Screening for chlamydial infection.

摘要: Abstract Objectives: To examine data on the effectiveness of screening for chlamydial infection by a physician or other health care professional. Specifically, we evidence that early treatment improves outcomes, as well strategies in nonpregnant women, pregnant and men, accuracy tests used screening. This review updates literature since last recommendation U.S. Preventive Services Task Force published 1996. Search Strategy: We searched topic chlamydia MEDLINE, HealthSTAR, Cochrane Library databases from January 1994 to July 2000, supplemented reference lists relevant articles experts field. Articles prior research abstracts were cited if particularly important key questions interpretation included articles. Selection Criteria: A single reader reviewed all English abstracts. selected full they about Chlamydia trachomatis genitourinary infections men analytic framework. Investigators read full-text version retrieved applied additional eligibility criteria. For topics, excluded did not provide sufficient information determine methods selecting subjects analyzing data. Data Collection Analysis: systematically three types studies women relate questions: (1) programs reducing prevalence rates infection, (2) risk factors (3) women. Our search found too few review, although pertinent are described. two men: men. Main Results: Nonpregnant The results randomized controlled trial conducted large maintenance organization indicate set reduces incidence pelvic inflammatory disease (PID) over 1-year period. Changes population have been documented because employed representative sample. Age continues be best predictor with most evaluating cut-offs at age younger than 25 years. Other may useful predictors, but these likely specific. critically 34 test performance. Results endocervical swab specimens first-void urine similar performance when using DNA amplification better sensitivity culture. Recurrent associated increased risks PID ectopic pregnancies. Pregnant Second recommendations based major demonstrating improved pregnancy outcomes following infection. identified no recent this our search. Very describe Nonculture testing techniques appear perform limited. Men. No described transmission preventing acute complications Studies lower years is strongest known factor so far. urethral compared tests. more sensitive Conclusions: Screening PID, it reductions uncontrolled studies. whether asymptomatic would reduce prevent complications. variety can detect acceptable specificity, including new use either swabs