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Repeat Chlamydia trachomatis infection in women: analysis through
a surveillance registry in Washington State, 1993-1998.
American Journal of Epidemiology 2000;152(12):1164-1170.
Xu F, Schillinger JA, Markowitz LE, Sternberg MR, Aubin MR, St. Louis ME.
Abstract
Repeat infections with Chlamydia trachomatis are associated with increased
risk for long-term sequelae. The authors analyzed the frequency and predictors
of repeat chlamydial infection by using a population-based chlamydia registry
in Washington State and evaluated whether women would seek care at the same
clinic for repeat infections. Among 32,698 women with an appropriately treated
initial chlamydial infection during 1993-1998, 15% developed one or more
repeat infections during a mean follow-up time of 3.4 years. Among women
less than age 20 years at the time of initial infection, 6% were reinfected
by 6 months, 11% by 1 year, and 17% by 2 years. Young age was the strongest
predictor for one and two or more repeat infections after controlling for
the length of follow-up and other variables. Only 36% of the repeat infections
were diagnosed at the same clinical setting as the initial infection, and
50% were diagnosed at the same type of clinic. Adolescent girls had the least
consistency in the source of care for chlamydia. This study suggests that
efforts to prevent repeat chlamydial infection in young women remain an urgent
public health priority and that the burden of repeat infection may be substantially
higher than estimates from clinic-based studies.