Chlamydia trachomatis infection in Sydney women.
BACKGROUND
In Australia, reported rates of Chlamydia trachomatis infection have been rising progressively since the mid-1990s. Opportunistic testing of sexually active young women attending clinical services for other reasons has already been implemented in a number of other countries.


OBJECTIVE
To help guide chlamydia testing of women, this study aimed to establish factors predictive of chlamydial infection in an Australian clinical setting.


METHODS
Women attending a sexual health service in Sydney who tested positive for C. trachomatis by polymerase chain reaction and who did not have any concurrent urogenital infections (n = 170) were compared with chlamydia-negative controls (n = 170). Factors independently associated with chlamydia were determined using logistic regression.


RESULTS
Although they were present in only a minority of infected women, symptoms of dysuria [adjusted odds ratio (AOR) = 3.2 (95% CI: 1.2-9.1), P = 0.03] and postcoital bleeding [AOR = 2.7 (95% CI: 1.0-7.1), P < 0.05] were each independently associated with chlamydia. Symptoms of vaginal discharge (P = 0.3), abdominal pain (P = 0.2), or intermenstrual bleeding (P = 0.1) did not help to discriminate between infected and uninfected women. The following factors were independently associated with chlamydia: younger age (P = 0.003); being overseas-born [AOR = 2.3 (95% CI: 1.3-4.0), P = 0.005]; sex with a partner from overseas [AOR = 2.0 (95% CI: 1.3-12.3), P = 0.01]; and sex with a partner known or suspected to be chlamydia-infected [AOR = 7.4 (95% CI: 3.6-15.0), P < 0.001].


CONCLUSIONS
Chlamydia testing is clinically indicated in sexually active young women with dysuria, postcoital bleeding or contact with a suspected chlamydia-infected partner. Consideration should be given to enhanced screening programs for travelling and migrant men and women in Australian cities.
Chen
Marcus Y
MY
Sydney Sexual Health Centre, Sydney Hospital, Sydney, Australia. mchen@mshc.org.au
Rohrsheim
Richard
R
Donovan
Basil
B
D000328:Adult; D017677:Age Distribution; D001315:Australia / Q000453:epidemiology; D016022:Case-Control Studies; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000453:epidemiology* / Q000635:transmission; D002692:Chlamydia trachomatis / Q000302:isolation & purification*; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D016017:Odds Ratio; D011336:Probability; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D015231:Sexually Transmitted Diseases, Bacterial / Q000175:diagnosis / Q000453:epidemiology*; D014505:Urban Population