Chlamydia trachomatis reinfection rates among female adolescents seeking rescreening in school-based health centers.
BACKGROUND
Chlamydia trachomatis (CT) infections are common among adolescents attending high and middle schools. The study objective was to determine the reinfection rates of CT for females attending school-based health centers.


METHODS
Adolescents attending school-based health centers who reported they were sexually active were screened for CT using nucleic acid amplification tests on cervical or urine samples. Between 1996 and 2003, 10,609 female students were tested. The overall annual prevalence for unduplicated students in a calendar year ranged from 15.1% to 19.5%. Reinfection was defined as a positive test result occurring between 30 and 365 days after an initial positive result.


RESULTS
There were 897 female students who tested positive for CT and returned for at least 1 subsequent test between 30 and 365 days later. Of these, 236 had 1 or more subsequent positive tests for a cumulative incidence of reinfection in 1 year of 26.3% (95% confidence interval = 23.4-29.2%). Young age at first infection was significantly associated with increased risk of subsequent infection (P <0.01). Across sites, the cumulative incidence of reinfection in these female students ranged from 14.3% to 38.9%.


CONCLUSIONS
The chlamydia cumulative incidence of reinfection in these female adolescents attending high and middle schools was high and supports the Centers for Disease Control and Prevention recommendation to screen adolescents frequently, especially those with a history of a previous chlamydia infection.
Gaydos
Charlotte A
CA
Johns Hopkins University, Baltimore, Maryland, USA. cgaydos@jhmi.edu
Wright
Catherine
C
Wood
Billie Jo
BJ
Waterfield
Gerry
G
Hobson
Sharon
S
Quinn
Thomas C
TC
D000293:Adolescent; D016497:Adolescent Health Services / Q000706:statistics & numerical data; D000328:Adult; D015142:Baltimore / Q000453:epidemiology; D002690:Chlamydia Infections / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control* / Q000652:urine; D002692:Chlamydia trachomatis; D005260:Female; D006801:Humans; D015994:Incidence; D010342:Patient Acceptance of Health Care; D015995:Prevalence; D012008:Recurrence; D012307:Risk Factors; D012572:School Health Services / Q000706:statistics & numerical data; D016482:Urinalysis / Q000706:statistics & numerical data; D016387:Women's Health