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Eficacia de las pruebas oportunistas de clamidia en la atención primaria en Australia: un ensayo controlado
Jane S Hocking1, Meredith Temple-Smith2, Rebecca Guy3
1Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.
Lancet (London, England)
|October 23, 2018
Resumen
Las pruebas oportunistas de clamidia en la atención primaria australiana no redujeron significativamente la prevalencia de clamidia en adultos jóvenes. El estudio sugiere que el cribado generalizado puede no ser una estrategia efectiva a nivel de la población para esta infección.
Área de la Ciencia:
- Salud pública
- Enfermedades infecciosas
- Medicina de Atención Primaria
Sus antecedentes:
- El cribado de Chlamydia trachomatis genital se promueve en los países de altos ingresos.
- Su efectividad a nivel poblacional sigue siendo objeto de debate.
- Este estudio investiga las pruebas oportunistas en la atención primaria australiana.
Objetivo del estudio:
- Evaluar el impacto de una intervención clínica multifacética de pruebas de clamidia en la prevalencia de clamidia en adultos jóvenes (de 16 a 29 años).
- Evaluar la eficacia del cribado oportunista en los entornos de atención primaria.
Principales métodos:
- Ensayos controlados aleatorizados por grupos en ciudades rurales de Australia.
- La intervención incluyó recordatorios, educación, pagos y comentarios sobre las tasas de pruebas.
- Prevalencia de clamidia estimada mediante encuestas antes y después de la intervención.
Principales resultados:
- La prevalencia de clamidia disminuyó tanto en los grupos de intervención (del 5,0% al 3,4%) como en los de control (del 4,6% al 3,4%).
- La diferencia en la reducción de la prevalencia entre los grupos no fue estadísticamente significativa (OR 0,9, IC del 95% 0,5-1,5).
- Más de 180.000 jóvenes adultos participaron en 120 clínicas.
Conclusiones:
- Las pruebas oportunistas de clamidia en la atención primaria pueden no lograr reducciones significativas de la prevalencia a nivel de población.
- Los hallazgos sugieren limitaciones de las estrategias actuales de detección de Chlamydia trachomatis.
- Se necesitan más investigaciones sobre la absorción sostenida y la eficacia.
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