Chlamydia trachomatis infection in the family planning clinical setting across New South Wales
Deborah J. Bateson A C , Edith Weisberg A and Harpreet Lota BA Sydney Centre for Reproductive Health Research, FPA Health, 328–336 Liverpool Rd, Ashfield, NSW 2131, Australia.
B Imperial College London, SAF Building, Exhibition Road, South Kensington SW7 2AZ, UK.
C Corresponding author. Email: deborahb@fpahealth.org.au
Sexual Health 3(1) 15-20 https://doi.org/10.1071/SH05017
Submitted: 17 March 2005 Accepted: 13 December 2005 Published: 20 February 2006
Abstract
Background: Following a small pilot study in 2003, a study was set up to determine the prevalence of genital Chlamydia trachomatis infection in young women presenting to Family Planning NSW centres across New South Wales and to evaluate the characteristics of those infected. Methods: A cross-sectional survey of 621 consecutive women aged from 16 to 24 years was carried out over a 3-month period in 2004 at five Family Planning NSW centres. Urine samples were tested for C. trachomatis using the polymerase chain reaction (PCR) method. Women with a positive result were reviewed and treated. Results: Of 925 eligible clients, 621 (67%) were recruited to the study. Chlamydia trachomatis was detected in 35 of the 621 recruits (5.6%, 95% CI 3.8–7.4). The prevalence at the Hunter centre was significantly higher than the combined prevalence at the other four participating centres (9.7% compared with 3.9%; P = 0.008). Two characteristics were identified as independent predictors of infection in this study: ‘reporting a recent change of partner in the past three months’ (crude odds ratio (OR) 3.33, 95% CI 1.67–6.64) and ‘reporting three or more partners in the past year’ (crude OR 3.69, 95% CI 1.83–7.46). Reported condom use, a history of one or more sexually transmissible infections and current combined oral contraceptive pill use were not associated with infection in this study. Conclusions: The prevalence of C. trachomatis infection is sufficiently high to support targeted testing of 16–24-year-old women in the Family Planning NSW setting and informs the development of a national screening strategy.
Acknowledgements
The authors thank Catherine Bernasconi at Family Planning NSW and Georgina Luscombe from the Department of Obstetrics and Gynaecology, University of Sydney, for their help with the data retrieval and analysis. This study could not have taken place without the dedicated support of all the staff at the five Family Planning NSW centres.
[1] Yohannes K, Roche P, Blumer C, Spencer J, Milton A, Bunn C, et al. Australia’s notifiable disease status, 2002: annual report of the National Notifiable Diseases Surveillance System. Comm Dis Int 2004; 28 6–68.
[2]
[3] Williams H, Tabrizi SN, Lee W, Kovacs GT, Garland S. Adolescence and other risk factors for Chlamydia trachomatis genitourinary infection in women in Melbourne, Australia. Sex Transm Infect 2003; 79 31–4.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[4] Heal C, Jones B, Veitch C, Lamb S, Hodgens S, Browning S, et al. Screening for Chlamydia in general practice. Austr Family Physician 2002; 31 779–82.
[5]
[6]
[7]
[8]
[9] Simms I, Stephenson JM. Pelvic inflammatory disease epidemiology: what do we know and what do we need to know? Sex Transm Infect 2000; 76 80–7.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[10] Fleming DT, Wasserheit JN. From epidemiological synergy to public health policy and practice: the contribution of other sexually transmitted diseases to sexual transmission of HIV infection. Sex Transm Infect 1999; 75 3–17.
| PubMed |
[11] Centers for Disease Control and Prevention Screening tests to detect Chlamydia trachomatis and Neisseria gonorrhoea infections – 2002. Morb Mortal Weekly Rep 2002; 51 1–27.
[12] Garrow SC, Smith DW, Hartnett GB. The diagnosis of Chlamydia, gonorrhoea and trichomonas infections by self obtained low vaginal swabs, in remote northern Australian clinical practice. Sex Transm Infect 2002; 78 278–81.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[13] Chen MY, Donovan B. Genital Chlamydia trachomatis infection in Australia: epidemiology and clinical implications. Sex Health 2004; 1 189–96.
| Crossref | GoogleScholarGoogle Scholar |
[14]
[15]
[16] Gaydos CA, Howell MR, Pare B. Chlamydia trachomatis infections in female military recruits. N Engl J Med 1998; 339 739–44.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[17] Turner CF, Rogers SM, Miller HG, Miller WC, Gribble JN, Chromy JR, et al. Untreated gonococcal and chlamydial infection in a probability sample of adults. JAMA 2002; 287 726–33.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[18] Marrazzo JM, White CL, Krekeler B, Ceclum CL, Lafferty WE, Stamm WE, et al. Community-based urine screening for Chlamydia trachomatis with a ligase chain reaction assay. Ann Intern Med 1997; 127 796–803.
| PubMed |
[19] Fenton KA, Korovessis C, Johnson AM, McCadden A, McManus S, Wellings K, et al. Sexual behaviour in Britain: reported sexually transmitted infections and prevalent genial Chlamydia trachomatis infection. Lancet 2001; 358 1851–3.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[20] Westom L. The effect of acute pelvic inflammatory disease on fertility. Am J Obstet Gynecol 1975; 121 707–13.
| PubMed |
[21] Louv WC, Austin H, Perlman J, Alexander WJ. Oral contraceptive use and the risk of chlamydial and gonococcal infection. Am J Obstet Gynecol 1989; 160 396–402.
[22] Baeten JM, Nyange PM, Richardson BA, Lavreys L, Chohan B, Martin HL, et al. Hormonal contraception and risk of sexually transmitted disease acquisition: Results from a prospective study. Am J Obstet Gynecol 2001; 185 380–5.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[23] Morrison CS, Bright P, Wong EL, Kwok C, Yacobsen I, Gaydos CA, et al. Hormonal contraceptive use, cervical ectopy and the acquisition of cervical infections. Sex Transm Dis 2004; 31 561–7.
| PubMed |
