Læknablaðið - 15.07.1995, Page 39

LÆKNABLAÐIÐ 1995; 81
ity, gestational age and results of diagnostic
tests for C. trachomatis. These results were
checked against the files of the Department of
Microbiology.
Samples were taken from the endocervical
canal using an ELISA-test (Chlamydiazyme®)
for diagnosis. Mucus was cleared from the cer-
vix and the swab rotated in the endocervix. All
tests were performed at the Department of
Microbiology according to the manufacturers’
recommendations. Chi-squared tests were
used to evaluate differences between the pre-
sent and the earlier study. The hospital ethical
committee approved the study.
Results
There were 686 women requesting termina-
tion of pregnancy in 1993. Of those 636 had
induced abortion by suction evacuation, 11
aborted spontaneously, three were not preg-
nant, two were refused termination of preg-
nancy and 34 women withdrew their request.
Of those who had the operation, 633 (92.3%)
had samples taken and 48 were C. trachomatis
positive (7.6%). The reduction from the previ-
ous study was significant (x,2=15.2; p=0.0001).
The mean age of Chlamydia positive women
was 21.8 years compared to 20.8 years in the
previous study. There were 338 women =£25
years and of those 38 were Chlamydia positive,
while 285 women were =£26 years and of
those 10 were Chlamydia positive (xt2=12.1;
p=0.005). The age distribution of the Chlamy-
dia positive women is shown in the table and
the figure shows that 77% of Chlamydia posi-
tive women were =£25 years. Of the women 200
were married or cohabiting and of those seven
were Chlamydia positive while 486 were single
of whom 41 was Chlamydia positive. The pro-
portion of married and cohabiting women was
the same in the 1982-84 study (16.4%) as in this
study (14.6%).
Table. The number and age distribuúon of women seeking
terminaúon of pregnancy and tested for Chlamydia traclioma-
tis in 1993.
Years N (%)
S19 21 (44)
20-24 16 (33)
25-29 6 (13)
30-34 2 ( 4)
35-39 1 ( 2)
2=40 2 ( 4)
Fig. The percentages of age distribution of women with Chla-
mydia trachomatis seeking termination of pregnancy in 1993.
Discussion
The aim of this study was to re-evaluate the
prevalence of C. trachomatis infection among
women seeking induced abortion and attempt
to assess whether the prevalence of C. tracho-
matis is receding after 10 years of screening and
active treatment where tracing of the consorts
of positive women was also done.
There was a significant reduction of the in-
cidence of positive Chlamydia tests among
these women. In the previous period 1982-84,
however Chlamydia tissue culture was used
and the enzyme linked assay used in 1993 is
significantly less sensitive. Even if this decline
in sensitivity of the test method is taken into
account a true reduction in prevalence is likely
to have taken place. Routine culture has also
been shown to have sensitivity well below
100%. In 1994 a sensitive PCR based method
was introduced and the results of testing for
Chlamydia in this group of women are current-
ly being evaluated.
About the same proportion of women had
samples taken as in the previous study (92.3%
in 1993 compared to 93.2% in 1982-84). Age
distribution and marital status in this study was
similar to the previous study and also the distri-
bution of positive and negative Chlamydia
tests in the older and younger age group. This
is similar to the results of other studies (2-3).
C. trachomatis most commonly infects younger
women, even though it can be found in the
older age groups. In this study the oldest wom-
an infected with C. trachomatis was 41 years