TY - JOUR

T1 - Repeat Chlamydia Diagnoses Increase the Hazard of Pelvic Inflammatory Disease among U.S. Army females

T2 - A Retrospective Cohort Analysis

AU - Bautista, Christian

AU - Hollingsworth, Bruce Philip

AU - Sanchez, Jose L.

N1 - This is the Author Accepted Manuscript, it is not the final published version

PY - 2018/11

Y1 - 2018/11

N2 - Background In the US military, chlamydia is the mostly commonly diagnosed bacterial sexually transmitted infection and the rates of pelvic inflammatory disease (PID) have remained high since the early 2000s.Methods The relationship between the number of chlamydia diagnoses and hazard of PID was investigated in a retrospective cohort analysis among US Army women from 2006 to 2012. Cox regression model was used to estimate hazard ratios for associations between the number of repeat chlamydia diagnoses and PID.Results The study population comprised 33,176 women with chlamydia diagnosis. Of these, 25,098 (75%) were diagnosed only once (“nonrepeaters”). By comparison, 6282 (19%), 1435 (4%), and 361 (1%) women had one, two and three repeat chlamydia diagnoses, respectively. Among these 4 groups, 1111, 325, 72, and 25 PID diagnoses were noted. According to the Cox regression analysis, for every additional diagnosis of chlamydia, the hazard of PID increased by 28% (95% confidence interval, 19%–38%) compared with women with a single diagnosis or nonrepeaters. Moreover, the corresponding adjusted hazard ratio of 1.28, 1.35, and 1.97 represented a significantly greater risk for PID among the three “repeater” groups compared with nonrepeaters.Conclusions We found an increased hazard of PID among US Army women with repeat chlamydia diagnoses and the characterization of a dose-response relationship. These findings reinforce the notion that early diagnosis and treatment of chlamydia is necessary to avoid subsequent PID and associated morbidity.

AB - Background In the US military, chlamydia is the mostly commonly diagnosed bacterial sexually transmitted infection and the rates of pelvic inflammatory disease (PID) have remained high since the early 2000s.Methods The relationship between the number of chlamydia diagnoses and hazard of PID was investigated in a retrospective cohort analysis among US Army women from 2006 to 2012. Cox regression model was used to estimate hazard ratios for associations between the number of repeat chlamydia diagnoses and PID.Results The study population comprised 33,176 women with chlamydia diagnosis. Of these, 25,098 (75%) were diagnosed only once (“nonrepeaters”). By comparison, 6282 (19%), 1435 (4%), and 361 (1%) women had one, two and three repeat chlamydia diagnoses, respectively. Among these 4 groups, 1111, 325, 72, and 25 PID diagnoses were noted. According to the Cox regression analysis, for every additional diagnosis of chlamydia, the hazard of PID increased by 28% (95% confidence interval, 19%–38%) compared with women with a single diagnosis or nonrepeaters. Moreover, the corresponding adjusted hazard ratio of 1.28, 1.35, and 1.97 represented a significantly greater risk for PID among the three “repeater” groups compared with nonrepeaters.Conclusions We found an increased hazard of PID among US Army women with repeat chlamydia diagnoses and the characterization of a dose-response relationship. These findings reinforce the notion that early diagnosis and treatment of chlamydia is necessary to avoid subsequent PID and associated morbidity.

U2 - 10.1097/OLQ.0000000000000878

DO - 10.1097/OLQ.0000000000000878

M3 - Journal article

VL - 45

SP - 770

EP - 773

JO - Sexually Transmitted Disease

JF - Sexually Transmitted Disease

SN - 1537-4521

IS - 11

ER -