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Randomised controlled trial of screening for Chlamydia trachomatis to prevent pelvic inflammatory disease : the POPI (prevention of pelvic infection) trial
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Oakeshott, P., Kerry, S., Aghaizu, A., Atherton, Helen, Hay, S., Taylor-Robinson, D., Simms, I. and Hay, P. (2010) Randomised controlled trial of screening for Chlamydia trachomatis to prevent pelvic inflammatory disease : the POPI (prevention of pelvic infection) trial. BMJ, 340 . c1642-c1642. doi:10.1136/bmj.c1642 ISSN 0959-535X.
An open access version can be found in:
Official URL: http://dx.doi.org/10.1136/bmj.c1642
Abstract
Objective
To determine whether screening and treating women for chlamydial infection reduces the incidence of pelvic inflammatory disease over the subsequent 12 months.
Design
Randomised controlled trial.
Setting
Common rooms, lecture theatres, and student bars at universities and further education colleges in London.
Participants
2529 sexually active female students, mean age 21 years (range 16-27).
Intervention Participants completed a questionnaire and provided self taken vaginal swabs, with follow-up after one year. Samples were randomly allocated to immediate testing and treatment for chlamydial infection, or storage and analysis after a year (deferred screening controls).
Main outcome measure Incidence of clinical pelvic inflammatory disease over 12 months.
Results
Baseline prevalence of chlamydia was 5.4% (68/1254) in screened women and 5.9% (75/1265) in controls. 94% (2377/2529) of women were followed up after 12 months. The incidence of pelvic inflammatory disease was 1.3% (15/1191) in screened women compared with 1.9% (23/1186) in controls (relative risk 0.65, 95% confidence interval 0.34 to 1.22). Seven of 74 control women (9.5%, 95% confidence interval 4.7% to 18.3%) who tested positive for chlamydial infection at baseline developed pelvic inflammatory disease over 12 months compared with one of 63 (1.6%) screened women (relative risk 0.17, 0.03 to 1.01). However, most episodes of pelvic inflammatory disease occurred in women who tested negative for chlamydia at baseline (79%, 30/38). 22% (527/2377) of women reported being tested independently for chlamydia during the trial.
Conclusion
Although some evidence suggests that screening for chlamydia reduces rates of pelvic inflammatory disease, especially in women with chlamydial infection at baseline, the effectiveness of a single chlamydia test in preventing pelvic inflammatory disease over 12 months may have been overestimated.
Trial registration ClinicalTrials.gov NCT00115388.
Item Type: | Journal Article | ||||
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Journal or Publication Title: | BMJ | ||||
Publisher: | BMJ Publishing Group Ltd. | ||||
ISSN: | 0959-535X | ||||
Official Date: | 8 April 2010 | ||||
Dates: |
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Volume: | 340 | ||||
Page Range: | c1642-c1642 | ||||
DOI: | 10.1136/bmj.c1642 | ||||
Status: | Peer Reviewed | ||||
Publication Status: | Published | ||||
Access rights to Published version: | Open Access (Creative Commons) | ||||
Open Access Version: |
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