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Screening for Chlamydia trachomatis Using Self-Collected Vaginal Swabs at a Public Pregnancy Termination Clinic in France: Results of a Screen-and-Treat Policy

Lavoué, Vincent MD*,†; Vandenbroucke, Laurent*,†; Lorand, Sophie MD*,†; Pincemin, Patrick*; Bauville, Estelle MD; Boyer, Laurence MD; Martin-Meriadec, Daniel MD; Minet, Jacques PhD; Poulain, Patrice MD*,†; Morcel, Karine MD, PhD*,†

doi: 10.1097/OLQ.0b013e318254ca6f
Original Study

Objective: To assess the prevalence of Chlamydia trachomatis (CT) infection and the risk factors for CT infection among women presenting for abortion at a clinic in France.

Methods: Women seeking surgically induced abortions were systematically screened by PCR on self-collected vaginal swabs between January 1, 2010, and September 30, 2010. CT-positive women were treated with oral azithromycin (1 g) before the surgical procedure.

Results: Of the 978 women included in the study, 66 were CT positive. The prevalence was 6.7% (95% confidence intervals [CI] 5.1%–8.3%). The risk factors for CT infection were the following: age <30 years (Odds ratio [OR]: 2.0 [95% CI: 1.2–3.5]), a relationship status of single (OR: 2.2 [95% CI: 1.2–4.0]), having 0 or 1 child (OR: 5.2 [95% CI: 2.0–13.0]), not using contraception (OR: 2.4 [95% CI: 1.4–4.1]), and completing 11 weeks or more of gestation (OR: 2.1 [95% CI: 1.3–3.6]). Multiple logistic regression indicated that 4 factors—having 0 or 1 child, a single relationship status, no contraceptive use, and a gestation of 11 weeks or more—were independently associated with CT infection. The rate of postabortion infection among all patients was 0.4% (4/978).

Conclusions: These results reveal a high prevalence (6.7%) of CT-positive patients among French women seeking induced abortions. Because it is not common practice to screen the general population for CT, screening before induced abortions seems relevant. A cost-effectiveness study is required to evaluate this screen-and-treat policy.

From the *Faculté de Médecine, Université de Rennes 1, Rennes, France; Département de Gynécologie et d'Obstétrique, CHU Rennes, Rennes, France; and Département de microbiologie, CHU Rennes, Rennes, France

The authors thank American Journal Experts for editing the manuscript.

V.L. and L.V. have both contributed equally to his work.

Correspondence: Vincent Lavoué, MD, Service de gynécologie et d'obstétrique, CHU Hôpital sud, 16 Bd de Bulgarie, BP 90347, F-35 203 Rennes Cedex 2, France. E-mail: vincent.lavoue@chu-rennes.fr.

Received for publication November 3, 2011, and accepted March 8, 2012.

© Copyright 2012 American Sexually Transmitted Diseases Association