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. 2000 Apr;76(2):103–109. doi: 10.1136/sti.76.2.103

Sociodemography of genital Chlamydia trachomatis in Coventry, UK, 1992–6

A Winter 1, P Sriskandabalan 1, A Wade 1, C Cummins 1, P Barker 1
PMCID: PMC1758289  PMID: 10858711

Abstract

Objective: To describe the sociodemographic and geographic risk factors for incident Chlamydia trachomatis genital infection.

Design: Cross sectional retrospective study of cases diagnosed in local genitourinary clinics.

Setting: Coventry, West Midlands, from 1992 to 1996.

Subjects: 582 female and 620 male Coventry residents aged 15–64 years diagnosed with one or more episodes of genital Chlamydia trachomatis infection by enzyme immunoassay. Subjects were assigned a Townsend deprivation score based on residence. The denominator population aged 15–64 years was derived from 1991 census data.

Results: The mean annual incidence of genital chlamydia was 151 episodes (95% CI 140–163) per 100 000 population in men and 138 episodes (95% CI 128–149) per 100 000 population in women. Highest subgroup incidence was observed in 15–19 year old black women (2367 (95% CI 1370–4560) per 100 000), and 20–24 year old black men (1951 (95% CI 1158–3220) per 100 000). In univariate analyses, the most important risk factor for chlamydia infection in males was being black (incidence 1377 (95% CI 1137–1652) per 100 000 for black v 133 (95% CI 122–145) per 100 000 for white; RR 10.4, p<0.0001) and for women was young age (incidence 475 (95% CI 415–540) per 100 000 for age group 15–19 years v 52 (95% CI 45–60) per 100 000 for age group 25–64 years; RR 9.1, p<0.0001). In Poisson regression models of first episodes of genital chlamydia, for both males and females the effect of ethnic group could not be fully explained by socioeconomic confounding. There were significant interactions between age and ethnic group for both sexes and between age and level of deprivation for men. Geographical analysis revealed a high incidence of genital chlamydia in estates on the edge of the city as well as the urban core.

Conclusions: There is a complex interaction between geographical location, age, ethnic group, and social deprivation on the risk of acquiring genital Chlamydia trachomatis in Coventry. Better population based data are needed.

