Sexually Transmitted Disease Surveillance 1994
Division of STD Prevention September 1995 U.S. Department of Health and Human Services Public Health Service Centers for Disease Control and Prevention National Center for HIV, STD, and TB Prevention (proposed) Division of STD Prevention Atlanta, Georgia 30333 Copyright Information All material contained in this report is in the public domain and may be used and reprinted without special permission; citation to source, however, is appreciated. Suggested Citation Division of STD Prevention. Sexually Transmitted Disease Surveillance, 1994. U.S. Department of Health and Human Services, Public Health Service. Atlanta: Centers for Disease Control and Prevention, September 1995. Copies can be obtained from Information Technology and Services Office, National Center for HIV, STD, and TB Prevention (proposed), Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop E-06, Atlanta, Georgia 30333 or by telephone at (404) 639-1819. Both the 1993 and 1994 reports are now available electronically on CDC WONDER. For information about registering for CDC WONDER, please contact CDC's Information Resource Management Office at (404) 332-4569. Chlamydia Infections due to Chlamydia trachomatis are among the most prevalent of all sexually transmitted diseases. In women these infections often result in serious reproductive tract complications, such as pelvic inflammatory disease, infertility, and ectopic pregnancy. In addition, infected pregnant women can infect their babies during delivery. While surveillance of chlamydial infections is improving, it remains incomplete in many areas of the country. A combination of factors limit the documentation of the incidence and prevalence of genital chlamydial infection: variable compliance with public health laws and regulations that require health care providers and laboratories to report cases to local health authorities; large numbers of asymptomatic persons who can be identified only through screening; limited resources to support screening activities; and incompletely developed information management infrastructures for collecting, maintaining, and analyzing morbidity data. Thus, for most areas, the number of reported chlamydia cases reported to CDC by state health departments reflects the degree of local interest in chlamydia as a public health problem and initial attempts to resolve reporting limitations rather than true disease burden or trends. -- In 1994, 448,984 chlamydial infections were reported to CDC from 47 states (Table_3). This is the first year that reported cases of chlamydia exceeded reported cases of gonorrhea (418,068 gonorrhea cases in 1994, Table_1). -- From 1984 through 1994 reported rates of chlamydia increased dramatically, from 3.2 cases per 100,000 population to 188.4 (Figure_1). Trends continue to primarily reflect increased screening, recognition of asymptomatic infection (mainly in women), and improved reporting capacity rather than true trends in disease incidence. -- As in previous years, rates of chlamydia were highest in the West and the Midwest, where substantial resources have been committed for organized screening programs (e.g., in family planning clinics) (Figure_2 and Figure_3). In the areas where these screening programs are in place, chlamydia rates far exceed gonorrhea rates. -- Between 1993 and 1994 rates of chlamydia reported from large cities (>200,000 population) increased 17% from 280.7 cases per 100,000 population to 328.4 (Figure_4, Table_6). -- Reported rates of chlamydia for women (265.3 per 100,000 population) exceed those for men (46.2 per 100,000 population) (Figure_5, Table_4, Table_5, Table_7, and Table_8). This is mainly due to increased detection of asymptomatic infection in women through screening. The low rates in men suggest that many of the sex partners of women with chlamydia are not diagnosed or reported. In addition, men diagnosed as having non-gonococcal urethritis are treated but frequently not tested. A large proportion of these men are infected with chlamydia, but they are not detected by surveillance systems based on laboratory reporting of positive chlamydia tests. -- Additional information on chlamydia screening programs in women and chlamydia in adolescents and minority populations can be found in the Special Focus Profiles section. Figure_1. Chlamydia - Reported rates: United States, 1984-1994 Figure_2. Chlamydia - Rates by state: United States, 1994 Figure_3. Chlamydia - Rates by region: United States, 1984-1994 Figure_4. Chlamydia - Rates in U.S. cities of >200,000 population, 1984-1994 Figure_5. Chlamydia - Rates by gender: United States, 1984-1994
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