Increase in gonorrhoea among very young adolescents, Catalonia, Spain, January 2012 to June 2013.

Between January 2012 and June 2013, 27 sexually transmitted infections were reported in adolescents aged 13-15 years in Catalonia, Spain. In the first half of 2013, there were nine cases of gonorrhoea, while in the same period of 2012, there was one. In June 2013, two gonorrhoea cases aged 13-14 years, linked to a common source through a social network, were reported. The public health response should be adapted to this vulnerable population.

Contingent screening for Down syndrome completed in the first trimester: a multicenter study.

OBJECTIVE: To assess a new contingent screening strategy for Down syndrome completed in the first trimester. METHODS: First-trimester screening combining nuchal translucency thickness measurement and assessment of serum analytes (combined test) was offered to pregnant women who presented for prenatal care during the first trimester to nine health centers and community hospitals in the area served by the Catalan Public Health Service. If an intermediate risk (1/101-1/1000) for Down syndrome was identified, women were referred to the Hospital Clinic Barcelona for risk reassessment that included the use of secondary ultrasound markers (nasal bone, ductus venosus blood flow and tricuspid flow). Intermediate-risk women were divided into two subgroups for further analysis: high-intermediate risk (1/101-1/250) and low-intermediate risk (1/251-1/1000). We compared feasibility and efficacy of both combined and contingent screening strategies. RESULTS: The combined test, the first screening stage, was performed in 16 001 pregnant women, of whom 1617 (10.1%) were found to have an intermediate risk. Further division of this group showed that 1.8% (n = 289) of women were at high-intermediate risk and 8.3% (n = 1328) at low-intermediate risk. The contingent screening strategy significantly reduced the false-positive rate, from 3.0% to 1.3-1.8% (P < 0.001), without affecting the detection rate (which was 75-79% and 76%, with and without the contingent screening strategy, respectively). However, only 45% of intermediate-risk patients underwent the second screening step due to a preference among high-intermediate-risk (1/101-1/250) women for invasive testing and to low uptake among low-intermediate-risk (1/251-1/1000) women. CONCLUSIONS: The proposed first-trimester contingent strategy reduces the screen false-positive rate without impacting on the detection rate of Down syndrome. The low compliance observed in our study may prevent its use in certain populations.

Epidemiological features and determinants for Chlamydia trachomatis infection among women in Catalonia, Spain.

We determined the prevalence of Chlamydia trachomatis (CT) infection and risk factors for its acquisition by women aged less than 35 years who were attending sexual health centres in the province of Barcelona in 2007. A convenience sample of 397 adolescents and young adult women aged between 16 and 35 years, stratified by age and recruitment site, were tested using realtime polymerase chain reaction by CT DNA. A standardized questionnaire was used to collect epidemiological and behavioural data on the participants, which were analysed in a multivariate logistic regression model. The overall prevalence of CT was 4%, significantly higher in those under 25 years of age (5.8% versus 1.6% over 25). The independent risk factors for CT infection were: foreign origin (odds ratio [OR] 4.7; confidence interval [CI] 1.02-21.8), having had a sexual partner in the last three months (OR 4.59; CI 1.16-18.08) and tobacco use the last 12 months (OR 6.38; CI 1.16-34.93). In conclusion, this is the first study performed in Catalonia showing a high prevalence of CT in young women, consistent with trends in the rest of Europe. Systematic monitoring of CT infection in sentinel populations such as this will inform future targeted screening programmes in our setting.