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Screening for cervical Chlamydia trachomatis infections in two Dutch populations
E A Thewessen1, W I van der Meijden, H J Doppenberg
1Department of Clinical Microbiology, University Hospital Rotterdam, The Netherlands.
Genitourinary Medicine
|October 1, 1990
Summary
Chlamydia trachomatis infection is prevalent in women attending STD clinics and abortion clinics. Risk factors include age, sexual partners, and vaginal discharge, suggesting screening and prophylactic antibiotics can reduce pelvic inflammatory disease.
Area of Science:
- Gynecology
- Infectious Diseases
- Public Health
Background:
- Chlamydia trachomatis and Neisseria gonorrhoeae are significant causes of sexually transmitted infections.
- Pelvic inflammatory disease (PID) is a serious complication of untreated STIs, particularly in women seeking abortion services.
- Understanding risk factors for C. trachomatis is crucial for targeted screening and prevention strategies.
Purpose of the Study:
- To determine the prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae in women attending an STD clinic and an abortion clinic.
- To identify independent risk factors associated with C. trachomatis infection in these distinct populations.
- To evaluate the potential role of screening and prophylactic antibiotics in reducing PID incidence.
Main Methods:
- Endocervical cultures for C. trachomatis and N. gonorrhoeae were performed on 492 women in an STD clinic (Group I) and 560 women in an abortion clinic (Group II).
- Multivariate analysis was employed to identify risk factors for C. trachomatis infection.
- Vaginal discharge Gram staining was conducted to assess polymorphonuclear cell counts and bacterial flora.
Main Results:
- Prevalence rates for C. trachomatis were 7.3% in Group I and 9.4% in Group II. N. gonorrhoeae prevalence was 2.5% in Group I and 0.4% in Group II.
- Independent risk factors for C. trachomatis in Group I included age, number of sexual partners, abnormal vaginal discharge, and endocervical mucopus.
- In Group II, age and endocervical mucopus were significant predictors. C. trachomatis was associated with Gardnerella type flora and comma-shaped rods in Group II.
- Higher polymorphonuclear cell counts were observed in C. trachomatis-positive women in both groups.
Conclusions:
- C. trachomatis infection is common in both STD and abortion clinic populations, with distinct risk factor profiles.
- Screening for C. trachomatis in abortion clinics may help reduce post-abortal PID.
- Prophylactic antibiotics, selectively used in high-risk patients, could minimize PID incidence and associated costs/side effects.
Keywords:
Abortion SeekersAbortion, InducedBiologyChlamydiaComparative StudiesData AnalysisData CollectionDelivery Of Health CareDemographic FactorsDeveloped CountriesDiseasesEuropeExaminations And DiagnosesFamily PlanningFertility Control, PostconceptionHealthHealth FacilitiesInfectionsLaboratory Examinations And DiagnosesMeasurementNetherlandsOutpatient ClinicPopulationPrevalenceReproductive Tract InfectionsResearch MethodologyRisk FactorsScreeningSexually Transmitted DiseasesSigns And SymptomsStudiesWestern Europe