Nearly 10 percent of female Army recruits tested positive for the bacteria that causes the sexually transmitted disease chlamydia (Chlamydia trachomatis), according to researchers from Johns Hopkins, the Department of Defense and the Army. The researchers also found that the number of recruits testing positive for chlamydia increased over the four-year duration of the study, from 1996 to 1999.
"These rates are of great concern, and the Army should implement routine screening of its female recruits at entry into the military to protect their health," says Charlotte Gaydos, Dr.P.H., associate professor of medicine at The Johns Hopkins University School of Medicine and lead author of the study appearing in the July issue of journal Sexually Transmitted Diseases.
"While chlamydia infection usually shows no symptoms in women, it is a major underlying cause of pelvic inflammatory disease, ectopic pregnancy and infertility," says Gaydos.
"These sustained high rates of chlamydia infection in female Army recruits provide clear justification for a chlamydia control program for young women entering the Army, consisting of initial screening and treatment followed by periodic rescreening," says Gaydos.
"Programs for screening and treating chlamydia infection have proven to be cost effective, especially when compared to the health problems associated with untreated infections, and a highly sensitive test is now available that requires only a urine sample," says Gaydos.
The researchers found several risk factors associated with infection, including black race, youth (under 25 years of age), Southern hometowns, more than one sex partner, and a history of other sexually transmitted diseases.
Gaydos and colleagues conducted urine-based testing for chlamydia on 23,010 non-healthcare-seeking female Army recruits between January 1996 and June 1999. Questionnaires were used to collect demographic and risk information, such as sexual history, presence or absence of symptoms, and prior history of sexually transmitted diseases.
They found that 9.51 percent of women tested positive for chlamydia for all years the study was conducted, and that during the course of the study, rates increased from 8.51 percent to 9.92 percent.
According to the U.S. Centers for Disease Control and Prevention, chlamydia is the most frequently reported bacterial sexually transmitted infection in the United States. More than 650,000 cases were reported in 1999, and three of every four reported cases occurred in persons under age 25. Under-reporting is substantial because most people with chlamydia are not aware of their infections and do not seek testing. An estimated 3 million Americans are infected with chlamydia each year.
Other authors of the study are René Howell and Thomas Quinn of Johns Hopkins, Kelly McKee Jr. of the Womack Army Medical Center, and Joel Gaydos of the Department of Defense Global Emerging Infections Surveillance and Response System.