1887
Surveillance and outbreak report Open Access
Like 0

Abstract

As genital (chlamydia) infection is often asymptomatic, surveillance of diagnosed cases is heavily influenced by the rate and distribution of testing. In 2007, we started supplementing case-based surveillance data from the Norwegian Surveillance System for Communicable Diseases (MSIS) with aggregated data on age group and sex of individuals tested. In this report, annual testing rates, diagnosis rates and proportion positive for chlamydia in Norway between 1990 and 2013 are presented. From 2007, rates are also stratified by age group and sex. The annual testing rate for chlamydia culminated in the early 1990s, with 8,035 tested per 100,000 population in 1991. It then declined to 5,312 per 100,000 in 2000 after which it remained relatively stable. Between 1990 and 2013 the annual rate of diagnosed cases increased 1.5 times from ca 300 to ca 450 per 100,000 population. The proportion of positive among the tested rose twofold from ca 4% in the 1990s to 8% in 2013. Data from 2007 to 2013 indicate that more women than men were tested (ratio: 2.56; 95% confidence interval (CI): 2.56–2.58) and diagnosed (1.54; 95% CI: 1.52–1.56). Among tested individuals above 14 years-old, the proportion positive was higher in men than women for all age groups. Too many tests are performed in women aged 30 years and older, where 49 of 50 tests are negative. Testing coverage is low (15%) among 15 to 24 year-old males. Information on sex and age-distribution among the tested helps to interpret surveillance data and provides indications on how to improve targeting of testing for chlamydia. Regular prevalence surveys may address remaining limitations of surveillance.

Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2015.20.36.30012
2015-09-10
2024-03-28
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2015.20.36.30012
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/20/36/eurosurv-20-30012-3.html?itemId=/content/10.2807/1560-7917.ES.2015.20.36.30012&mimeType=html&fmt=ahah

