Socioeconomic factors and other sources of variation in the prevalence of genital chlamydia infections: A systematic review and meta-analysis

Abstract

BackgroundThe success of chlamydia screening programmes relies on their ability to effectively target those with greatest need. Young people from disadvantaged backgrounds may be at greater need for chlamydia screening, but existing evidence on the variation of prevalence with social position is inconclusive. We carried out a systematic review to examine variation in chlamydia prevalence in populations and possible sources of this variation.MethodsStudies were eligible if they reported chlamydia prevalence derived from population-based samples that included young people aged 15–24 years from Europe, North America or Australia. Systematic searches of the following databases were undertaken from their inception to November 2014: MEDLINE, Embase, Web of Science and PsychINFO. There were no restrictions by language or publication date. Independent screening for eligibility and data extraction were carried out by two reviewers. Where possible, data were pooled in a meta-analysis using a random effects model. Heterogeneity was further investigated using meta-regression techniques.ResultsOf 1248 unique titles and abstracts and 263 potentially relevant full texts, 29 studies were eligible for inclusion. There was relatively strong evidence that disadvantaged young people had an increased risk of having a chlamydia infection across multiple measures of disadvantage, including lower educational attainment (OR 1.94, 95 % CI: 1.52 to 2.47), lower occupational class (OR 1.49, 95 % CI: 1.07 to 2.08) and residence in deprived areas (OR 1.76, 95 % CI: 1.15 to 2.71) with an overall OR of 1.66 (95 % CI: 1.37 to 2.02). Socioeconomic disadvantage was associated with chlamydia infection in both men and women. There was weaker evidence that prevalence estimates also varied by gender and age.ConclusionsThis review provides evidence of a consistent association between socioeconomic disadvantage and higher risk of Chlamydia infection. This association may reflect a number of factors including social variation in engagement with Chlamydia control programmes. Chlamydia screening could therefore reduce or increase health inequalities, depending on service provision and uptake by different socioeconomic groups.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-2069-7) contains supplementary material, which is available to authorized users.

Cervicitis: an Unresolved Gynecological Problem

“…Однако есть несколь-ко исследований, показывающих отсутствие связи между хламидийной инфекцией и развитием поражений шейки матки. Таким образом, роль хламидийной инфекции как фак-тора риска цервикальных поражений по-прежнему остается спорной [31][32][33].…”

La prevalencia actual de infección genital por Chlamydia trachomatis en adolescentes y mujeres jóvenes chilenas asintomáticas justifica la vigilancia periódica

“…Los estudios internacionales y algunos nacionales, hasta ahora reportados, sugieren una prevalencia que depende del nivel socio-económico (más alta aparentemente en regiones donde predomina el estrato socio-económico más bajo) lo cual ha sido vinculado con una mayor ocurrencia de factores de riesgo predisponentes para esta infección 4,14,18 . El presente estudio tiene por objetivo determinar la prevalencia de infección por clamidias en población femenina adolescente y adulta joven usando un kit diagnóstico que incorpora RPC en tiempo real o cuantitativa.…”

“…En el mundo son pocos los países que mantienen un programa de vigilancia de ITS 4,11,18,40,[45][46][47] . Uno de ellos es E.U.A., quien a través del CDC mantiene un registro de reporte anual que permite conocer de las variaciones experimentadas en dicho indicadores y más importante aún, del desarrollo de resistencia a las terapias antimicrobianas existentes 9 .…”

“…Parte de dicho incremento se explica por el aumento (4,1%) de la población entre los 15 y 49 años 1,3 . Otros factores determinantes de tal cambio son: la incorporación de nuevos y mejores métodos de diagnóstico y el cambio cultural, en términos de predisposición al tamizaje y conducta sexual 4,5 . La importancia de conocer la prevalencia de esta infección y de las variaciones que experimente, se basa en la morbilidad que genera.…”

Study of Chlamydia trachomatis Infection in Infertile Females at a Tertiary Care Hospital in Mumbai, India

“…This correlated well with the present study stating prevalence of Chlamydia trachomatis infection is less educated group. In Joanna Crichton et al study [19] , which was a metanalysis for socioeconomic factors and other sources of variation in the prevalence of genital chlamydia infections, it was found that there is an association between lower educational opportunities/attainment and increased risk of Chlamydia infection and it also provides evidence of a consistent association between socioeconomic disadvantage and higher risk of Chlamydia infection. This was in concordance with the present study.…”