V. Lavoue
Speeches:
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Screening for chlamydia trachomatis using
self-collected vaginal swabs at a public pregnancy
termination clinic in France: results of a screen-
and-treat policy
Lavoue´, V; Vandenbroucke, L; Lorand, S;
Pincemin, P; Bauville, E; Boyer, L; Martin-
Meriadec, D; Minet, J; Poulain, P; Morcel, K
CHU de Rennes, Centre IVG, Service d’obste´trique, Hoˆpital Sud,
France
Objective: To assess the prevalence of Chlamydia trachomatis
(CT) infection and the risk factors for CT infection among
women presenting for a termination of pregnancy (TOP) at a
clinic in France.
Methods: Women seeking surgically induced TOP were
systematically screened by PCR on self-collected vaginal swabs
between January 1, 2010, and September 30, 2010. CT-positive
women were treated with oral azithromycin (1g) prior to the
surgical procedure.
Results: Out of the 978 women included in the study, 66 were
CT-positive. The prevalence was 6.7% (95% CI 5.1–8.3%). The
risk factors for CT infection were the following: age <30 years
(Odds ratio [OR] = 2.0 [95% CI 1.2–3.5]), a relationship status of
single (OR = 2.2 [95% CI 1.2–4.0]), having 0 or 1 child
(OR = 5.2 [95% CI 2.0–13.0]), not using contraception (OR = 2.4
[95% CI 1.4–4.1]) and completing 11 weeks or more of gestation
(OR = 2.1 [95% CI 1.3–3.6]). Multiple logistic regression
indicated that four factors – having 0 or 1 child, a single
relationship status, no contraceptive use and a gestation of
11 weeks or more – were independently associated with CT
infection. The rate of post-TOP infection among all patients was
0.4% (4/978).
Conclusions: These results reveal a high prevalence (6.7%) of CT-
positive patients among French women seeking induced abortions.
A cost-effectiveness study is required to evaluate this screen-and-
treat policy.