Timing of progression from Chlamydia trachomatis infection to pelvic inflammatory disease: a mathematical modelling study
نویسندگان
چکیده
BACKGROUND Pelvic inflammatory disease (PID) results from the ascending spread of microorganisms from the vagina and endocervix to the upper genital tract. PID can lead to infertility, ectopic pregnancy and chronic pelvic pain. The timing of development of PID after the sexually transmitted bacterial infection Chlamydia trachomatis (chlamydia) might affect the impact of screening interventions, but is currently unknown. This study investigates three hypothetical processes for the timing of progression: at the start, at the end, or throughout the duration of chlamydia infection. METHODS We develop a compartmental model that describes the trial structure of a published randomised controlled trial (RCT) and allows each of the three processes to be examined using the same model structure. The RCT estimated the effect of a single chlamydia screening test on the cumulative incidence of PID up to one year later. The fraction of chlamydia infected women who progress to PID is obtained for each hypothetical process by the maximum likelihood method using the results of the RCT. RESULTS The predicted cumulative incidence of PID cases from all causes after one year depends on the fraction of chlamydia infected women that progresses to PID and on the type of progression. Progression at a constant rate from a chlamydia infection to PID or at the end of the infection was compatible with the findings of the RCT. The corresponding estimated fraction of chlamydia infected women that develops PID is 10% (95% confidence interval 7-13%) in both processes. CONCLUSIONS The findings of this study suggest that clinical PID can occur throughout the course of a chlamydia infection, which will leave a window of opportunity for screening to prevent PID.
منابع مشابه
Timing of progression of Chlamydia trachomatis infection to pelvic inflammatory disease: a mathematical modelling study
Timing of progression of Chlamydia trachomatis infection to pelvic inflammatory disease: a mathematical modelling study BMC Infectious Diseases 2012, 12:187 doi:10.1186/1471-2334-12-187 Sereina A Herzog ([email protected]}) Christian L Althaus ([email protected]}) Janneke C M Heijne ([email protected]}) Pippa Oakeshott ([email protected]}) Sally Kerry ([email protected]}) P...
متن کاملAuthor's response to reviews Title: Timing of progression of Chlamydia trachomatis infection to pelvic inflammatory disease: a mathematical modelling study Authors:
متن کامل
Describing the progression from Chlamydia trachomatis and Neisseria gonorrhoeae to pelvic inflammatory disease: systematic review of mathematical modeling studies.
BACKGROUND Chlamydia screening is recommended to prevent pelvic inflammatory disease (PID). A systematic review was conducted to determine how the natural history of Chlamydia trachomatis or Neisseria gonorrhoeae infection and progression to PID have been described in mathematical modeling studies. METHODS Four databases, from their earliest dates to October 2009, and reference lists of inclu...
متن کاملThe Prevalence of Chlamydia trachomatis Infection in Women Attending Health Clinics in Shiraz, Islamic Republic of Iran
Background Chlamydia trachomatis (CT) is a common cause of sexually transmitted infections (STI) and a prevalent microorganism found in the vaginal discharge of sexually active women. The infection usually has no symptoms; although it may cause chronic complications such as pelvic inflammatory disease (PID), ectopic pregnancy, chronic pelvic pain, tubal infertility and cervical cancer. This stu...
متن کاملIncidence of Non-Gonococcal Infection in Childbearing and Pregnant Women in Ardabil
Non-gonococcal infections causes are made up of Chlamydia trachomatis (one of the most common infection Non-Gonococcal), Ureaplasma urealyticum (a possible causal in acute pyelonephritis, pelvic inflammatory disease, curiuamniutis, bacterial vaginosis, preterm birth, Non-Gonococcal urethritis, miscarriage, infertility and spontaneous abortion), Gardnerella vaginalis and Streptococcus agalactiae...
متن کامل