オーストラリアにおけるプライマリケアにおけるオポルトニスティック・クラミジア検査の集団有効性:クラスターランダム化対照試験
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
まとめ
オーストラリアのプライマリケアにおけるオポルトニスティック・クラミジア検査は,若年成人におけるクラミジアの流行を有意に減少させなかった. この研究は,広範なスクリーニングが,この感染症に対する効果的な集団レベル戦略ではないことを示唆しています.
科学分野:
- 公衆衛生
- 感染症
- 主要治療薬
背景:
- 高所得国では,性器のクラミジア・トラコマティスのスクリーニングが推奨されています.
- 人口レベルでの有効性は未だに議論されている.
- この研究は,オーストラリアのプライマリケアにおける機会的検査を調査しています.
研究 の 目的:
- 若い成人 (16-29歳) のクラミジアの流行に多面的な臨床試験の影響を評価する.
- プライマリケアにおける 機会性スクリーニングの有効性を評価する.
主な方法:
- オーストラリアの田舎の町を対象としたクラスターランダム化制御試験
- 介入には,リマインダー,教育,支払い,検査率に関するフィードバックが含まれています.
- 介入前の調査と介入後の調査で推定されたクラミジアの発生率
主要な成果:
- クラミジアの罹患率は介入群 (5. 0% から 3. 4%) と対照群 (4. 6% から 3. 4%) で減少した.
- グループ間の流行減少の違いは統計的に有意ではなかった (OR 0. 9,95%CI 0. 5から1. 5).
- 120のクリニックで 18万人以上の若者が参加しました
結論:
- 初等医療におけるオポルトニスティックなクラミジア検査は,人口のレベルでの有意な減少を達成できないかもしれません.
- この発見は,現在のクラミジア・トラコマティスのスクリーニング戦略の限界を示唆しています.
- 持続的な吸収と有効性に関するさらなる研究が必要である.
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