Publication

What do diagnoses of pelvic inflammatory disease in specialist sexual health services in England tell us about chlamydia control?

Davis, Grahame S
; 
Horner, Patrick J
; 
Price, Malcolm J
; 
Mitchell, Holly D
; 
Soldan, Kate
Abstract
Background: Pelvic inflammatory disease (PID) is an outcome measure for the evaluation of chlamydia screening programs. We explore PID diagnoses in specialist sexual health services (SSHSs) in England to inform the evaluation of the National Chlamydia Screening Programme, which was implemented nationally in 2008. Methods: We conducted descriptive analyses using data on diagnoses of PID-with and without Chlamydia trachomatis (CT) and/or Neisseria gonorrhoeae (GC)-by age and year of birth, in SSHSs between 2009 and 2019 from the GUMCAD STI Surveillance System database. Rates were calculated per 100 000 females residing in England. Results: CT screening activity peaked in 2010. The rates of all PID diagnoses decreased between 2009 and 2019 by 39%. CT-associated PID (CT-PID) declined by 58%, and nonspecific PID declined by 37%. GC-PID increased by 34%. CT-PID decreased across all age groups with the highest observed decline, 71%, in 15- to 19-year-olds. A dose-response relationship was observed between CT-PID rates and screening, with rates lowest in those with the greatest exposure to screening. Conclusions: There was a marked decline in diagnoses of CT-PID, and nonspecific PID, at SSHSs after the introduction of widespread chlamydia screening, whereas GC-PID diagnoses increased. This ecological trend was broadly consistent with what we would have expected to see if widespread screening reduced the incidence of chlamydia-associated PID (and of nonspecific PID), as has been observed in randomized controlled trials of screening.
MIDER Authors
Citations
Altmetric:
Date
2021-08-16
Type
Article
Other
Subject
Communicable diseases
Collections
UHB Sexual Health
Show all metadata
Citation
Davis GS, Horner PJ, Price MJ, Mitchell HD, Soldan K. What Do Diagnoses of Pelvic Inflammatory Disease in Specialist Sexual Health Services in England Tell Us About Chlamydia Control? J Infect Dis. 2021 Aug 16;224(12 Suppl 2):S113-S120. doi: 10.1093/infdis/jiab175
Journal / Source Title
The Journal of Infectious Diseases
DOI
10.1093/infdis/jiab175
URI
http://hdl.handle.net/20.500.14200/6067
PMID
34396397
Publisher
Oxford University Press
Publisher’s URL
https://academic.oup.com/jid
Publisher’s statement
Note / Copyright