Randomised controlled trial of screening for Chlamydia trachomatis to prevent pelvic inflammatory disease: the POPI (prevention of pelvic infection) trial.
Randomised controlled trial of screening for Chlamydia trachomatis to prevent pelvic inflammatory disease: the POPI (prevention of pelvic infection) trial.
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DOI：
10.1136/bmj.c1642
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发表时间：
2010-04-08
期刊：
影响因子：
--
通讯作者：
Hay P
中科院分区：
文献类型：
--
作者：
Oakeshott P;Kerry S;Aghaizu A;Atherton H;Hay S;Taylor-Robinson D;Simms I;Hay P
目的确定筛查和治疗妇女衣原体感染是否可以降低随后12个月内盆腔炎的发病率。设计随机对照试验。在伦敦的大学和继续教育学院设置公共休息室、演讲厅和学生酒吧。研究对象为2529名性行为活跃的女大学生，平均年龄21岁（16-27岁）。干预参与者完成了一份问卷，并提供了自己采取的阴道拭子，一年后随访。样本被随机分配到立即检测和治疗衣原体感染，或储存和分析一年后（延迟筛选控制）。主要观察指标12个月内临床盆腔炎的发病率。结果筛查组和对照组的基线衣原体感染率分别为5.4%（68/1254）和5.9%（75/1265）。94%（2377/2529）的女性在12个月后随访。在接受筛查的女性中，盆腔炎的发病率为1.3%（15/1191），而对照组为1.9%（23/1186）（相对危险度为0.65，95%置信区间为0.34 - 1.22）。在基线时衣原体感染检测阳性的74名对照妇女中有7名（9.5%，95%置信区间4.7%至18.3%）在12个月内发展为盆腔炎，而63名筛查妇女中有1名（1.6%）（相对风险0.17，0.03至1.01）。然而，大多数盆腔炎发作发生在基线衣原体检测阴性的女性中（79%，30/38）。22%（527/2377）的女性报告在试验期间接受了独立的衣原体检测。结论尽管有证据表明衣原体筛查可降低盆腔炎的发病率，尤其是在基线时有衣原体感染的女性中，但单次衣原体检测在预防盆腔炎12个月以上的有效性可能被高估。试用注册ClinicalTrials.gov NCT 00115388。
Objective To determine whether screening and treating women for chlamydial infection reduces the incidence of pelvic inflammatory disease over the subsequent 12 months. Design Randomised controlled trial. Setting Common rooms, lecture theatres, and student bars at universities and further education colleges in London. Participants 2529 sexually active female students, mean age 21 years (range 16-27). Intervention Participants completed a questionnaire and provided self taken vaginal swabs, with follow-up after one year. Samples were randomly allocated to immediate testing and treatment for chlamydial infection, or storage and analysis after a year (deferred screening controls). Main outcome measure Incidence of clinical pelvic inflammatory disease over 12 months. Results Baseline prevalence of chlamydia was 5.4% (68/1254) in screened women and 5.9% (75/1265) in controls. 94% (2377/2529) of women were followed up after 12 months. The incidence of pelvic inflammatory disease was 1.3% (15/1191) in screened women compared with 1.9% (23/1186) in controls (relative risk 0.65, 95% confidence interval 0.34 to 1.22). Seven of 74 control women (9.5%, 95% confidence interval 4.7% to 18.3%) who tested positive for chlamydial infection at baseline developed pelvic inflammatory disease over 12 months compared with one of 63 (1.6%) screened women (relative risk 0.17, 0.03 to 1.01). However, most episodes of pelvic inflammatory disease occurred in women who tested negative for chlamydia at baseline (79%, 30/38). 22% (527/2377) of women reported being tested independently for chlamydia during the trial. Conclusion Although some evidence suggests that screening for chlamydia reduces rates of pelvic inflammatory disease, especially in women with chlamydial infection at baseline, the effectiveness of a single chlamydia test in preventing pelvic inflammatory disease over 12 months may have been overestimated. Trial registration ClinicalTrials.gov NCT00115388.
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影响因子：
3.6
作者：
Low, N.;Egger, M.;Herrmann, B.
通讯作者：
Herrmann, B.
影响因子：
3.1
作者：
Schachter, J;Chernesky, MA;Hook, EW
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Hook, EW
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2.5
作者：
Oakeshott, Pippa;Kerry, Sally;Hay, Phillip
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1.4
作者：
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作者：
MIETTINEN, O;NURMINEN, M
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NURMINEN, M