References

  1. European Centre for Disease Prevention and Control (ECDC). Annual epidemiolgical report. Reporting on 2011 surveillance data and 2012 epidemic intelligence data. Stockholm: ECDC; 2013.
  2. Kløvstad H, Aavitsland P. Chlamydia trachomatis infections in norway, 1986 to 2006, surveillance data. Sex Transm Dis. 2009;36(1):17-21.  https://doi.org/10.1097/OLQ.0b013e31818653b0  PMID: 18923334 
  3. U.S. Preventive Services Task Force. Screening for chlamydial infection: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2007;147(2):128-34.  https://doi.org/10.7326/0003-4819-147-2-200707170-00172  PMID: 17576996 
  4. Centers for Disease Control and Prevention (CDC). CDC Grand Rounds: Chlamydia prevention: challenges and strategies for reducing disease burden and sequelae. MMWR Morb Mortal Wkly Rep. 2011;60(12):370-3. PMID: 21451447 
  5. European Centre for Disease Prevention and Control (ECDC). Chlamydia control in Europe - a survey of Member States. Stockholm: ECDC; 2014.
  6. Low N, Bender N, Nartey L, Shang A, Stephenson JM. Effectiveness of chlamydia screening: systematic review. Int J Epidemiol. 2009;38(2):435-48.  https://doi.org/10.1093/ije/dyn222  PMID: 19060033 
  7. European Centre for Disease Prevention and Control (ECDC). Chlamydia control in Europe: literature review. Stockholm: ECDC; 2014.
  8. Norsk gynekologisk forening. Veileder i fødselshjelp. [Guide for obstetrics]; 2008. Norwegian. Available from: http://www.helsebiblioteket.no/retningslinjer/gynekologi/f%C3%B8dselshjelp-veileder-i-f%C3%B8dselshjelp-2008
  9. The Norwegian Directorate for Health and Social Affairs. Nasjonale faglige retningslinjer for svangerskapsomsorgen. [National Clinical Guideline for Antenatal Care]; 2006. Available from: https://helsedirektoratet.no/Lists/Publikasjoner/Attachments/393/nasjonal-faglig-retningslinje-for-svangerskapsomsorgen-fullversjon.pdf
  10. The Norwegian Directorate of Health. Nasjonale faglige retningslinjer for antibiotikabruk i primærhelsetjenesten. [National professional guidelines for the use of antibiotics in primary care]; 2013. Norwegian. Available from: http://www.helsebiblioteket.no/retningslinjer/antibiotika/forord
  11. The Norwegian Institute of Public Health. Smittevernboka. [National Infection control Guidance]. Available from: http://www.fhi.no/publikasjoner-og-haandboker/smittevernboka
  12. Aavitsland P, Lystad A. [Indications for testing for sexually transmitted Chlamydia trachomatis infections]. Tidsskr Nor Laegeforen. 1995;115(25):3141-4. PMID: 8539697 
  13. Kløvstad H, Grjibovski A, Aavitsland P. Population based study of genital Chlamydia trachomatis prevalence and associated factors in Norway: a cross sectional study. BMC Infect Dis. 2012;12(1):150.  https://doi.org/10.1186/1471-2334-12-150  PMID: 22747602 
  14. Statens Serum Institut. Chlamydia 2012. EPI-NEWS. 2013; 36.
  15. The Swedish Institute for Communicable Disease Control (SMI). Epidemiologisk årsrapport 2012. [Epidemiological Annual Report 2012]. Stockholm: SMI; 2013. Swedish.
  16. Löfdahl M, Rydevik G, Blaxhult A, Herrmann B. [Chlamydia infection among Swedish women. Contact tracing and reporting routines must be improved]. Lakartidningen. 2008;105(44):3116-20. PMID: 19031978 
  17. Wise J. Only 15% of young men in England were tested for chlamydia last year despite recommendations. BMJ. 2014;348(jun18 25):g4121.
  18. Bakken IJ, Nordbø SA, Skjeldestad FE. Chlamydia trachomatis testing patterns and prevalence of genital chlamydial infection among young men and women in central Norway 1990-2003: a population-based registry study. Sex Transm Dis. 2006;33(1):26-30.  https://doi.org/10.1097/01.olq.0000187929.36118.d2  PMID: 16385219 
  19. Kløvstad H, Natås O, Tverdal A, Aavitsland P. Systematic screening with information and home sampling for genital Chlamydia trachomatis infections in young men and women in Norway: a randomized controlled trial. BMC Infect Dis. 2013;13(1):30.  https://doi.org/10.1186/1471-2334-13-30  PMID: 23343391 
  20. Ghaderi S, Nordbø SA, Bakken IJ. [Chlamydia infections in South Trøndelag--treatment and follow-up]. Tidsskr Nor Laegeforen. 2011;131(5):461-3.  https://doi.org/10.4045/tidsskr.10.0384  PMID: 21383798 
  21. Træen B, Stigum H, Magnus P. Rapport fra seksualvaneundersøkelsene 1987, 1992, 1997 og 2002. [Report of sexual behaviour surveys in 1987, 1992, 1997 and 2002]. Oslo: Norwegian Institute of Public Health; 2003. Norwegian.
  22. Pedersen W, Samuelsen SO. [New patterns of sexual behaviour among adolescents]. Tidsskr Nor Laegeforen. 2003;123(21):3006-9. PMID: 14618164 
  23. Kreftregisteret. Masseundersøkelser mot livmorhalskreft 2013. [Mass screening for cervical cancer]. Norwegian. Available from: http://kreftregisteret.no/no/Forebyggende/Nyhetssaker/
  24. Lov om vern mot smittsomme sykdommer. [Communicable disease control act]. LOV-1994-08-05-55. Norwegian.
  25. Schmid BV, Over EA, van den Broek IV, Op de Coul EL, van Bergen JE, Fennema JS, et al. Effects of population based screening for Chlamydia infections in the Netherlands limited by declining participation rates. PLoS ONE. 2013;8(3):e58674.  https://doi.org/10.1371/journal.pone.0058674  PMID: 23527005 
  26. van den Broek IV, Brouwers EE, Götz HM, van Bergen JE, Op de Coul EL, Fennema JS, et al. Systematic selection of screening participants by risk score in a Chlamydia screening programme is feasible and effective. Sex Transm Infect. 2012;88(3):205-11.  https://doi.org/10.1136/sextrans-2011-050219  PMID: 22215696 
  27. Götz HM, van Klaveren D. Use of prediction rules in control of sexually transmitted infections: challenges and chances. Sex Transm Dis. 2014;41(5):331-2.  https://doi.org/10.1097/OLQ.0000000000000128  PMID: 24722389 
  28. Falasinnu T, Gilbert M, Salway TH, Gustafson P, Ogilvie G, Shoveller J. Predictors identifying those at increased risk for STDs: a theory-guided review of empirical literature and clinical guidelines. Int J STD AIDS. 2014.
  29. van Valkengoed IG, Morré SA, van den Brule AJ, Meijer CJ, Devillé W, Bouter LM, et al. Low diagnostic accuracy of selective screening criteria for asymptomatic Chlamydia trachomatis infections in the general population. Sex Transm Infect. 2000;76(5):375-80.  https://doi.org/10.1136/sti.76.5.375  PMID: 11141855 
/content/10.2807/1560-7917.ES.2015.20.36.30012
Loading

Data & Media loading...

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error