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  • Chlamydia Trachomatis
  • OneFile (GALE)  (12)
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  • 1
    Language: English
    In: Pediatrics, February 2011, Vol.127(2), pp.e336-44
    Description: We assessed differences in chlamydia screening rates according to race/ethnicity, insurance status, age, and previous sexually transmitted infection (STI) or pregnancy. A retrospective cohort study was performed using electronic medical record and billing data for women 14 to 25 years of age in 2002-2007, assessing differences in the odds of a chlamydia test being performed at that visit. Adjusted odds of a chlamydia test being performed were lower among women 14 to 15 years of age (odds ratio: 0.83 [95% confidence interval: 0.70-1.00]) and 20 to 25 years of age (20-21 years, odds ratio: 0.78 [95% confidence interval: 0.70-0.89]; 22-23 years, odds ratio: 0.76 [95% confidence interval: 0.67-0.87]; 24-25 years, odds ratio: 0.64 [95% confidence interval: 0.57-0.73]), compared with women 18 to 19 years of age. Black women had 3 times increased odds (odds ratio: 2.96 [95% confidence interval: 2.66-3.28]) and Hispanic women nearly 13 times increased odds (odds ratio: 12.89 [95% confidence interval: 10.85-15.30]) of testing, compared with white women. Women with public (odds ratio: 1.74 [95% confidence interval: 1.58-1.91]) and public pending (odds ratio: 6.85 [95% confidence interval: 5.13-9.15]) insurance had increased odds of testing, compared with women with private insurance. After first STI diagnosis, differences according to race/ethnicity persisted but were smaller; after first pregnancy, differences persisted. Despite recommendations to screen all sexually active young women for chlamydia, providers screened women differently according to age, race/ethnicity, and insurance status, although differences were reduced after first STI or pregnancy.
    Keywords: Chlamydia Infections -- Diagnosis ; Health Personnel -- Standards ; Mass Screening -- Methods
    ISSN: 00314005
    E-ISSN: 1098-4275
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  • 2
    In: Sex Transm Dis, 2001, Vol.28(5), pp.247-251
    Description: BACKGROUND: The temporal pattern of partners and sexual encounters may be key factors in the acquisition and transmission of sexually transmitted diseases (STDs). Behavior among adolescent women is of particular interest because they frequently have the highest prevalence and incidence of infection. GOAL: To examine coital diary data collected during a 7-month longitudinal study of young women at high risk of STDs and to describe their sexual behaviors, with particular attention to issues of partner sequence and overlap. STUDY DESIGN: A 7-month longitudinal study of young women infected with or having a sexual contact infected with Neisseria gonorrhoeae, Chlamydia trachomatis, or Trichomonas vaginalis attending the STD clinic or one of four neighborhood adolescent health clinics. Data were collected at enrollment and at 1, 3, 5, and 7-month follow-up visits. Coital diaries were kept between visits. RESULTS: The average frequency of coital events was 0.94 per week. The median number of sexual partners during the follow-up period was one, and overlapping of partnerships was an uncommon occurrence. The number of days between the last coital event of a current relationship and the first encounter of a new relationship differed for those choosing a new partner (mean, 20.6 days) and those who returned to a previous partner (mean, 7.9 days;P 〈 0.001). CONCLUSION: Although at high risk for STDs, high-risk behavior was not common among the study population. Partner choice and the behavior of these partners may be more important elements than personal high-risk behavior in accounting for the high prevalence of sexually transmitted infections among inner-city adolescent women.
    Keywords: Teenage Girls -- Sexual Behavior ; Sexually Transmitted Diseases -- Research;
    ISSN: 0148-5717
    E-ISSN: 15374521
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  • 3
    In: Journal of the Royal Statistical Society: Series A (Statistics in Society), October 2011, Vol.174(4), pp.975-989
    Description: Bacterium causes genital chlamydia infection. Yet little is known about the efficiency of transmission of this organism. Ethical constraint against exposing healthy subjects to infected partners precludes the possibility of quantifying the risk of transmission through controlled experiments. This research proposes an alternative strategy that relies on observational data. Specifically, we present a stochastic model that treats longitudinally observed states of infection in a group of young women as a Markov process. The model proposed explicitly accommodates the parameters of transmission, including per‐encounter sexually transmitted infection acquisition risks, with and without condom protection, and the probability of antibiotic treatment failure. The male‐to‐female transmission probability of is then estimated by combining the per‐encounter disease acquisition risk and the organism's prevalence in the male partner population. The model proposed is fitted in a Bayesian computational framework.