Key Words: chlamydia infections; epidemiology; ethnicity; deprivation

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Selected References

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  1. Acosta-Cázares B., Ruiz-Maya L., Escobedo de la Peña J. Prevalence and risk factors for Chlamydia trachomatis infection in low-income rural and suburban populations of Mexico. Sex Transm Dis. 1996 Jul-Aug;23(4):283–288. doi: 10.1097/00007435-199607000-00007. [DOI] [PubMed] [Google Scholar]
  2. Becker K. M., Glass G. E., Brathwaite W., Zenilman J. M. Geographic epidemiology of gonorrhea in Baltimore, Maryland, using a geographic information system. Am J Epidemiol. 1998 Apr 1;147(7):709–716. doi: 10.1093/oxfordjournals.aje.a009513. [DOI] [PubMed] [Google Scholar]
  3. Bhopal R. Is research into ethnicity and health racist, unsound, or important science? BMJ. 1997 Jun 14;314(7096):1751–1756. doi: 10.1136/bmj.314.7096.1751. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Burstein G. R., Gaydos C. A., Diener-West M., Howell M. R., Zenilman J. M., Quinn T. C. Incident Chlamydia trachomatis infections among inner-city adolescent females. JAMA. 1998 Aug 12;280(6):521–526. doi: 10.1001/jama.280.6.521. [DOI] [PubMed] [Google Scholar]
  5. Cohen D. A., Nsuami M., Etame R. B., Tropez-Sims S., Abdalian S., Farley T. A., Martin D. H. A school-based Chlamydia control program using DNA amplification technology. Pediatrics. 1998 Jan;101(1):E1–E1. doi: 10.1542/peds.101.1.e1. [DOI] [PubMed] [Google Scholar]
  6. Egger M., Low N., Smith G. D., Lindblom B., Herrmann B. Screening for chlamydial infections and the risk of ectopic pregnancy in a county in Sweden: ecological analysis. BMJ. 1998 Jun 13;316(7147):1776–1780. doi: 10.1136/bmj.316.7147.1776. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Ellen J. M., Kohn R. P., Bolan G. A., Shiboski S., Krieger N. Socioeconomic differences in sexually transmitted disease rates among black and white adolescents, San Francisco, 1990 to 1992. Am J Public Health. 1995 Nov;85(11):1546–1548. doi: 10.2105/ajph.85.11.1546. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Grun L., Tassano-Smith J., Carder C., Johnson A. M., Robinson A., Murray E., Stephenson J., Haines A., Copas A., Ridgway G. Comparison of two methods of screening for genital chlamydial infection in women attending in general practice: cross sectional survey. BMJ. 1997 Jul 26;315(7102):226–230. doi: 10.1136/bmj.315.7102.226. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Hawker J. I., Bakhshi S. S., Ali S., Farrington C. P. Ecological analysis of ethnic differences in relation between tuberculosis and poverty. BMJ. 1999 Oct 16;319(7216):1031–1034. doi: 10.1136/bmj.319.7216.1031. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Hughes G., Simms I., Rogers P. A., Swan A. V., Catchpole M. New cases seen at genitourinary medicine clinics: England 1997. Commun Dis Rep CDR Suppl. 1998 Dec;8(7):S1–11. [PubMed] [Google Scholar]
  11. Jonsson M., Karlsson R., Persson K., Juto P., Edlund K., Evander M., Gustavsson A., Bodén E., Rylander E., Wadell G. The influence of sexual and social factors on the risk of Chlamydia trachomatis infections: a population-based serologic study. Sex Transm Dis. 1995 Nov-Dec;22(6):355–363. doi: 10.1097/00007435-199511000-00007. [DOI] [PubMed] [Google Scholar]
  12. Lacey C. J., Merrick D. W., Bensley D. C., Fairley I. Analysis of the sociodemography of gonorrhoea in Leeds, 1989-93. BMJ. 1997 Jun 14;314(7096):1715–1718. doi: 10.1136/bmj.314.7096.1715. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Low N., Daker-White G., Barlow D., Pozniak A. L. Gonorrhoea in inner London: results of a cross sectional study. BMJ. 1997 Jun 14;314(7096):1719–1723. doi: 10.1136/bmj.314.7096.1719. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Matondo P., Wall R., Morgan K., Hickman M., Dore C., Kapembwa M. Epidemiology of gonococcal and chlamydial infections in Harrow and Brent. Genitourin Med. 1996 Oct;72(5):352–357. doi: 10.1136/sti.72.5.352. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Mertz K. J., McQuillan G. M., Levine W. C., Candal D. H., Bullard J. C., Johnson R. E., St Louis M. E., Black C. M. A pilot study of the prevalence of chlamydial infection in a national household survey. Sex Transm Dis. 1998 May;25(5):225–228. doi: 10.1097/00007435-199805000-00001. [DOI] [PubMed] [Google Scholar]
  16. Morris R., Carstairs V. Which deprivation? A comparison of selected deprivation indexes. J Public Health Med. 1991 Nov;13(4):318–326. [PubMed] [Google Scholar]
  17. Oakeshott P., Kerry S., Hay S., Hay P. Opportunistic screening for chlamydial infection at time of cervical smear testing in general practice: prevalence study. BMJ. 1998 Jan 31;316(7128):351–352. doi: 10.1136/bmj.316.7128.351. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Orr P., Sherman E., Blanchard J., Fast M., Hammond G., Brunham R. Epidemiology of infection due to Chlamydia trachomatis in Manitoba, Canada. Clin Infect Dis. 1994 Nov;19(5):876–883. doi: 10.1093/clinids/19.5.876. [DOI] [PubMed] [Google Scholar]
  19. Rankin J., Bhopal R. Current census categories are not a good match for identity. BMJ. 1999 Jun 19;318(7199):1696–1696. doi: 10.1136/bmj.318.7199.1696. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Ridgway G. L., Mumtaz G., Robinson A. J., Franchini M., Carder C., Burczak J., Lee H. Comparison of the ligase chain reaction with cell culture for the diagnosis of Chlamydia trachomatis infection in women. J Clin Pathol. 1996 Feb;49(2):116–119. doi: 10.1136/jcp.49.2.116. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Scholes D., Stergachis A., Heidrich F. E., Andrilla H., Holmes K. K., Stamm W. E. Prevention of pelvic inflammatory disease by screening for cervical chlamydial infection. N Engl J Med. 1996 May 23;334(21):1362–1366. doi: 10.1056/NEJM199605233342103. [DOI] [PubMed] [Google Scholar]
  22. Simms I., Catchpole M., Brugha R., Rogers P., Mallinson H., Nicoll A. Epidemiology of genital Chlamydia trachomatis in England and Wales. Genitourin Med. 1997 Apr;73(2):122–126. doi: 10.1136/sti.73.2.122. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Smith J. R., Murdoch J., Carrington D., Frew C. E., Dougall A. J., MacKinnon H., Baillie D., Byford D. M., Forrest C. A., Davis J. A. Prevalence of Chlamydia trachomatis infection in women having cervical smear tests. BMJ. 1991 Jan 12;302(6768):82–84. doi: 10.1136/bmj.302.6768.82. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Stergachis A., Scholes D., Heidrich F. E., Sherer D. M., Holmes K. K., Stamm W. E. Selective screening for Chlamydia trachomatis infection in a primary care population of women. Am J Epidemiol. 1993 Aug 1;138(3):143–153. doi: 10.1093/oxfordjournals.aje.a116840. [DOI] [PubMed] [Google Scholar]
  25. Van Duynhoven Y. T., van de Laar M. J., Schop W. A., Mouton J. W., van der Meijden W. I., Sprenger M. J. Different demographic and sexual correlates for chlamydial infection and gonorrhoea in Rotterdam. Int J Epidemiol. 1997 Dec;26(6):1373–1385. doi: 10.1093/ije/26.6.1373. [DOI] [PubMed] [Google Scholar]
  26. Wallace R., Wallace D. Socioeconomic determinants of health: community marginalisation and the diffusion of disease and disorder in the United States. BMJ. 1997 May 3;314(7090):1341–1345. doi: 10.1136/bmj.314.7090.1341. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Wood S. M., Muscat I. Screening and treatment to prevent post abortion chlamydial pelvic infection. Lancet. 1989 Oct 14;2(8668):928–929. doi: 10.1016/s0140-6736(89)91601-2. [DOI] [PubMed] [Google Scholar]
  28. Zelin J. M., Robinson A. J., Ridgway G. L., Allason-Jones E., Williams P. Chlamydial urethritis in heterosexual men attending a genitourinary medicine clinic: prevalence, symptoms, condom usage and partner change. Int J STD AIDS. 1995 Jan-Feb;6(1):27–30. doi: 10.1177/095646249500600106. [DOI] [PubMed] [Google Scholar]

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