Re-evaluating selective screening criteria for chlamydial infection among women in the U S Pacific Northwest.

Abstract:

OBJECTIVES:Screening women for Chlamydia trachomatis (CT) infection using selective screening criteria has been operational in the northwestern United States (Region X) since 1988. Changes in the field, including declines in CT prevalence, introduction of sensitive laboratory tests, and budgetary pressures necessitate reevaluating the selective screening approach to ensure program credibility and efficiency. GOALS:The goals of this study were to assess 1). performance of screening criteria in Region X, 2). predictors of CT infection, and 3). optimization of these criteria. STUDY DESIGN:We conducted cross-sectional analysis of 409882 CT test records of women from 1998 to 2000 using multivariate logistic regression and sensitivity and efficiency analyses. RESULTS:Young age (<25 yrs), cervical signs of infection, and recent exposure to or history of chlamydial infection were strongly associated with testing positive. Behavioral risks showed a weak association with infection. Currently used selective screening criteria were sensitive but not efficient. Criteria weighted toward young age, exposure to chlamydia, or cervicitis would increase criteria efficiency by nearly 25% in some settings while detecting >90% of infections. CONCLUSION:Evaluating selective screening criteria can result in modifications that could increase screening efficiency.

journal_name

Sex Transm Dis

authors

La Montagne DS,Patrick LE,Fine DN,Marrazzo JM,Region X Infertility Prevention Project.

doi

10.1097/01.olq.0000124613.85111.6b

subject

Has Abstract

pub_date

2004-05-01 00:00:00

pages

283-9

issue

5

eissn

0148-5717

issn

1537-4521

pii

00007435-200405000-00005

journal_volume

31

pub_type

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