    Keywords: Bacterial Infection ; Binary Outcome ; Longitudinal Study ; Markov Chain Monte Carlo Methods ; Markov Model ; Observational Data ; Transmission Probability
    ISSN: 0964-1998
    E-ISSN: 1467-985X
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  • 4
    Language: English
    In: The Journal of Pediatrics, 1996, Vol.128(2), pp.288-295
    Description: To determine whether condom use among high-risk female adolescents could be increased by a behavioral intervention, with the use of infection with as a biomarker of condom practices. Prospective, randomized, controlled intervention. Urban family planning and sexually transmitted disease clinics. Two hundred nine female adolescents, aged 15 through 19 years, who were treated for genitourinary infection, were randomly assigned to standard (control) or experimental (behavioral intervention) groups. One hundred twelve subjects returned for follow-up 5 to 7 months after enrollment and comprise the study subjects. Subjects completed a multiinstrument questionnaire measuring sexual behavior, condom practices, attitudes and beliefs, cognitive complexity, sociodemographics, and motivation at enrollment and follow-up. Endourethral and endocervical sites were sampled for . Among the 112 subjects who returned for repeated examination, those who had received the experimental intervention reported increased use of condoms by their sexual partners for protection against sexually transmitted diseases (odds ratio = 2.4; = 0.02) and for vaginal intercourse (odds ratio = 3.1; = 0.005) at the 6-month follow-up. Multivariable logistic regression analysis controlling for condom use at enrollment demonstrated that the experimental intervention (odds ratio = 2.8; = 0.03) and the higher cognitive complexity (odds ratio = 4.6; = 0.02) independently contributed to greater condom use at follow-up. Despite greater use of condoms among the group who had received the intervention, use remained inconsistent and rates of reinfection with were not significantly different (26% vs 17%; = 0.3). Although a brief behavioral intervention among high-risk female adolescents can increase condom use by their sexual partners, incident infection does not appear to be reduced, because condom use remained inconsistent. (J P 1996;128:288-95 )
    Keywords: Medicine
    ISSN: 0022-3476
    E-ISSN: 1097-6833
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  • 5
    In: Sexually Transmitted Diseases, 2016, Vol.43(12), pp.741-749
    Description: BACKGROUND: Sexual transmission rates of Chlamydia trachomatis (Ct) cannot be measured directly; however, the study of concordance of Ct infection in sexual partnerships (dyads) can help to illuminate factors influencing Ct transmission. METHODS: Heterosexual men and women with Ct infection and their sex partners were enrolled and partner-specific coital and behavioral data collected for the prior 30 days. Microbiological data included Ct culture, and nucleic acid amplification testing (NAAT), quantitative Ct polymerase chain reaction, and ompA genotyping. We measured Ct concordance in dyads and factors (correlates) associated with concordance. RESULTS: One hundred twenty-one women and 125 men formed 128 dyads. Overall, 72.9% of male partners of NAAT-positive women and 68.6% of female partners of NAAT-positive men were Ct-infected. Concordance was more common in dyads with culture-positive members (78.6% of male partners, 77% of female partners). Partners of women and men who were NAAT-positive only had lower concordance (33.3%, 46.4%, respectively). Women in concordant dyads had significantly higher median endocervical quantitative Ct polymerase chain reaction values (3,032) compared with CT-infected women in discordant dyads (1013 inclusion forming units DNA equivalents per mL; P 〈 0.01). Among 54 Ct-concordant dyads with ompA genotype data for both members, 96.2% had identical genotypes. CONCLUSIONS: Higher organism load appears associated with concordance among women. Same-genotype chlamydial concordance was high in sexual partnerships. No behavioral factors were sufficiently discriminating to guide partner services activities. Findings may help model coitus-specific transmission probabilities.
    Keywords: Chlamydia Infections -- Genetic Aspects ; Chlamydia Infections -- Development And Progression ; Virulence (Microbiology) -- Genetic Aspects ; Genotypes -- Health Aspects ; Disease Susceptibility -- Genetic Aspects;
    ISSN: 0148-5717
    E-ISSN: 15374521
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  • 6
    In: Sexually Transmitted Diseases, 1992, Vol.19(2), pp.99-104
    Description: :
    Keywords: Gonorrhea ; Care and Treatment ; Chlamydia Infections ; Clinical Epidemiology ; Evaluation ; Sexually Transmitted Diseases ; Reporting ; Medicine;
    ISSN: 0148-5717
    E-ISSN: 15374521
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  • 7
    In: Sexually Transmitted Diseases, 1989, Vol.16(2), pp.103-106
    Description: The present study was undertaken to evaluate the utility of a gram stain of endocervical secretions in the prediction of endocervical infection with Chlamydia trachomatis. Endocervical examinations, Gram stains and chlamydial cultures were performed on 214 women who were attending a sexually transmitted diseases clinic and were at increased risk for chlamydial infection. Almost 24% of the Gram stains were judged inadequate because of the presence of ectocervical material. However, significantly higher isolation rates for C. trachomatis were found for those women with valid smears and 10 or more polymorphonuclear cells on their smear (44% vs 19%, P = .0008). This relationship was independent of the presence of gonococcal infection. Based on the results of this study, endocervical Gram stains appear to be a valuable screening tool for chlamydial infection, particularly among those without mucopurulent discharge.
