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    Wednesday, July 15, 2009

    IMPORTANCE OF CHLAMYDIA SCREENING

    "One of the biggest frustrations in public-health circles today involves a tiny bacterium called Chlamydia trachomatis." some CDC experts "estimate that twice that many cases go undetected." Thus far, "efforts to screen for chlamydia have run into a number of obstacles," with one issue being "simple awareness." And, "many primary-care doctors may be too time-pressed to bring up chlamydia screening during office visits," or do not think it is an issue affecting their patient demographics. Therefore, the "CDC, along with the National Chlamydia Coalition, an umbrella group of nearly 40 medical associations, are working to spread the word about the importance of screening for chlamydia."

    Chlamydia infection is the most common sexually transmitted disease, responsible for a record 1.1 million cases reported to the Centers for Disease Control and Prevention in 2007, and experts there estimate that twice that many cases go undetected. Left untreated, chlamydia can cause infertility or potentially fatal ectopic pregnancies. But many women aren’t even aware that they were exposed to it—possibly years ago—until they try to have a baby and can’t.

    Chlamydia can be detected with a simple urine test. It can be treated with a single dose of antibiotics, and the CDC has been urging all sexually active women under 26 years old to be tested for it annually, as well as older women who have had a change of sexual partner. Yet fewer than 40 % of women in those categories are being screened. “You’d think this would be a no-brainer,” says John Douglas, director of the CDC’s division of STD prevention. “That’s why we’re trying to get the message out.”
    The CDC, along with the National Chlamydia Coalition, an umbrella group of nearly 40 medical associations, are working to spread the word about the importance of screening for chlamydia.

    Chlamydia is especially prevalent among women ages 15 to 19 and African-Americans, but sample studies have found the infection in nearly 10% of all female Army recruits, 10% of female college freshmen and 14% of women in managed-care plans. Experts say it’s about three times as prevalent in women than men, but it may be that men eliminate it from their bodies more readily, while it goes on to cause far more damage in women.

    Many girls in the prime chlamydia age group are under the care of pediatricians, who may be uncomfortable bringing up sex with patients they’ve treated since infancy. Even when pediatricians discuss the human papilloma virus (HPV) vaccine with adolescents and parents, it’s often in the context of preventing cancer in the future, not current sexual activity.“But to pretend that teenagers aren’t having sex is very dangerous.”

    Even when women are treated for chlamydia, about 25% become reinfected within six months—probably due to a partner who wasn’t treated. So the CDC recommends that doctors give women a second course of antibiotics for their partners, even without being seen by a doctor themselves. It can be treated either with a weekly dose of doxycycline or a single dose of azithromycin, which goes by the brand name Zithromax, made by Pfizer Inc., in many countries.

    Chlamydia can be spread by oral or anal sex, as well as vaginal sex; condoms greatly reduce the transmission rate. No one knows for sure how long an infected person remains contagious. But experts advise caution. More insidiously, even when a woman no longer tests positive for an active infection, the chlamydia bacteria may have moved into her upper genital tract and set off pelvic inflammatory disease. PID can cause pelvic pain—or it can be asymptomatic—but it often leaves inflammation and scar tissue that blocks a woman’s fallopian tubes, preventing fertilization. PID is also the most common cause of ectopic pregnancy, which can be fatal. “It’s not the infection itself but the body’s response to get rid of the bacteria that causes the scarring,” There is also evidence of old chlamydia infections in women with endometriosis—a condition in which bits of uterine lining tissue grow outside the uterus, which can also cause pain and infertility. Chlamydia infecting the uterine wall can cause miscarriages, and that it can invade ovaries and lead to early ovarian decline and early menopause. Such scarring can sometimes be seen with a hysterosalpingogram. Severe scar tissue may need to be removed surgically before a woman can get pregnant or to resolve pelvic pain.

    The CDC recommends that all pregnant women be tested for chlamydia at the first prenatal visit, although if you are planning to become pregnant, it’s a good idea to be tested for all STDs well in advance. Older women who are experiencing pelvic pain, intermittent bleeding, unusual vaginal discharge or signs of early menopause should ask their doctor if chlamydia could be involved

    Please remember, as with all our articles we provide information, not medical advice.
    For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.


    * Tune in tomorrow for WHICH ORAL ANTIBIOTICS ARE SAFE DURING PREGNANCY AND BREASTFEEDING?

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