Chlamydia trachomatis infection in a rural population: the importance of screening men

This prospective observational cohort study describes the demographics, risk of re-infection, and geographical distribution of chlamydia infections in a rural North Carolina county. Data were collected between 1 November 1992 and 21 January 1994 from private physician reports and from screening patients at the county health department STD clinic. The overall chlamydia rate in the county was 563 cases per 100,000 person-years. Rates were highest among women, 15-19-year-olds and non-whites (662, 3982 and 1272 cases per 100,000 person-years, respectively). The 6-month cumulative incidence of re-infection was 10%. Geographic mapping of case rates showed contiguity among high-risk block groups. The rate in men, 449 cases per 100,000 person-years, was higher than expected. Issues concerning the development of screening programmes for men are discussed.