    Keywords: Chlamydia Infections -- Diagnosis ; Uterine Cervicitis -- Diagnosis;
    ISSN: 0148-5717
    E-ISSN: 15374521
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  • 8
    In: Sexually Transmitted Diseases, 1991, Vol.18(1), pp.36-40
    Description: In developed nations, the most common sexually transmitted disease is infection with Chlamydia trachomatis. In the United States, the standard therapy for chlamydia infections involves a seven-day treatment period with tetracycline, erythromycin, or doxycycline. However, some cases require a longer treatment period, up to 21 days, to eliminate the infection. After the treatment period has ended, the patient is retested to make sure that the infection has been cured. This procedure is called a test-of-cure (TOC). But recurrent infections with the same strain of Chlamydia trachomatis, following seven days of treatment and TOC, are not uncommon, and may indicate that the standard therapy time should be increased. In an attempt to evaluate the relationship between the duration of treatment and the rate of recurrence of infection, the medical records of 2,983 patients, who were treated with the standard therapy for chlamydia infection, were reviewed. During a two-year follow-up period, the rate of recurrence of infection was 29 percent. Recurrence of infection was associated with young age, but not with gender or race. To determine if a longer treatment period could reduce the rate of recurrence of infection, 220 patients with chlamydia were treated with tetracycline for either 7 or 21 days. Among patients who returned, the recurrence rate was 14 percent for the seven-day treatment and 18 percent for the 21-day treatment. The difference in the recurrence rate between the two treatment groups was not statistically significant. It is concluded that a 21-day treatment period is no more effective than a seven-day treatment period in preventing recurrence of chlamydia infection. (Consumer Summary produced by Reliance Medical Information, Inc.)
    Keywords: Tetracyclines -- Evaluation ; Chlamydia Infections -- Drug Therapy ; Chlamydia Trachomatis;
    ISSN: 0148-5717
    E-ISSN: 15374521
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  • 9
    In: Sexually Transmitted Diseases, 1992, Vol.19(6), pp.351-354
    Description: Control of bacterial sexually transmitted diseases (STD) depends on adequate antibiotic therapy. During a 4-week period, a survey concerning compliance was administered to all patients attending an STD clinic who were being treated with one of the standard antibiotic regimens for presumed gonococcal or chlamydial infections. Of the 497 eligible patients, 406 (81.7%) were surveyed between 24 hours and 72 hours after the end of treatment. Of those being treated with the standard 7-day regimen of tetracycline or erythromycin, 63.4% complied. Compliance was not associated with race, gender, symptoms, or antibiotic regimen. Those who were younger, were sexual contacts of an infected partner, or had gastrointestinal side effects were more likely not to comply with treatment.
    Keywords: Chlamydia Trachomatis ; Drug Therapy ; Neisseria Gonorrhoeae ; Patient Compliance ; Evaluation ; Medicine;
    ISSN: 0148-5717
    E-ISSN: 15374521
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  • 10
    In: Sexually Transmitted Diseases, 1996, Vol.23(3), pp.226-229
    Description: BACKGROUND AND OBJECTIVES:: GOALS:: STUDY DESIGN:: The study population consisted of all 4,329 sexually active girls between the ages of 13 and 19 attending the four adolescent health clinics in Indianapolis, Indiana, during the period beginning October 1, 1985, and ending June 30, 1994. All girls were cultured for Chlamydia trachomatis, and behavioral data were collected for those attending the clinics before 1989. The trend in quarterly isolation rates was examined using linear regression analysis. RESULTS:: Results showed that there was a significant decrease (P = 0.0001), from 25.9% to 9.7%, in the first-visit chlamydial isolation rate over the study period. Behavioral data showed decreases in the frequency of sexual intercourse and in lifetime years of sexual activity, as well as an increase in condom use. CONCLUSIONS::
    Keywords: Chlamydia Infections ; Demographic Aspects ; Teenage Girls ; Health Aspects ; Medicine;
    ISSN: 0148-5717
    E-ISSN: 15374521
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