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International Journal of Epidemiology Apr 2009Screening programmes are promoted to control transmission of and prevent female reproductive tract morbidity caused by genital chlamydia. The objective of this study was... (Review)
Review
BACKGROUND
Screening programmes are promoted to control transmission of and prevent female reproductive tract morbidity caused by genital chlamydia. The objective of this study was to examine the effectiveness of register-based and opportunistic chlamydia screening interventions.
METHODS
We searched seven electronic databases (Cinahl, Cochrane Controlled Trials Register, DARE, Embase, Medline, PsycINFO and SIGLE) without language restrictions from January 1990 to October 2007 and reference lists of retrieved articles to identify studies published before 1990. We included studies examining primary outcomes (pelvic inflammatory disease, ectopic pregnancy, infertility, adverse pregnancy outcomes, neonatal infection, chlamydia prevalence) and harms of chlamydia screening in men and non-pregnant and pregnant women. We extracted data in duplicate and synthesized the data narratively or used random effects meta-analysis, where appropriate.
RESULTS
We included six systematic reviews, five randomized trials, one non-randomized comparative study and one time trend study. Five reviews recommended screening of women at high risk of chlamydia. Two randomized trials found that register-based screening of women at high risk of chlamydia and of female and male high school students reduced the incidence of pelvic inflammatory disease in women at 1 year. Methodological inadequacies could have overestimated the observed benefits. One randomized trial showed that opportunistic screening in women undergoing surgical termination of pregnancy reduced post-abortal rates of pelvic inflammatory disease compared with no screening. We found no randomized trials showing a benefit of opportunistic screening in other populations, no trial examining the effects of more than one screening round and no trials examining the harms of chlamydia screening.
CONCLUSION
There is an absence of evidence supporting opportunistic chlamydia screening in the general population younger than 25 years, the most commonly recommended approach. Equipoise remains, so high-quality randomized trials of multiple rounds of screening with biological outcome measures are still needed to determine the balance of benefits and harms of chlamydia screening.
Topics: Adolescent; Chlamydia Infections; Chlamydia trachomatis; Female; Genital Diseases, Female; Humans; Male; Mass Screening; Pelvic Inflammatory Disease; Program Evaluation; Research Design; Young Adult
PubMed: 19060033
DOI: 10.1093/ije/dyn222 -
BMJ (Clinical Research Ed.) Mar 2001
Review
Topics: Anti-Bacterial Agents; Drug Administration Schedule; Evidence-Based Medicine; Female; Humans; Pelvic Inflammatory Disease
PubMed: 11250853
DOI: 10.1136/bmj.322.7287.658 -
BMC Public Health Oct 2023Pelvic inflammatory disease (PID) is a widespread female public problem worldwide. And it could lead to infertility, preterm labor, chronic pelvic pain, and ectopic...
BACKGROUND
Pelvic inflammatory disease (PID) is a widespread female public problem worldwide. And it could lead to infertility, preterm labor, chronic pelvic pain, and ectopic pregnancy (EP) among reproductive-aged women. This study aimed to assess the global burden and trends as well as the chaning correlation between PID and EP in reproductive-aged women from 1990 to 2019.
METHODS
The data of PID and EP among reproductive-aged women (15 to 49 years old) were extracted from the Global Burden of Disease study 2019. The disease burden was assessed by calculating the case numbers and age-standardized rates (ASR). The changing trends and correlation were evaluated by calculating the estimated annual percentage changes (EAPC) and Pearson's correlation coefficient.
RESULTS
In 2019, the ASR of PID prevalence was 53.19 per 100,000 population with a decreasing trend from 1990 (EAPC: - 0.50), while the ASR of EP incidence was 342.44 per 100,000 population with a decreasing trend from 1990 (EAPC: - 1.15). Globally, PID and EP burdens changed with a strong positive correlation (Cor = 0.89) globally from 1990 to 2019. In 2019, Western Sub-Saharan Africa, Australasia, and Central Sub-Saharan Africa had the highest ASR of PID prevalence, and Oceania, Eastern Europe, and Southern Latin America had the highest ASR of EP incidence. Only Western Europe saw significant increasing PID trends, while Eastern Europe and Western Europe saw increasing EP trends. The highest correlations between PID and EP burden were observed in Burkina Faso, Laos, and Bhutan. General negative correlations between the socio-demographic index and the ASR of PID prevalence and the ASR of EP incidence were observed at the national levels.
CONCLUSION
PID and EP continue to be public health burdens with a strong correlation despite slightly decreasing trends detected in ASRs globally. Effective interventions and strategies should be established according to the local situation by policymakers.
