Risk factors for Chlamydia trachomatis infection of the cervix: a prospective study of 2000 patients at a family planning clinic.

ABSTRACT

PIP: Chlamydia trachomatis is an obligatory intracellular parasite. The initial genital tract infection in women is most commonly of the columnar cells of the cervix, from which it may spread to other pelvic organs. The parasite may also be carried asymptomatically. Complications of infection are varied. Among women aged younger than 20 years, Chlamydia trachomatis has been shown to cause 63% of acute pelvic inflammatory disease, with an incidence of 30% in all age groups. Among males, Chlamydia trachomatis infection is the cause of 50% of cases of nonspecific urethritis. Such infection may be associated with epididymitis and/or prostatitis, and may subsequently lead to infertility. Neonates exposed to maternal Chlamydia trachomatis infection may develop conjunctivitis or pneumonia. Chlamydia trachomatis infection is probably the most common venereal disease in the world. 2034 patients attending a family planning clinic in Christchurch between May 1984 and July 1985 were tested for the presence of Chlamydia trachomatis infection of the cervix with the goal of defining the high risk groups in which screening may be indicated. 357 of the women had Chlamydia trachomatis infection of the cervix. They were of mean age 21.6 years, and had had an average of eight sex partners since first intercourse. Women who were not infected with Chlamydia were of mean age 23 years and had had an average of six sex partners since first intercourse. Risk factors for acquiring infection with Chlamydia trachomatis were having more than five lifetime partners, being age 20 years or younger, and being pregnant, regardless of the age or number of partners. These findings confirm the need to screen all sexually active women aged 20 years and younger for infection with Chlamydia trachomatis.