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Previous Volume 339:739-744 September 10, 1998 Number 11 Next

	Full Text PDF Editorial by Stamm, W. E. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background Asymptomatic genital Chlamydia trachomatis infections in women can lead to pelvic inflammatory disease, infertility, and ectopic pregnancy. To design a chlamydia-control program, we conducted a large survey of women in the U.S. military.

Methods From January 1996 through December 1997, urine samples from 13,204 new female U.S. Army recruits from 50 states were screened by ligase chain reaction for C. trachomatis infection. Information on potential risk factors was obtained by questionnaire. With multivariate analysis, we identified criteria for a screening program.

Results The overall prevalence of chlamydial infection was 9.2 percent, with a peak of 12.2 percent among the 17-year-old recruits. The prevalence was 15 percent or more among the recruits from five southern states. The following risk factors were independently associated with chlamydial infection: having ever had vaginal sex (odds ratio for infection, 5.9), being 25 years of age or less (odds ratio, 3.0), being black (odds ratio, 3.4), having had more than one sex partner in the previous 90 days (odds ratio, 1.4), having had a new partner in the previous 90 days (odds ratio, 1.3), having had a partner in the previous 90 days who did not always use condoms (odds ratio, 1.4), and having ever had a sexually transmitted disease (odds ratio, 1.2). A screening program for subjects 25 years of age or less (87.9 percent of our sample) would have identified 95.3 percent of the infected women.

Conclusions Among female military recruits, the prevalence of chlamydial infection is high. A control program that screens female recruits who are 25 years old or younger with urine DNA-amplification assays has the potential to reduce infection, transmission, and the sequelae of chlamydial infection.

Source Information

From the Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore (C.A.G., M.R.H., B.P., T.C.Q.); Walter Reed Army Institute of Research, Washington, D.C. (K.L.C., J.C.G.); U.S. Army Medical Department Activity, Fort Jackson, S.C. (D.A.E., R.M.H.); Henry M. Jackson Foundation, Rockville, Md. (J.C.G.); Womack Army Medical Center, Fort Bragg, N.C. (K.T.M.); and the National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md. (T.C.Q.). The opinions expressed in this article are those of the authors and are not necessarily endorsed by the U.S. Army or the Department of Defense.

Address reprint requests to Dr. Charlotte Gaydos at the Division of Infectious Diseases, Johns Hopkins University, 1159 Ross Research Bldg., 720 Rutland Ave., Baltimore, MD 21205.

Full Text of this Article

Related Letters:

Chlamydia Infections in Female Military Recruits
Soteriades E. S., Coolidge J. A. S., Zangwill M., Ansong K. S., Gaydos C. A., Quinn T. C., McKee K. T., Gaydos J. C.
Extract | Full Text  
N Engl J Med 1999; 340:237-238, Jan 21, 1999. Correspondence

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