Abstract:
BACKGROUND:Evaluating chlamydia prevalence trends from sentinel surveillance is important for understanding population disease burden over time. However, prevalence trend estimates from surveillance data may be misleading if they do not account for changes in risk profiles of individuals who are screened (case mix) and changing performance of the screening tests used. METHODS:We analyzed chlamydia screening data from a sentinel surveillance population of 389,555 young women (1990-2012) and 303,699 young men (2003-2012) entering the US National Job Training Program. This period follows the introduction of national chlamydia screening programs designed to prevent transmission and reduce population disease burden. After ruling out bias due to case mix, we used an expectation-maximization-based maximum likelihood approach to account for measurement error from changing screening tests, and generated minimally biased long-term chlamydia prevalence trend estimates among youth and young adults in this sentinel surveillance population. RESULTS:Adjusted chlamydia prevalence among women was high throughout the study period, but fell from 20% in 1990 to 12% in 2003, and remained between 12% and 14% through 2012. Adjusted prevalence among men was steady throughout the study period at approximately 7%. For both women and men, adjusted prevalence was highest among Black and American Indian youth and young adults, and in the Southern and Midwestern regions of the United States throughout the study period. CONCLUSIONS:Our minimally biased trend estimates provide support for an initial decrease in chlamydia prevalence among women soon after the introduction of national chlamydia screening programs. Constant chlamydia prevalence in more recent years suggests that screening may not be sufficient to further reduce chlamydia prevalence among high-risk youth and young adults.
journal_name
Sex Transm Disjournal_title
Sexually transmitted diseasesauthors
Learner ER,Torrone EA,Fine JP,Pence BW,Powers KA,Miller WCdoi
10.1097/OLQ.0000000000000798subject
Has Abstractpub_date
2018-08-01 00:00:00pages
554-559issue
8eissn
0148-5717issn
1537-4521journal_volume
45pub_type
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journal_title:Sexually transmitted diseases
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doi:10.1097/OLQ.0b013e3182593be7
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journal_title:Sexually transmitted diseases
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journal_title:Sexually transmitted diseases
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doi:10.1097/OLQ.0000000000000338
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journal_title:Sexually transmitted diseases
pub_type: 杂志文章,评审
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journal_title:Sexually transmitted diseases
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doi:10.1097/OLQ.0b013e31815ea2bb
更新日期:2008-04-01 00:00:00
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journal_title:Sexually transmitted diseases
pub_type: 杂志文章
doi:10.1097/00007435-197707000-00005
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journal_title:Sexually transmitted diseases
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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journal_title:Sexually transmitted diseases
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journal_title:Sexually transmitted diseases
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doi:10.1097/01.olq.0000135988.19969.62
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pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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journal_title:Sexually transmitted diseases
pub_type: 杂志文章,多中心研究,随机对照试验
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journal_title:Sexually transmitted diseases
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doi:10.1097/00007435-199503000-00005
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journal_title:Sexually transmitted diseases
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更新日期:2012-09-01 00:00:00
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journal_title:Sexually transmitted diseases
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pub_type: 杂志文章,评审
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更新日期:2012-03-01 00:00:00
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journal_title:Sexually transmitted diseases
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doi:10.1097/00007435-199809000-00001
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journal_title:Sexually transmitted diseases
pub_type: 杂志文章
doi:10.1097/01.olq.0000194617.91454.3f
更新日期:2006-05-01 00:00:00
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journal_title:Sexually transmitted diseases
pub_type: 杂志文章,评审
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更新日期:2017-12-01 00:00:00
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journal_title:Sexually transmitted diseases
pub_type: 杂志文章
doi:10.1097/OLQ.0000000000000304
更新日期:2015-08-01 00:00:00
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journal_title:Sexually transmitted diseases
pub_type: 杂志文章
doi:10.1097/OLQ.0b013e3181aad9df
更新日期:2009-10-01 00:00:00
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