Abstract

FERNANDES, Sofia Lages Trindade. Screening for genital infection by Chlamydia trachomatis and reduction of pelvic inflammatory disease: an evidence-based review. Rev Port Med Geral Fam [online]. 2018, vol.34, n.6, pp.384-397. ISSN 2182-5173.  https://doi.org/10.32385/rpmgf.v34i6.12249.

Introduction: Chlamydia trachomatis infection is the most commonly reported sexually transmitted infection in Europe and is associated with pelvic inflammatory disease (PID) and its complications: infertility, ectopic pregnancy and chronic pelvic pain. Aim: To evaluate the effectiveness of screening for Chlamydia trachomatis infection in sexually active, asymptomatic individuals, in reducing the occurrence of PID. Data sources: Medline, Cochrane Library, NGC, NICE, DARE, CMA Infobase, TRIP Data-base, USPSTF, DGS. Methods of review: Systematic review according to the PRISMA guideline, of standards, guidelines, meta-analyses, systematic reviews (SR) and controlled randomized trials (CRT) published in English and Portuguese between January 2000 to September 2016, using the key-words Chlamydia trachomatis and mass screening. The SORT scale was used to evaluate the levels of evidence (LE) and strength of recommendation. Results: Thirteen out of 550 articles were selected: two meta-analyses, two SR and nine guidelines. All guidelines recommend screening (SORT B or C) but the target population varies according to the risk factors included, the main ones being gender and age. The two meta-analyses corroborate the efficacy of this screening in the reduction of PID, with evidence of moderate quality (LE 2). Both meta-analyses are based on four CRT: two showed a reduction in the incidence of PID one year after single screening and the other two, with better methodological quality, did not reveal a statistically significant difference. In both SR the authors emphasize the need for more evidence to support screening (NE 2). Conclusions: There is evidence of moderate quality, but inconsistent and difficult to generalise, on the effectiveness of screening for Chlamydia trachomatis in reducing the incidence of PID.

Keywords : Chlamydia trachomatis; Mass screening.

        · abstract in Portuguese     · text in Portuguese     · Portuguese ( pdf )