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Gaps in Chlamydia testing threaten reproductive health, CDC warns

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Both the rate of screening for Chlamydia trachomatis infection and the rate of retesting patients after treatment fall far below recommended levels



The latest estimate from the Centers for Disease Control and Prevention (CDC) points to a pervasive problem: Only 38% of sexually active young women were screened for C. trachomatis in the previous year. The CDC recommends annual screening for all sexually active women 25 years and younger, as well as for older women who have a risk factor for Chlamydia (i.e., a new sex partner or multiple sex partners). In addition, all pregnant women should be screened.1

The 38% figure comes from a nationally representative estimate of Chlamydia screening among teenage girls and women 15 to 25 years old in the United States. Researchers collected the data as part of the 2006–2008 cycle of the National Survey of Family Growth, a nationally representative household survey.2

Testing was most common among African American women, those who had multiple sex partners, and those who received public insurance or who were uninsured. These are some of the groups at highest risk of infection with Chlamydia, the most commonly reported infectious disease in the United States, with an estimated 2.8 million infections occurring each year.1

Young people are at greatest risk of infection because the cervix is not yet fully matured. Many cases go undetected because most people have few or no symptoms. Left untreated, Chlamydia can cause severe long-term health consequences, including chronic pelvic pain, potentially fatal ectopic pregnancy, and infertility.

“This new research makes it clear that we are missing too many opportunities to protect young women from health consequences that can last a lifetime,” said Kevin Fenton, MD, director of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention.

“Annual Chlamydia screening can protect young women’s reproductive health now and safeguard it for the future.”

Retesting after treatment is also urged

Besides annual screening of young women, the CDC recommends that anyone given a diagnosis of chlamydial infection be retested 3 months after initial treatment to ensure that the infection has cleared. However, additional data from the CDC show that the rate of retesting remains low, with many reinfections likely being missed.

Researchers examined data on more than 60,000 men and women who tested positive for Chlamydia between 2007 and 2009 at facilities participating in the CDC’s Infertility Prevention Project in New York, New Jersey, and the US Virgin Islands. They found that just 14% of men and 22% of women were retested within 30 to 180 days. Of those who were retested, 25% of men and 16% of women again tested positive for Chlamydia

“It is critical that health-care providers are not only aware of the importance of testing sexually active young women every year for Chlamydia infections, but also of retesting anyone who is diagnosed,” said Gail Bolan, MD, director of the CDC’s Division of STD Prevention. “Chlamydia can be easily treated and cured with antibiotics, and retesting plays a vital role in preventing serious future health consequences.”

Detecting Chlamydia: What the CDC recommends
  • Annual screening among all sexually active women 25 years and younger
  • Annual screening for older women who have a risk factor for Chlamydia (i.e., a new sex partner or multiple sex partners)
  • Screening of every pregnant woman
  • Re-testing for Chlamydia 3 months after initial treatment

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