Topics: Pregnancy; Infant, Newborn; Female; Humans; Adult; Adolescent; Young Adult; Middle Aged; Pelvic Inflammatory Disease; Pregnancy, Ectopic; Reproduction; Incidence; Australasia; Global Burden of Disease; Global Health
PubMed: 37784046
DOI: 10.1186/s12889-023-16663-y -
Acta Obstetricia Et Gynecologica... 2009For most women, intrauterine contraceptive devices (IUCD) are a safe option. Upper genital tract infections (pelvic inflammatory disease, PID) occur when pathogenic... (Review)
Review
For most women, intrauterine contraceptive devices (IUCD) are a safe option. Upper genital tract infections (pelvic inflammatory disease, PID) occur when pathogenic microorganisms ascend from the cervix and invade the endometrium and the fallopian tubes, causing an inflammatory reaction. Evidence-based recommendations regarding intrauterine contraception and risk of infection were presented at the Congress of the European Society of Contraception, in Prague, 2008: A clinical history (including sexual history) should be taken as part of the routine assessment for intrauterine contraception to identify women at high risk of sexually transmitted infections (STI); if appropriate a test should be offered; if symptoms or signs are present, appropriate diagnostic tests should be done, results awaited, necessary treatment completed, and IUCD insertion postponed until resolution. Prophylactic antibiotics are not recommended (evidence level II-3). STI screening is not routinely recommended. PID among IUCD users is most strongly related to the insertion process and to the background risk of STI (evidence level II-2). Conditions which represent an unacceptable health risk if an IUCD is inserted (WHO Medical Eligibility Criteria, MEC, Categories 3-4) are current PID, current purulent cervicitis, chlamydial or gonorrheal infection. For continuation as well as initiation, WHO MEC categories 3-4 are allotted to women with known pelvic tuberculosis, puerperal sepsis and septic abortion.
Topics: Antibiotic Prophylaxis; Female; HIV Infections; Humans; Intrauterine Devices; Pelvic Infection; Pelvic Inflammatory Disease; Risk Factors; Sexually Transmitted Diseases
PubMed: 19172421
DOI: 10.1080/00016340802707473 -
Women's Health (London, England) Jul 2008Pelvic inflammatory disease (PID), the infection and inflammation of the female upper genital tract, is a common cause of infertility, chronic pain and ectopic... (Review)
Review
Pelvic inflammatory disease (PID), the infection and inflammation of the female upper genital tract, is a common cause of infertility, chronic pain and ectopic pregnancy. Diagnosis and management are challenging, largely resulting from varying signs and symptoms and a polymicrobial etiology that is not fully delineated. Owing to the potential for serious sequelae, a low threshold for diagnosis and treatment is recommended. As PID has a multimicrobial etiology, including Neisseria gonorrhoeae, Chlamydial trachomatis and anaerobic and mycoplasmal bacteria, treatment of PID should consist of a broad spectrum antibiotic regimen. Recent treatment trials have focused on shorter duration regimens, such as azithromycin, and monotherapies including ofloxacin, but data are sparse. Research comparing sequelae development by differing antimicrobial regimens is extremely limited, but will ultimately shape future treatment guidelines.
Topics: Adult; Anti-Bacterial Agents; Azithromycin; Chlamydia trachomatis; Female; Humans; Infertility, Female; Neisseria gonorrhoeae; Ofloxacin; Pelvic Inflammatory Disease; Pregnancy; Pregnancy, Ectopic; Risk Factors; Sexually Transmitted Diseases; Ureaplasma; Women's Health
PubMed: 19072503
DOI: 10.2217/17455057.4.4.383 -
The Journal of Infectious Diseases Jul 2017Health consequences of sexually transmitted diseases disproportionately affect women, making it important to determine whether newly emerged pathogens cause sequelae.... (Review)
Review
Health consequences of sexually transmitted diseases disproportionately affect women, making it important to determine whether newly emerged pathogens cause sequelae. Although the pathogenic role of Mycoplasma genitalium in male urethritis is clear, fewer studies have been conducted among women to determine its pathogenic role in the female reproductive tract. Pelvic inflammatory disease (PID) is an important cause of infertility and ectopic pregnancy, and Chlamydia trachomatis and Neisseria gonorrhoeae are recognized microbial causes. Emerging data demonstrate an association between M. genitalium and PID, and limited data suggest associations with infertility and preterm birth, yet the attributable risk for female genital tract infections remains to be defined. Further investigations are needed to better define the impact of M. genitalium on women's reproductive health. Importantly, prospective studies evaluating whether screening programs and targeted treatment of M. genitalium improve reproductive outcomes in women are necessary to guide public health policy for this emerging pathogen.
