Læknablaðið - 15.07.1995, Blaðsíða 33

LÆKNABLAÐIÐ 1995; 81
545
Diagnostic Efforts for the Detection
of Chlamydia trachomatis Infections
in lceland 1982-1994
ÓlafurSteingrímsson1’, Jón H. Ólafsson21, Karl G. Kristinsson1’, ReynirT. Geirsson3’, Vigfús Þorsteins-
son4), Raymond W. Ryan5)
Steingrímsson Ó", Ólafsson JH2’, Kristinsson KG1’,
Geirsson RT3’, Þorsteinsson V4’, Ryan RW5’
Læknablaðið 1995; 81: 545-9
The results of diagnostic testing for the detection of
Chlamydial infections in Iceland during the years
1982 to 1994 were reviewed. During those 13 years
123,461 laboratory tests were performed in 101,574
examinations. These examinations were positive in
14,462 instances. The first diagnostic test to be in-
troduced was cell culture in 1982. From then on the
number of examinations and the number of positive
examinations increased steadily until 1988, when
positive examinations reached a peak at approxi-
mately 570 cases per 100,000 inhabitants. In 1990 a
sharp decline in both the total number of exam-
inations and positive results was observed. The per-
centage of positive examinations declined during the
study period. In 1991 and 1992 the number of exam-
inations, the number of positive examinations and
the percentage of positive examinations increased
but the number of positive tests declined again in
1993. In 1994 the polymerase chain reaction assay
(PCR) replaced the much less sensitive Chlamydia-
zyme® assay and the number of positive examin-
ations rose again although the number of tests de-
clined. The dramatic reduction in prevalence experi-
enced in Sweden does not seem to have taken place
in Iceland.
In Sweden a substantial effort was made to screen
asymptomatic populations. In Iceland the screening
of asymptomatic patients increased from the begin-
Frá sýklafræðideild Landspítalans1’, húð- og kynsjúkdóma-
deild Landspitalans2’, kvennadeild Landspítalans31, Fjórð-
ungssjúkrahúsinu á Akureyri4’, Læknaskóla Connecticut-
fylkis, Farmington, Connecticut5’. Fyrirspurnir, bréfaskipti:
Ólafur Steingrimsson, sýklafræðideild Landspítalans, póst-
hólf 1465,101 Reykjavík.
ning of the study period until 1988 but declined
thereafter. Screening of asymptomatic populations
as well as contact tracing may be important for
bringing about a significant reduction of the preva-
lence of sexually transmitted infections caused by
Chlamydia trachomatis.
Introduction
Genital Chlamydia trachomatis infections
are a major health care problem world-wide
(1,2). Accurate figures on the prevalence of
these infections, on a national scale, are not
available except in a few countries, and com-
parisons between different communities are
difficult. Sweden led the field in providing na-
tion-wide diagnostic facilities for Chlamydia
infections. Recent reports (3,4) have shown a
significant decline in the number of cases diag-
nosed, indicating a decrease in the prevalence
of C. trachomatis infections. Since the intro-
duction of diagnostic facilities for these infec-
tions in Iceland, a substantial effort has been
made to diagnose and treat them. The number
of diagnosed cases has declined since the peak
in 1988 but the dramatic reduction (40%) re-
ported from Sweden (3) has not been observed
in Iceland. Contact tracing and screening of
From the Departments of Miorobiology1’, Venereology2’,
Gynecology and Obstetrics31, the National University Hos-
pital, Reykjavík, lceland, the Regional Hospital, Akureyri4’,
lceland, the University of Connecticut School of Medicine5’,
Farmington, Connecticut, U.S.A. Correspondence: Ólafur
Steingrímsson, Department of Microbiology, the National
University Hospital, P.O. Box 1465,101 Reykjavík, lceland.
Tel. 354-560 1900. Fax 354-560 1904.