Randomised controlled trial of screening for Chlamydia trachomatis to prevent pelvic inflammatory disease : the POPI (prevention of pelvic infection) trial
Randomised controlled trial of screening for Chlamydia trachomatis to prevent pelvic inflammatory disease : the POPI (prevention of pelvic infection) trial
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.
Chlamydia trachomatis
Oakeshott, Pippa
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Kerry, Sally
45167362-3df0-427c-88db-045cb9e8c63c
Aghaizu, Adamma
51b0777f-8376-4a63-8302-fa03034bc984
Atherton, Helen
9bb8932e-7bb7-4781-ab97-114613de99b1
Hay, Sima
0de001bf-1a9c-438f-a96b-0e1847369a3e
Taylor-Robinson, David
cd59969a-7143-4103-8895-dde4495a2b94
Simms, Ian
fa9272d7-0ad4-4cdd-88ab-4cd59498272b
Hay, Phillip
c5c26cd0-742d-4035-93d2-a43be55047e9
8 April 2010
Oakeshott, Pippa
aa3fe875-115a-4d6c-bdd2-c13e1c53129d
Kerry, Sally
45167362-3df0-427c-88db-045cb9e8c63c
Aghaizu, Adamma
51b0777f-8376-4a63-8302-fa03034bc984
Atherton, Helen
9bb8932e-7bb7-4781-ab97-114613de99b1
Hay, Sima
0de001bf-1a9c-438f-a96b-0e1847369a3e
Taylor-Robinson, David
cd59969a-7143-4103-8895-dde4495a2b94
Simms, Ian
fa9272d7-0ad4-4cdd-88ab-4cd59498272b
Hay, Phillip
c5c26cd0-742d-4035-93d2-a43be55047e9
Oakeshott, Pippa, Kerry, Sally, Aghaizu, Adamma, Atherton, Helen, Hay, Sima, Taylor-Robinson, David, Simms, Ian and Hay, Phillip
(2010)
Randomised controlled trial of screening for Chlamydia trachomatis to prevent pelvic inflammatory disease : the POPI (prevention of pelvic infection) trial.
BMJ, 340, [c1642].
(doi: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.
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Accepted/In Press date: 16 February 2010
Published date: 8 April 2010
Keywords:
Chlamydia trachomatis
Identifiers
Local EPrints ID: 487496
URI: http://eprints.soton.ac.uk/id/eprint/487496
ISSN: 0959-535X
PURE UUID: 4ecf6d18-28c6-41e4-a69f-84704b9f6fdf
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Date deposited: 21 Feb 2024 17:44
Last modified: 18 Mar 2024 04:18
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Contributors
Author:
Pippa Oakeshott
Author:
Sally Kerry
Author:
Adamma Aghaizu
Author:
Helen Atherton
Author:
Sima Hay
Author:
David Taylor-Robinson
Author:
Ian Simms
Author:
Phillip Hay
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