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Original article
National prevalence estimates of chlamydia and gonorrhoea in the Netherlands
  1. Janneke C M Heijne1,
  2. Ingrid V F van den Broek1,
  3. Sylvia M Bruisten2,
  4. Jan E A van Bergen1,3,4,
  5. Hanneke de Graaf5,
  6. Birgit H B van Benthem1
  1. 1 Centre for Infectious Diseases Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
  2. 2 Public Health Laboratory, Department of Infectious Diseases, GGD Amsterdam, Amsterdam, The Netherlands
  3. 3 STI AIDS Netherlands (Soa Aids Nederland), Amsterdam, The Netherlands
  4. 4 Department of General Practice/Family Medicine, Division of Clinical Methods and Public Health, Academic Medical Center, Amsterdam, The Netherlands
  5. 5 Research Department, Rutgers, Utrecht, The Netherlands
  1. Correspondence to Dr Janneke C M Heijne, Centre for Infectious Diseases Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, The Netherlands; janneke.heijne{at}


Objectives National prevalence estimates of Chlamydia trachomatis (chlamydia) and Neisseria gonorrhoeae (gonorrhoea) are important for providing insights in the occurrence and control of these STIs. The aim was to obtain national prevalence estimates for chlamydia and gonorrhoea and to investigate risk factors associated with infection.

Methods Between November 2016 and January 2017, we performed a national population-based cross-sectional probability sample survey among men and women aged 18–34 years in the Netherlands. Individuals were invited to complete a questionnaire about sexual health. At the end of the questionnaire, sexually active individuals could request a home-based sampling kit. Samples were tested for chlamydia and gonorrhoea using nucleic acid amplification test (NAAT). Logistic regression analyses were performed for predictors of participation and chlamydia infection.

Results Of the 17 222 invited individuals, 4447 (26%) participated. Of these, 3255 were eligible for prevalence survey participation and 550 (17%) returned a sample. Participation in the prevalence survey was associated with age (20+) and risk factors for STI. We did not detect any gonorrhoea. The overall weighted prevalence of chlamydia was 2.8% (95% CI 1.5% to 5.2%); 1.1% (0.1% to 7.2%) in men and 5.6% (3.3% to 9.5%) in women. Risk factors for chlamydia infections in women aged 18–24 years were low/medium education level, not having a relationship with the person you had most recent sex with and age at first sex older than 16.

Conclusions Chlamydia and gonorrhoea prevalence were low in the general Dutch population, as was the participation rate. Repeated prevalence surveys are needed to analyse trends in STI prevalences and to evaluate control policies.

  • chlamydia trachomatis
  • neisseria gonorrhoea
  • epidemiology (general)
  • sexual health
  • surveillance

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  • Handling editor Catherine H Mercer

  • Contributors JCMH, IVFvdB and BHBvB designed the prevalence study. JCMH analysed the data and drafted the manuscript. HdG supervised the ‘Sexual Health in the Netherlands’ survey. SMB was responsible for the laboratory work. All authors contributed to the interpretation of the results, commented on the manuscript and approved the final version.

  • Funding The sexual health survey was funded by the Ministry of Health, Welfare and Sport.

  • Disclaimer The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Ethical approval for the prevalence survey was obtained by the medical ethics committee of the University Medical Center of Utrecht, the Netherlands (identification no. 16/392).

  • Provenance and peer review Not commissioned; externally peer reviewed.