J. Mossong1, N. Majéry2, C. Mardaga3 , M. Muller4, F. Schneider1

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Presentation transcript:

J. Mossong1, N. Majéry2, C. Mardaga3 , M. Muller4, F. Schneider1 Where to Screen for Chlamydia trachomatis? Results from a study involving young men and women in secondary schools, family planning and an occupational health center in Luxembourg Poster Y-005 J. Mossong1, N. Majéry2, C. Mardaga3 , M. Muller4, F. Schneider1 1National Health Laboratory, Luxembourg 2Multisector Health at Work Services, Luxembourg 3Family Planning, Luxembourg 4Health Directorate, Luxembourg Contact: joel.mossong@lns.etat.lu Abstract Results In logistic regression, the following were independent risk factors for CT infection Age 18-22 years, odds ratio (OR) 1.94 (95% confidence interval (CI) 1.14-3.30) Female sex, OR 2.45 (95% CI 1.47-4.07) Setting for screening family planning centre, OR 3.07 (95% CI 1.84-5.12) occupational health centre, OR 2.30 (95% CI 1.30-4.08) Reporting inconsistent condom use “never” OR 2.89 (95% CI 1.55-5.38); “sometimes” OR 2.63 (95% CI 1.46-4.72) “often” OR 2.13 (95% CI 1.12-4.06) 3 or more partners in the past year OR 2.43 (95% CI 1.60-3.67) Background. Several countries are considering national Chlamydia trachomatis (CT) screening programs although appropriate settings and modalities remain unclear. We conducted a prospective screening pilot in three settings in Luxembourg with a short sexual behavior questionnaire to estimate prevalence and determine risk factors of CT infection. Methods. Screening was offered to sexually active volunteer participants aged less than 25 years in three settings: i) women in 3 family planning centers (FPC), ii) young women and men in 29 secondary schools and iii) women and men in an occupational health center (OHC) for newly recruited employees and workers. First catch urine samples were tested using the COBAS Amplicor assay. Free treatment was offered to positive participants. Multiple logistic regression was performed to define risk factors. Results. The overall prevalence was 4.4% with rates among women three times higher than in men (5.5% vs. 1.8%). The prevalence rates among women were for FPC 99/1361 (7.3%), secondary schools 18/792 (2.3%), and OHC 41/733 (5.6%). The prevalence rates among men were for secondary schools 5/534 (0.9%) and OHC 18/727 (2.5%). Mean age of positive female and male participants was 20.5 and 22.2 years, respectively (p=0.002). Presence of CT infection in women was significantly associated (p<=0.05) with inconsistent frequency of condom use (often, sometimes, and never), and 3 partners or more in the last 12 months. For men, presence of CT infection was significantly associated (p<=0.05) with lack of condom use and 3 partners or more. Conclusion. Screening is feasible in the three settings, but the prevalence of CT infection among men and women is highest in age groups that have left secondary school. Mandatory occupational health checks for newly recruited employees and workers should be considered a valuable additional screening opportunity for young men and women. Offering screening programs in family planning and occupational health settings should contribute to a reduction of CT infections in the community. The overall prevalence of CT infection among 4147 samples tested was 4.4%, but differed by sex, being three times higher in females (5.5%) compared to males (1.8%), and by setting. Prevalence of CT infection varied also by age and sex with a peak in the age group 20-22 y olds. Mean age of positive female and male participants was 20.5 and 22.2 years, respectively (p=0.002). Prevalence of CT infection was associated with inconsistent frequency of condom use. Only participants reporting “always” using a condom had lower prevalence. For both men and women, prevalence of CT infection increased with the number of reported sexual partners in the previous year. Methods Introduction Methods Conclusions Screening was offered to sexually active volunteer participants aged less than 25 years in three settings: women in 3 family planning centers (FPC) young women and men in 29 secondary schools women and men in an occupational health center (OHC) for newly recruited employees and workers. First catch urine samples were tested using the COBAS Amplicor assay. Logistic regression was performed to assess independent risk factors. Several countries are considering or have started national Chlamydia trachomatis (CT) screening programs. Appropriate settings for screening and modalities including whom to screen remain unclear. We conducted a prospective pilot in 3 settings in Luxembourg to estimate prevalence determine risk factors of CT infection. Screening is feasible in the three settings, but the prevalence of CT infection is highest in age groups that have left secondary school. Females aged 18-22 have the highest risk of being positive for CT infection and should be the main target of any future screening program Inconsistent condom use and multiple partners in the previous year are independent risk factors, which educational programmes could target Mandatory occupational health checks for newly recruited employees and workers should be considered a valuable additional screening opportunity for young men and women. Offering screening programs in family planning and occupational health settings should contribute to a reduction of CT infections in the community.