Has chlamydia trachomatis prevalence in young women in England, scotland and wales changed? evidence from national probability surveys

D. Z. Kounali*, N. J. Welton, Katherine Soldan, S. C. Woodhall, J. Kevin Dunbar, S. J. Migchelsen, C. H. Mercer, P. Horner, A. E. Ades

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

We evaluate the utility of the National Surveys of Attitudes and Sexual Lifestyles (Natsal) undertaken in 2000 and 2010, before and after the introduction of the National Chlamydia Screening Programme, as an evidence source for estimating the change in prevalence of Chlamydia trachomatis (CT) in England, Scotland and Wales. Both the 2000 and 2010 surveys tested urine samples for CT by Nucleic Acid Amplification Tests (NAATs). We examined the sources of uncertainty in estimates of CT prevalence change, including sample size and adjustments for test sensitivity and specificity, survey non-response and informative non-response. In 2000, the unadjusted CT prevalence was 4.22% in women aged 18–24 years; in 2010, CT prevalence was 3.92%, a non-significant absolute difference of 0.30 percentage points (95% credible interval −2.8 to 2.0). In addition to uncertainty due to small sample size, estimates were sensitive to specificity, survey non-response or informative non-response, such that plausible changes in any one of these would be enough to either reverse or double any likely change in prevalence. Alternative ways of monitoring changes in CT incidence and prevalence over time are discussed.

Original languageEnglish
Article numbere107
JournalEpidemiology and Infection
Volume147
DOIs
Publication statusPublished - 2019

Bibliographical note

Funding Information:
Acknowledgements. The study was funded by the NIHR Health Protection Research Unit in Evaluation of Interventions at University of Bristol, in partnership with Public Health England (PHE). The views expressed are those of the author and not necessarily those of the NHS, the NIHR, the Department of Health or PHE.

Funding Information:
The study was funded by the NIHR Health Protection Research Unit in Evaluation of Interventions at University of Bristol, in partnership with Public Health England (PHE). The views expressed are those of the author and not necessarily those of the NHS, the NIHR, the Department of Health or PHE.

Publisher Copyright:
© NIHR Health Protection Research Unit in Evaluation of Interventions 2019.

Keywords

  • Chlamydia trachomatis
  • Prevalence
  • Sexually transmitted infections (STIs)

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