CHLAMYDIA-TRACHOMATIS INFECTIONS IN FEMALE MILITARY RECRUITS

Background. Asymptomaticgenital Chlamydia trachomatis infections in wo men can lead to pelvic inflammatory disease, infertility, and ectopic pregnancy. To design a chlamydia-control program, we conducted a large survey of women in the U.S. military. Methods From January 1996 throu gh December 1997, urine samples from 13,204 new female U.S. Army recru its from 50 states were screened by ligase chain reaction for C. trach omatis infection. Information on potential risk factors was obtained b y questionnaire. With multivariate analysis, we identified criteria fo r a screening program. Results The overall prevalence of chlamydial in fection was 9.2 percent, with a peak of 12.2 percent among the 17-year -old recruits. The prevalence was 15 percent or more among the recruit s from five southern states. The following risk factors were independe ntly associated with chlamydial infection: having ever had vaginal sex (odds ratio for infection, 5.9), being 25 years of age or less (odds ratio, 3.0), being black (odds ratio, 3.4), having had more than one s ex partner in the previous 90 days (odds ratio, 1.4), having had a new partner in the previous 90 days (odds ratio, 1.3), having had a partn er in the previous 90 days who did not always use condoms (odds ratio, 1.4), and having ever had a sexually transmitted disease (odds ratio, 1.2). A screening program for subjects 25 years of age or less (87.9 per cent of our sample) would have identified 95.3 percent of the infe cted women. Conclusions. Among female military recruits, the prevalenc e of chlamydial infection is high. A control program that screens fema le recruits who are 25 years old or younger with urine DNA-amplificati on assays has the potential to reduce infection, transmission, and the sequelae of chlamydial infection. (N Engl J Med 1998;339:739-44.) (C) 1998, Massachusetts Medical Society.