Trends in the prevalence of chlamydial infections - The impact of community-wide testing

Background: Evaluation of existing testing programs should guide the national effort to expand programs for the prevention of chlamydial infections, The Columbus (Ohio) Health Department instituted community-wide testing for Chlamydia trachomatis in 1988. Goals: To assess trends in the prevalence of chlamydial infection, the coverage of screening, and concurrent trends in the prevalence of gonorrhea. Study Design: This was a cross-sectional study of women 15. to 44 years of age tested for C. trachomatis at over 50 provider sites in Columbus, Ohio, from 1989 to 1992. Results: The prevalence of chlamydial infection among all women tested decreased by 33% from 1989 to 1992, Prevalence decreased least (19%) among black women 15 to 19 years of age, the group with the highest initial prevalence (20.2%), even though 42% of this population in the city was tested, Prevalence did not decrease at all among prenatal patients 15 to 19 years of age, For women tested for both gonorrhea and chlamydia, gonorrhea decreased by 39% during the 4-year period. Conclusions: Screening appeared to have limited effect on the prevalence of chlamydial infection for groups with highest initial prevalence, despite the relatively high percentage of the population tested. Expanding screening programs to include men and instituting behavioral interventions may be necessary to reduce more rapidly the prevalence of chlamydia among these women.