Randomized trial demonstrates reduced pelvic inflammatory disease incidence in high-risk women screened for chlamydia, indicating the clinical benefit of selective testing.
Key Points
To determine whether selective screening and treatment for cervical Chlamydia trachomatis infection prevents pelvic inflammatory disease in high-risk women.
Randomized controlled trial of 2607 high-risk women aged 18 to 34 years identified through a questionnaire mailed to health maintenance organization enrollees.
Eligible participants were randomly assigned to selective screening for C. trachomatis (n=1009) or usual care (n=1598) and monitored for one year.
Confirmed pelvic inflammatory disease cases were evaluated using an intention-to-screen analysis and adjusted using logistic regression.
In the screening arm, 64% of women (645/1009) underwent testing, with 7% testing positive and receiving treatment.
At one-year follow-up, verified pelvic inflammatory disease occurred in 9 women in the screening group versus 33 women in the usual care group (RR, 0.44; 95% CI, 0.20 to 0.90).