The Impact of a Comprehensive Chlamydia Prevention Program in Wisconsin

Abstract

An analysis using case reports, laboratory records of tests for C. trachomatis, and Hospital Discharge Summary data shows that, following implementation of a chlamydia prevention program in Wisconsin in 1985, statewide declines were observed in prevalence, incidence and complications of infection. In 1990, prevalence rates among teenage women peaked at 2,794 infections per 100,000 15-19-year-old females. Between 1987 and 1991 (a period of stable testing volume), the proportion of positive tests decreased in all age-groups for females (by 29-41%) and males (by 10-14%), and the incidence of new infections in women decreased in clinic populations by 27%-50%. Between 1986 and 1991, hospitalization rates declined by 33% for pelvic inflammatory disease and by 20% for ectopic pregnancy.

Epidemiological, social, diagnostic and economic evaluation of population screening for genital chlamydial infection

“…22,53 Experience in Sweden and the USA, and pilot studies in the UK 60 and The Netherlands, 68 show that this approach is feasible. Ecological associations between falling rates of chlamydia and its complications in Sweden 56,57,69,70 and the USA 71,72 during the 1990s have been widely cited as evidence of the effectiveness of opportunistic screening. [73][74][75] This interpretation ignores evidence that the fall in pelvic inflammatory disease in Sweden began before any chlamydia control activities were introduced.…”

Chlamydia Trachomatis: Common Misperceptions and Misunderstandings

“…2 Initial support for this policy came from the clinical observation that routine, periodic endocervical screening reduces CT transmission and the related morbidity enough at the community level and make the benefits of screening outweigh the harms. 2,[11][12][13][14][15][16] The results of these studies have now been corroborated by mathematical models, increasing confidence in the efficacy of this approach to the control of CT. 2 Admittedly, screening is rarely conducted in isolation of risk-reduction counseling and other educational interventions that have been associated with safer sexual practices and a concomitant decrease in incident STDs. 17 The favorable individual-and community-level effects attributed to the identification and treatment of CT-infected young women might therefore be due to factors such as increased condom use, decreased numbers of sex partners, and less concurrency in relationships.…”

“…[3][4][5][6][7][8][9] On the other hand, data collected at sentinel surveillance sites suggests that efforts to control this infection have been successful. [11][12][13][14][15][16][17] While there is still no reason for complacency, evidence that over the last decade the decreased prevalence of chlamydial infections documented at these locations has cut across all age, sex, and racial groups ,11-17 may justify diminished concern. At a minimum it suggests the apparent escalation in the scope of the CT epidemic may simply be an artifact of improved test sensitivity, increased reporting, and expanded screening for this hyperendemic infection.…”

Screening op urogenitale Chlamydia trachomatis-infecties: de stand van zaken

“…In de jaren tachtig en begin jaren negentig daalde in Zweden en in de VS in aansluiting op de ontplooide screeningsinitiatieven de prevalentie van chlamydia en in het kielzog ook de prevalentie van PID en extra-uteriene graviditeit (EUG). [40][41][42] Toch blijkt de laatste jaren ondanks deze screeningsprogramma's de prevalentie in Zweden weer toe te nemen. En ook in landen waar geen screening was, daalde in de jaren tachtig de chlamydia-prevalentie als gevolg van de hiv-aids-epidemie.…”