Topics: Female; Humans; Infertility, Female; Male; Mycoplasma Infections; Mycoplasma genitalium; Pelvic Inflammatory Disease; Pregnancy; Pregnancy, Ectopic; Premature Birth; Risk Factors; Uterine Cervicitis
PubMed: 28838078
DOI: 10.1093/infdis/jix198 -
American Family Physician Mar 2006Pelvic inflammatory disease (PID) is an infection of the upper genital tract in women that can include endometritis, parametritis, salpingitis, oophoritis, tubo-ovarian... (Review)
Review
Pelvic inflammatory disease (PID) is an infection of the upper genital tract in women that can include endometritis, parametritis, salpingitis, oophoritis, tubo-ovarian abscess, and peritonitis. The spectrum of disease ranges from subclinical, asymptomatic infection to severe, life-threatening illness; sequelae include chronic pelvic pain, ectopic pregnancy, and infertility. PID is diagnosed clinically, with laboratory and imaging studies reserved for patients who have an uncertain diagnosis, are severely ill, or do not respond to initial therapy. The Centers for Disease Control and Prevention diagnostic criteria include uterine, adnexal, or cervical motion tenderness with no other obvious cause in women at risk of PID. Empiric treatment should be initiated promptly and must cover Chlamydia trachomatis and Neisseria gonorrhoeae; the possibility of fluoroquinolone-resistant N. gonorrhoeae also should be considered. Hospitalization for initial parenteral therapy is necessary for patients with tubo-ovarian abscess and for those who are pregnant, severely ill, unable to follow a prescribed treatment plan, or unable to tolerate oral antibiotics. Patients also should be hospitalized if a surgical emergency cannot be excluded or if no clinical improvement occurs after three days. Routine screening for asymptomatic chlamydial infection can help prevent PID and its sequelae.
Topics: Anti-Bacterial Agents; Centers for Disease Control and Prevention, U.S.; Female; Guidelines as Topic; Humans; Pelvic Inflammatory Disease; United States
PubMed: 16529095
DOI: No ID Found -
Contraception Dec 2016Use of highly effective contraception among women living with HIV is critical to prevent unintended pregnancy and subsequent risk of maternal complications and perinatal... (Review)
Review
BACKGROUND
Use of highly effective contraception among women living with HIV is critical to prevent unintended pregnancy and subsequent risk of maternal complications and perinatal HIV transmission. However, it is not known whether use of intrauterine devices (IUDs) among women with advanced HIV disease poses an increased risk of pelvic infection or HIV progression and transmission.
OBJECTIVES
To identify evidence regarding the risk of pelvic infection, HIV disease progression or HIV transmission among women with HIV using IUDs and whether this risk differs by severity of HIV disease.
METHODS
We searched the PubMed database for all articles published from database inception through January 2016. For the outcome of pelvic infection, we included studies that examined women using IUDs and reported risk of pelvic inflammatory disease (PID) or pelvic infections among women with varying levels of HIV severity or among women with HIV compared with women without HIV. For the outcomes of HIV disease progression and HIV transmission to noninfected male partners, we included studies of women with HIV using IUDs compared with other contraceptive methods or no method.
RESULTS
The review identified eight articles from six study populations which addressed pelvic infections or other IUD-related complications and found mixed results. One study that directly compared women with varying levels of HIV disease severity found no differences in complication rates between those with severe or mild disease after short- and longer-term follow-up. The remaining studies generally found low or no incidence of PID among IUD users. Among eight articles from seven study populations that reported on HIV disease progression, there were generally no differences between women using IUDs compared with other contraceptives, nor were there changes between baseline and follow-up. One article that reported directly on HIV disease transmission to noninfected male partners found no difference in HIV disease transmission, and five articles found no differences in genital viral shedding among women using IUDs. No direct evidence addresses potential differences in HIV disease progression or transmission by HIV disease severity.
CONCLUSION
Limited evidence of fair to poor quality found no differences in infectious complications when comparing IUD complication rates among women with varying levels of HIV disease severity. One study found that IUD use was not associated with HIV transmission, and studies generally found no differences in genital viral shedding or disease progression; however, there was little direct evidence to address potential differences related to HIV severity.
Topics: Contraception; Equipment Safety; Female; HIV Infections; Humans; Intrauterine Devices; Pelvic Inflammatory Disease; Randomized Controlled Trials as Topic; Risk Assessment; Severity of Illness Index
PubMed: 27343750
DOI: 10.1016/j.contraception.2016.06.011 -
Infectious Diseases in Obstetrics and... 2011Pelvic inflammatory disease (PID) is a global health concern that is associated with significant morbidity and is a major cause of infertility. Throughout history... (Review)
Review
Pelvic inflammatory disease (PID) is a global health concern that is associated with significant morbidity and is a major cause of infertility. Throughout history animals have been used for anatomical studies and later as models of human disease. In particular, nonhuman primates (NHPs) have permitted investigations of human disease in a biologically, physiologically, and anatomically similar system. The use of NHPs as human PID models has led to a greater understanding of the primary microorganisms that cause disease (e.g., Chlamydia trachomatis and Neisseria gonorroheae), the pathogenesis of infection and its complications, and the treatment of people with PID. This paper explores historical and contemporary aspects of NHP modeling of chlamydial PID, with an emphasis on advantages and limitations of this approach and future directions for this research.
Topics: Animals; Callithrix; Cercopithecinae; Chlamydia Infections; Chlamydia trachomatis; Disease Models, Animal; Female; Pelvic Inflammatory Disease
PubMed: 21869858
DOI: 10.1155/2011/675360 -
Cirugia Espanola Sep 2008
Topics: Adult; Female; Humans; Pelvic Inflammatory Disease; Splenosis
PubMed: 18783677
DOI: 10.1016/s0009-739x(08)72160-2