クラミジアおよびゴノコック感染症のスクリーニング:米国予防サービスタスクフォースの最新証拠報告と体系的レビュー
Amy Cantor1,2,3, Tracy Dana1, Jessica C Griffin1
1Pacific Northwest Evidence-based Practice Center, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland.
JAMA
|September 14, 2021
まとめ
クラミジアのスクリーニングは,若い女性の骨盤炎症のリスクを大幅に減らす. 検査の精度はほとんどのサイトで高いが,男性と妊婦についてはさらなる研究が必要である.
科学分野:
- 公衆衛生
- 感染症
- 予防医学
背景:
- 米国予防サービスタスクフォース (USPSTF) は以前,性的に活発な若い女性に対して,クラミジアと淋病のスクリーニングを推奨していた.
- 男性でのスクリーニングの証拠は不十分で,更新されたレビューが必要でした.
研究 の 目的:
- 成人および青少年におけるクラミジアおよびゴノコック感染症のスクリーニングに関する最新の証拠レビューを提供すること.
- 検診の有効性,検査の正確性,有害性に関するUSPSTFの勧告を参考にすること.
主な方法:
- 2014年から2021年までのランダム化臨床試験と観察研究の体系的レビュー.
- 独立した調査員によるデータ抽出と品質評価
- スクリーニングの有効性,リスクの階層化,試験の精度,およびスクリーニングの害の分析
主要な成果:
- 若い女性の骨盤炎症疾患 (PID) のリスクが低下した.
- 22歳未満の年齢は,広範囲の基準に匹敵する,クラミジアのリスクの主要な予測因子でした.
- クラミジアとゴノコックスの検査は,ほとんどの解剖学的部位と自己採取した標本において高い精度を示した.
結論:
- クラミジアのスクリーニングは,若い女性のPIDリスクを減らすのに有効です.
- 現在のリスク予測ツールは 年齢を超えて 精度が限られています
- 男性,妊婦のスクリーニング有効性,最適な間隔,副作用に関するさらなる研究が必要である.
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