Læknablaðið - 15.07.1995, Blaðsíða 43

LÆKNABLAÐIÐ 1995; 81
555
Of the 160 students only 96 called about the
results (60%). This is similar to the pilot study
late 1994.
Discussion
A higher prevalence was expected in this
group of young people in the main study in
view of the fact that in the pilot part conducted
a year before, the prevalence for the male
students measured 4.5%, and the prevalence
among boys of the same age in the same school
was 3/60 or 5%. If this study and the pilot study
are combined the prevalence is 8/271 (3%) for
all three colleges. The most plausible explana-
tion for this relatively low figure is coincidence
because of the low number of individuals.
In a study done in Sweden of 751 adolescent
female high school students with sexual debut,
the prevalence of C trachomatis infection mea-
sured 2.1%. They screened first catch urine
with an enzyme immunoassey (IDEIA III) and
verified with fluorescein isothiocyanate-conju-
gated (FITC) ntonoclonal antibodies (7). This
figure is similar to the one in the study present-
ed here, but the methods differ and our meth-
od is more sensitive.
It is not certain that prevalence figures for
these college students are representative for
this age group in the whole country but there is
no indication that the sexual behaviour of col-
lege students is different from other young
people. It is therefore possible that the true
prevalence of Chlamydia infection in young
asymptomatic people in Iceland age 18-20 is
somewhere between 2 and 3%.
The cost of Chlamydia infection in Iceland is
not known. The morbidity in women is mainly
front salpingitis, infertility and as extra uterine
gravidity. In the USA the cost of Chlamydia
infection was estimated to be over 1.4 billion
dollars per year in 1987 (8). The equivalent
figure for Iceland would be about 90 million
Icelandic crowns per year.
For screening to be cost effective the preva-
lence must reach a certain figure. This figure is
a function of the cost of the morbidity caused
by the disease, the cost of screening and the
prevalence of the disease. It has been calculat-
ed that for Chlamydia screening to be cost
effective the prevalence must lie between 5
and 6% (9).
The use of urine samples for detecting Chla-
mydia has made it possible to screen popula-
60
Fig 1. Number of partners during the six months prior to the
study.
tions and thus saving much money through
reducing long term morbidity. Because of the
well-structured health care system in Iceland
and the small population it is tempting to as-
sume that it would be possible to eradicate
Chlamydia the same way as gonorrhoea.
To conclude: The prevalence of asympto-
matic Chlamydia infection in college students
in this school was low, probably too low for
screening to be cost effective. The procedure
was not satisfactory as a screening method be-
cause of the low percentage that enquired
about their tests.
REFERENCES
1. Steingrímsson Ó, Ólafsson JH, Kristinsson KG, Geirsson
RT, Thorsteinsson V, Ryan RV. Results of diagnostic
testing for infections caused by Chlamydia trachomatis in
Iceland 1982-1994. Læknablaðið 1995; 81: 545-9.
2. Mdller BR, Þorsteinsson SB, Þórarinsson H, Kolbeins-
son A. Chlamydia trachomatis. Einkenni chlamydiasýk-
inga hjá mönnum. Læknablaðið 1982; 68: 203-7.
3. Steingrímson Ó, Þórarinsson H, Sigfúsdóttir A, Kol-
beinsson A. Könnun á tíðni sýkinga af völdum C. tracho-
matis á íslandi í samanburði við tíðni lekanda. Lækna-
blaðið 1983; 69: 289-93.
4. Óskarsson T, Geirsson RT, Steingrímsson Ó, Thórarins-
son H. Lower genital tract infection with Neisseria gonor-