Direct and Indirect Effects of Screening for Chlamydia trachomatis on the Prevention of Pelvic Inflammatory Disease

• DOI: 10.1097/ede.0b013e31829e110e
• Publication Date: 2013-09-27T22:50:22Z
• Authors: Sereina A. Herzog; Janneke C. M. Heijne; Pippa Scott; Christian L. Althaus; Nicola Low
• Keywords: Pelvic inflammatory disease; Chlamydia trachomatis infection

Background: Pelvic inflammatory disease (PID) results from the ascending spread of microorganisms, including Chlamydia trachomatis, to upper genital tract. Screening could improve outcomes by identifying and treating chlamydial infections before they progress PID (direct effect) or reducing chlamydia transmission (indirect effect). Methods: We developed a compartmental model that represents hypothetical heterosexual population explicitly incorporates progression clinical PID. screening was introduced, with coverage increasing each year for 10 years. estimated separate contributions direct indirect effects on cases prevented per 100,000 women. explored influence varying time point at which occur risk after repeated infections. Results: The probability baseline 3.1% age 25 After 5 years, intervention scenario had 187 women years 956 At start screening, most were effect. effect produced small net increase in cases, outweighed reduced 2.2 later occurs, greater contribution Increasing infection increases number screening. Conclusions: This study shows roles prevention potential harms, cannot be demonstrated observational studies.