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. 2018 Oct 26;18(1):534.
doi: 10.1186/s12879-018-3432-y.

Prevalence, risk factors, and medical costs of Chlamydia trachomatis infections in Shandong Province, China: a population-based, cross-sectional study

Pengcheng Huai  1   2   3 , Furong Li  2 , Zhen Li  2 , Lele Sun  2   4 , Xi'an Fu  2   4 , Qing Pan  2   4 , Gongqi Yu  2   4 , Zemin Chai  2   4 , Tongsheng Chu  2 , Zihao Mi  2   4 , Fangfang Bao  2   4 , Honglei Wang  2   4 , Bingni Zhou  2   4 , Chuan Wang  2   4 , Yonghu Sun  2   4 , Guiye Niu  2   4 , Yuan Zhang  2   4 , Fanghui Fu  2   4 , Xiaoqiao Lang  2   4 , Xiaoling Wang  2   4 , Hui Zhao  2   4 , Daina Liu  2   4 , Hong Liu  2   4 , Dianchang Liu  2 , Jian Liu  2 , Aiqiang Xu  3   5 , Furen Zhang  6   7
Affiliations

Prevalence, risk factors, and medical costs of Chlamydia trachomatis infections in Shandong Province, China: a population-based, cross-sectional study

Pengcheng Huai et al. BMC Infect Dis. .

Abstract

Background: A population-based study of Chlamydia trachomatis (CT) infections is essential in designing a specific control program; however, no large investigation of CT infections among the general population in mainland China has been conducted since 2000. We aimed to determine the prevalence, risk factors, and associated medical costs of CT among residents, 18-49 years of age, in Shandong, China.

Methods: From May to August 2016, a multistage probability sampling survey involving 8074 individuals was distributed. Data were collected via face-to-face interviews, followed by self-administered questionnaire surveys. First-void urines were collected and tested for CT and Neisseria gonorrhoeae (NG) using nucleic acid amplification.

Results: The weighted prevalence of CT infection was 2.3% (95% confidence interval [CI], 1.5-3.2) in females and 2.7% (1.6-3.8) in males. Women, 30-34 years of age, had the highest prevalence of CT infections (3.5%, 2.6-4.4), while the highest prevalence of CT infections in males was in those 18-24 years of age (4.3%, 0.0-8.8). Neisseria gonorrhoeae infection had a prevalence of 0.1% (0.0-0.3) in women and 0.03% (0.0-0.1) in men. Risk factors for CT infections among females included being unmarried, divorced, or widowed (odds ratio [OR], 95% CI 3.57, 1.54-8.24) and having two or more lifetime sex partners (3.72, 1.14-12.16). Among males, first intercourse before 20 years of age (1.83, 1.10-3.02) and having two or more lifetime sex partners (1.85, 1.14-3.02) were associated with CT infections. The estimated lifetime cost of CT infections in patients 18-49 years of age in Shandong was 273 million (range, 172-374 million) China Renminbi in 2016.

Conclusions: This study demonstrated a high burden of CT infections among females < 35 years of age and males < 25 years of age in Shandong. Thus, a CT infection control program should focus on this population, as well as others with identified risk factors.

Keywords: China; Chlamydia trachomatis; General population; Medical cost; Neisseria gonorrhea; Prevalence; Risk factor.

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Conflict of interest statement

Ethics approval and consent to participate

This study was conducted in accordance with the ethical principles stated in the Helsinki Declaration. This study was reviews and approved by the Ethics Committee of Shandong Provincial Institute of Dermatology and Venereology (approval number: 2016–04). There were several sensitive questions related to sex in the questionnaires. Participants may refuse to answer those questions or provide untruthful information if they signed informed consent. In order to obtain true and accurate information, oral informed consent instead of written consent was obtained from each participant by interviewers before interview. This procedure was approved by the ethics committee. The name was not written on the questionnaire and the confidentiality of the data was kept properly.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Geographic locations of Shandong Province and 12 primary sampling units
Fig. 2
Fig. 2
The method of calculating the medical costs of CT infection for females. Abbreviations: PID pelvic inflammatory disease, CT Chlamydia trachomatis
Fig. 3
Fig. 3
The method of calculating the medical costs of CT infection for males. Abbreviations: CT Chlamydia trachomatis
Fig. 4
Fig. 4
Flow chart for participant selection. Abbreviations: CT Chlamydia trachomatis, NG neisseria gonorrhoeae
See this image and copyright information in PMC

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