…”

“…Screening for chlamydia in females aged <25 years has been described as one of the most beneficial and cost-effective preventive services that can be offered in medical practice (58), and has been considered as an A-rated recommended preventive service (strongest recommendation) (93). Screening of men has not been shown to be cost-efficient and, although this practice could prevent many infections in women, its impact on the burden of disease in women by testing young men or specific risk groups is controversial (38,50).…”

“…The various screening modalities have contributed to the increase in the number of detected cases, without this increase representing a real rise in incidence, given that it essentially reveals previously undetected asymptomatic infections. Moreover, recent studies using mathematical models suggest that screening reduces the prevalence of infection (50,90).…”