Sex Transm Infect 77:26-32 doi:10.1136/sti.77.1.26

Predictors of repeat Chlamydia trachomatis infections diagnosed by DNA amplification testing among inner city females

  1. Gale R Burstein1,
  2. Jonathan M Zenilman1,
  3. Charlotte A Gaydos1,
  4. Marie Diener-West2,
  5. M René Howell1,
  6. Wayne Brathwaite3,
  7. Thomas C Quinn1,4
  1. 1Division of Infectious Diseases, Johns Hopkins University, Baltimore, MD, USA
  2. 2Department of Biostatistics
  3. 3Baltimore City Health Department, Baltimore, MD, USA
  4. 4National Institute of Allergy and Infectious Diseases, National Institute of Health, Bethesda, MD, USA
  1. 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 gib5{at}
  • 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.


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