The contribution of Chlamydia trachomatis to adverse reproductive health and the implications for control policy

衣原体是欧洲最常见的性传播细菌感染之一。大多数人没有症状，但如果不及时治疗，可能会导致严重的并发症，包括不孕不育。筛查规划可识别和治疗无症状者，并减少长期并发症。然而，这些方案有个人和财政方面的成本，必须与其收益相平衡。为了做到这一点，我们需要知道感染后并发症发生的频率。但这方面的证据是有限的，而且主要是基于可能与今天无关的旧研究。拟议的研究将审查目前关于衣原体与生殖健康之间关系的知识，然后利用过去25年来从加拿大马尼托巴省居民那里收集的信息来衡量这种关系。这些发现将用于开发一个数学模型来估计衣原体筛查的潜在影响，并确定筛查方案是否具有成本效益。最后，将与主要专业人员、公众和患者代表进行访谈，以了解影响筛查政策的因素。这项研究将总结每项研究的结果，为衣原体筛查提供基于证据的政策建议。

Chlamydia is one of the commonest sexually transmitted bacterial infections in Europe. Most people have no symptoms, but left untreated it can cause serious complications, including infertility. Screening programmes can identify and treat asymptomatic people and reduce long-term complications. However these programmes have costs, personal and financial, that must be balanced against their benefit. In order to do this we need to know how often complications occur after an infection. But the evidence on this is limited and based mainly on old studies that may not be relevant today. The proposed research will review current knowledge about the association between chlamydia and reproductive health and then measure this association using information collected from residents of Manitoba Province, Canada, over the last 25 years. These findings will be used to develop a mathematical model to estimate the potential impact of Chlamydia screening and to determine whether screening programmes are cost effective. Finally, interviews will be conducted with key professionals and public and patient representatives to understand the factors that influence screening policy. The research will conclude by drawing together the findings from each study to produce evidence based policy recommendations for Chlamydia screening.