Predictors of repeat Chlamydia trachomatis infections diagnosed by DNA amplification testing among inner city females
- Gale R Burstein1,
- Jonathan M Zenilman1,
- Charlotte A Gaydos1,
- Marie Diener-West2,
- M René Howell1,
- Wayne Brathwaite3,
- Thomas C Quinn1,4
- 1Division of Infectious Diseases, Johns Hopkins University, Baltimore, MD, USA
- 2Department of Biostatistics
- 3Baltimore City Health Department, Baltimore, MD, USA
- 4National Institute of Allergy and Infectious Diseases, National Institute of Health, Bethesda, MD, USA
- Gale Burstein, MD, MPH, Centers for Disease Control and Prevention, Division of Adolescent and School Health, 4770 Buford Hwy, NE, MS K-33, Atlanta, GA 30341, USA
- Accepted 14 November 2000
Objective: To describe the epidemiology of prevalent and incident chlamydia infection in order to assess the appropriate interval for chlamydia screening; and to identify risk factors predictive of infection and repeat infections.
Design: Prospective longitudinal study of a consecutive sample of 3860 sexually active females aged 12–60 years tested for C trachomatis by polymerase chain reaction in Baltimore City clinics during 11 904 patient visits over a 33 month period.
Results: Chlamydia prevalence, incidence, and frequency to diagnosis of infection varied by age. Among 2073 females <25 years, chlamydia infection was found in 31.2%. The median times to first and repeat incident infections were 7.0 months and 7.6 months, respectively. Among 1787 females ≥25 years, chlamydia infection was found in 9.6%. Median times to first and repeat incident infections were 13.8 months and 11.0 months, respectively. Age <25 years yielded the highest risk of infection.
Conclusions: Since a high burden of chlamydia was found among mostly asymptomatic females <25 years in a spectrum of clinical settings, we recommend chlamydia screening for all sexually active females <25 years at least twice yearly.