V. Lavoue


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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,
    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.