[Opportunistic screening for genital infections with Chlamydia trachomatis among the sexually active population of Amsterdam. Il Over 90% participation and almost 5% prevalence].
OBJECTIVE
To determine in an opportunistic screening programme for Chlamydia trachomatis (CT) the participation and the CT prevalence among the heterosexual population.


METHODS
Heterosexually active men and women, 15-40 years old, who consulted a general practitioner in Amsterdam, the Netherlands, in the period May 1996-April 1997, without symptoms of a sexually transmitted disease, were asked after informed consent had been given to provide a first-voided urine sample and a few sociodemographic data. The urine was investigated for CT by means of a ligase chain reaction. In case of a CT infection, the general practitioner was asked for information on treatment and partner notification.


RESULTS
A total of 3689 persons were eligible for the study of whom 214 (5.8%) refused participation. Men refused more often than women (9.0% and 4.3% respectively). No relation was found with ethnic background or health care insurance (national health cost insurance/private medical insurance). Refusers were somewhat younger than participants (not statistically significant). CT was diagnosed in 4.9% (95% confidence interval (95% CI): 4.1-5.9) of the women and in 4.7% (95% CI: 3.6-6.1) of the men. In women a decreasing trend was seen in the prevalence of CT with an increase in age: from 13.4% in the group 15-19 years old to 2.3% in the group 35-40 years old. Independent of age a higher prevalence was found in Surinam Creole women. In 83% of the CT patients the general practitioner spoke with the patient about partner notification; usually there was one partner.


CONCLUSIONS
There was a high participation rate (94%) in this opportunistic screening programme in which urine was tested for presence of CT. The CT prevalence in this asymptomatic population was almost 5%, but it was significantly higher in young women and women from Surinam. It is proposed to start such a screening programme in all general practices in Amsterdam.
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002690:Chlamydia Infections / Q000453:epidemiology*; D002692:Chlamydia trachomatis / Q000302:isolation & purification*; D016021:Epidemiologic Studies; D005260:Female; D005831:Genital Diseases, Female / Q000453:epidemiology*; D005832:Genital Diseases, Male / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data*; D009426:Netherlands / Q000453:epidemiology; D010349:Patient Compliance / Q000706:statistics & numerical data*; D015995:Prevalence; D017678:Sex Distribution