Randomised controlled trial of screening for Chlamydia trachomatis to prevent pelvic inflammatory disease: the POPI (prevention of pelvic infection) trial.
BMJ
; 340: c1642, 2010 Apr 08.
Article
en En
| MEDLINE
| ID: mdl-20378636
ABSTRACT
OBJECTIVE:
To determine whether screening and treating women for chlamydial infection reduces the incidence of pelvic inflammatory disease over the subsequent 12 months.DESIGN:
Randomised controlled trial.SETTING:
Common rooms, lecture theatres, and student bars at universities and further education colleges in London.PARTICIPANTS:
2529 sexually active female students, mean age 21 years (range 16-27). INTERVENTION Participants completed a questionnaire and provided self taken vaginal swabs, with follow-up after one year. Samples were randomly allocated to immediate testing and treatment for chlamydial infection, or storage and analysis after a year (deferred screening controls). MAIN OUTCOMEMEASURE:
Incidence of clinical pelvic inflammatory disease over 12 months.RESULTS:
Baseline prevalence of chlamydia was 5.4% (68/1254) in screened women and 5.9% (75/1265) in controls. 94% (2377/2529) of women were followed up after 12 months. The incidence of pelvic inflammatory disease was 1.3% (15/1191) in screened women compared with 1.9% (23/1186) in controls (relative risk 0.65, 95% confidence interval 0.34 to 1.22). Seven of 74 control women (9.5%, 95% confidence interval 4.7% to 18.3%) who tested positive for chlamydial infection at baseline developed pelvic inflammatory disease over 12 months compared with one of 63 (1.6%) screened women (relative risk 0.17, 0.03 to 1.01). However, most episodes of pelvic inflammatory disease occurred in women who tested negative for chlamydia at baseline (79%, 30/38). 22% (527/2377) of women reported being tested independently for chlamydia during the trial.CONCLUSION:
Although some evidence suggests that screening for chlamydia reduces rates of pelvic inflammatory disease, especially in women with chlamydial infection at baseline, the effectiveness of a single chlamydia test in preventing pelvic inflammatory disease over 12 months may have been overestimated. Trial registration ClinicalTrials.gov NCT00115388.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Infecciones por Chlamydia
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Chlamydia trachomatis
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Tamizaje Masivo
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Enfermedad Inflamatoria Pélvica
Tipo de estudio:
Clinical_trials
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Diagnostic_studies
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Etiology_studies
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Incidence_studies
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Prognostic_studies
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Risk_factors_studies
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Screening_studies
Límite:
Adolescent
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Adult
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Female
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Humans
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Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
BMJ
Asunto de la revista:
MEDICINA
Año:
2010
Tipo del documento:
Article