Stable chlamydia prevalence does not exclude increasing burden of disease

摘要

In the November 2011 issue of Sexually Transmitted Diseases, Satterwhite et al. report the results of over 5 million chlamydia screening tests in 15- to 24-year-old females attending Infertility Prevention Project (IPP) family planning clinics in the United States (US) from 2004 through 2008.1 The results of their analysis suggest that chlamydia test positivity in this population did not change significantly from 2004 to 2008 after controlling for age, race, test usage, and geography. Based on their results, they propose that the increase in chlamydia case rates of more than 20% over this same period2 is not evidence of an increasing burden of disease. Rather, the authors contend that increasing cases are the result of increasing usage of more sensitive nucleic acid amplification testing combined with increasing coverage of chlamydia screening. They conclude that the chlamydia burden of disease in the US is not increasing despite increasing case reports.