Background An opportunistic screening program for Chlamydia trachomatis (CT) was introduced in Germany in 2008, targeting sexually active women under the age of 25. The program suffers from low coverage (∼12%) and its impact on the epidemiology of CT in the German setting remains unclear. As CT is not notifiable in Germany, we used alternative data sources to describe CT-epidemiology in the context of the screening program.

Methods Urine-PCR results from two population-based, nationwide health surveys of adults (DEGS, 2008–2011, subsample=2,364) and minors (KiGGS-Wave 2, 2014–2017, subsample=619) were analyzed. Weighted CT-prevalences were estimated for adults. Prevalence estimation for age-subgroups and adolescents was not possible due to high coefficients of variation, instead unweighted CT-positive proportions were calculated in an explorative analysis. Data from a CT laboratory sentinel system were used to obtain the number of screening tests performed and the proportion of positive results by age and year.

Results The weighted prevalence of CT in the general German population aged 18–44 was estimated at 1.2% (95% confidence interval (95%CI): 0.6%–2.2%) among women and 1.9% (95%CI: 1.2%–3.0%) among men. The highest unweighted CT-positive proportions were found in the younger age groups in both women (18–24y: 2.4%, 95%CI 1.1%–5.0%; 25–34y: 1.5%, 95%CI 0.7%–3.3%) and men (18–24y: 2.0%, 95%CI 0.9%–4.4%; 25–34y: 2.9%, 95%CI 1.6%–5.2%). Among 15- to 17-year-old girls, an unweighted CT-positive proportion of 6.2% (95%CI 2.9%–12.6%) was found. Sentinel data from 2014–2016 (467,474 screening-tests of 15–24 year-old women) showed positive-result proportions of 3.4% (95%CI 3.1%–3.7%), 6.1% (95%CI 5.9%–6.4%) and 3.9% (95%CI 3.7%–4.0%) among 15-, 19- and 24-year-olds, respectively.

Conclusion The German screening program seems to correctly target the women most at risk and may thus prevent cases of CT-sequelae. However, through its low coverage and the exclusion of men, who serve as a reservoir for the infection, the program is not likely to reduce CT-prevalence effectively.

Disclosure No significant relationships.