[Diagnostic efforts for the detection of chlamydia trachomatis infections in Iceland 1982-1994.]

The results of diagnostic testing for the detection of Chlamydial infections in Iceland during the years 1982 to 1994 were reviewed. During those 13 years 123,461 laboratory tests were performed in 101,574 examinations. These examinations were positive in 14,462 instances. The first diagnostic test to be introduced was cell culture in 1982. From then on the number of examinations and the number of positive examinations increased steadily until 1988, when positive examinations reached a peak at approximately 570 cases per 100,000 inhabitants. In 1990 a sharp decline in both the total number of examinations and positive results was observed. The percentage of positive examinations declined during the study period. In 1991 and 1992 the number of examinations, the number of positive examinations and the percentage of positive examinations increased but the number of positive tests declined again in 1993. In 1994 the polymerase chain reaction assay (PCR) replaced the much less sensitive Chlamydiazyme(R) assay and the number of positive examinations rose again although the number of tests declined. The dramatic reduction in prevalence experienced in Sweden does not seem to have taken place in Iceland. In Sweden a substantial effort was made to screen asymptomatic populations. In Iceland the screening of asymptomatic patients increased from the beginning of the study period until 1988 but declined thereafter. Screening of asymptomatic populations as well as contact tracing may be important for bringing about a significant reduction of the prevalence of sexually transmitted infections caused by Chlamydia trachomatis.