Chlamydia is the most commonly reported infectious disease in the United
States and may be one of the most dangerous sexually transmitted diseases
among women today. While the disease can be easily cured with antibiotics,
millions of cases go unrecognized. If left untreated, chlamydia can have
severe consequences, particularly for women. Up to 40 percent of women
with untreated chlamydia will develop pelvic inflammatory disease (PID),
and
one in five women with pid becomes infertile. Chlamydia also can cause
prematurity, eye disease, and pneumonia in infants. Moreover, women infected
with chlamydia
are three to five times more likely to become infected with HIV, if exposed.
Seventy-five
percent of women and 50 percent of men with chlamydia have no symptoms.
The majority of cases therefore go undiagnosed and unreported.
The number of reported cases-about 660,000 cases in 1999-is merely
the tip of the iceberg.
An estimated three million people contract chlamydia each year (Cates,
1999).
Chlamydia is believed to be declining overall in the United States, primarily
because of increased efforts to screen and treat women for chlamydia.
Chlamydia is estimated to have declined from well over four million annual
infections in the early 1980s to the current level of three million annual
infections (Cates, 1999).
Reported chlamydia rates in women greatly exceed those in men largely
because screening programs have been primarily directed at women.True
rates are probably far more similar for women and men.
Since 1994, there has been increased funding available for chlamydia
screening in publicly funded family planning and STD clinics. The percentage
of women testing positive for chlamydia-chlamydia positivity-in family planning clinics by state
provides a good indication of where the disease remains most wide-spread.
The highest level of infection tends to be seen in areas where screening
and treatment have not been as widely implemented. The greatest declines
have generally been in areas of the country with the most effective and
prolonged screening programs.
From 1988 to 1999, the Pacific northwest-Washington, Oregon, Idaho, and Alaska-witnessed a 62 percent decline in infection among women tested for chlamydia in family planning clinics.
In the Mid-Atlantic States-Delaware, Washington, D.C., Maryland, Pennsylvania,
Virginia, and West Virginia-similar trends are occurring, with a decline
of 16 percent since 1994 (DSTDP, CDC, 2000).
From 1997 to 1999, chlamydia test positivity in family planning clinics actually increased in eight out of 10 regions. However, these reported increases are most likely due to changes in newly available and better laboratory tests and expanded screening programs to populations with higher levels of disease (DSTDP, CDC, 2000).
