Inexpensive screening of all sexually active young women under 30 for Chlamydia trachomatis infection would vastly reduce infertility and the costly medical complications of this sexually transmitted disease, according to results of a Johns Hopkins study.
The study, which compared results using three screening strategies at family planning clinics in Baltimore, showed that screening young women under 30 at family planning clinics for chlamydia is the most efficient way to identify infected women.
The finding is important because chlamydia is the number one sexually transmitted disease in the United States and causes an additional four million infections each year, according to Thomas C. Quinn, M.D., professor of medicine at Hopkins and a senior researcher at the National Institutes of Health. Untreated chlamydia causes pelvic inflammatory disease, which damages the upper genital tract in women, resulting in infertility and potentially fatal ectopic pregnancy.
Results of the study appear in the Feb. 15 issue of Annals of Internal Medicine.
"This is such a common infection," Quinn says, "that in addition to screening all women under 30, women under 20 should be screened twice a year. It may cost more money up front, but in the long run, the test is cost-effective because it's so sensitive it identifies more infections." Up to 70 percent of women with chlamydial infection may not have symptoms, according to Quinn.
"Managed care companies paying for medical care would benefit from reduced costs because chlamydial infections would be identified early and treated before they progress to pelvic inflammatory disease," adds Quinn.
The screening was done with a new, simple urine test that is more sensitive than previous tests for the microbe that causes the disease, Chlamydia trachomatis, says Quinn. In their study of 7,699 women at two family planning clinics in Baltimore, the Hopkins team found that screening all asymptomatic women under 30 was more effective than either of two other strategies: screening all women under 20 using detailed questionnaires and physical examinations (the Centers for Disease Control and Prevention criteria) and screening all asymptomatic women (universal screening) who visit the clinics.
Other authors of the study include M. Rene Howell and Charlotte A. Gaydos.
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