Chlamydia Reports to CDC Hit All Time High

I have not been paying too much attention to chlamydia infections lately so an article from the CDC in MedPage Today, a CE and CME accredited medical news service, about the incidence of the disease in 2007 caught me by surprise. Below is an excerpt from it with boldface emphasis mine (see: Chlamydia Reports Hit All-Time High):

More than 1.1 million cases of chlamydia were reported in 2007 -- the largest number ever for any reportable condition, the CDC said. The number is equivalent to a rate of 370.2 cases per 100,000 population, an increase of 7.5% compared with 2006, the agency said in its annual report on sexually transmitted diseases (STDs)....The increase in chlamydia is probably the result of increased screening, more sensitive tests, and more complete national reporting, the agency said,...[A spokesperson for the CDC added] that racial and sexual disparities in STD incidence are especially worrisome. For instance, the CDC found, the rate of chlamydia was 543.6 cases per 100,000 women, almost three times the 190 cases per 100,000 men. The gonorrhea rate was also higher among women at 123.5 per 100,000 women, compared with 113.7 per 100,000 among men. And -- although they represent only 12% of the U.S. population -- blacks had about 70% percent of reported gonorrhea cases and almost half of all chlamydia and syphilis cases (48% and 46%, respectively). For young black women, the situation is especially dire: Those between the ages of 15 and 19 had a chlamydia rate of 9,646.7 per 100,000 population and a gonorrhea rate of 2,955.7 per 100,000....But the consequences for women of both chlamydia and gonorrhea can be serious, the agency said. Up to 40% of untreated chlamydia and gonorrhea infections can result in pelvic inflammatory disease, which causes as many as 50,000 women to become infertile every year.

Here's some details about lab testing for chlamydia from Lab Tests Online:

The preferred method of testing currently is the molecular test also known as nucleic acid amplification tests (NAAT). This test is based on amplification of the DNA that is present in Chlamydia trachomatis. Molecular testing for Chlamydia trachomatis is currently the standard and is widely utilized..... Until the legal system changes, only a positive culture result proving infection with chlamydia is admissible in court. All positive molecular tests for Chlamydia trachomatis should be verified by the same or another methodology for confirmation. Molecular tests need to be validated for different sources of specimens. They have not been FDA approved for performance with ocular, pharyngeal, or rectal sites.

The Chlamydia Rapid Test, an immunoassay and rapid alternative to the nucleic acid amplification tests (PCR), has good sensitivity and specificity and can yield a result in 30 minutes  (see: New Rapid Chlamydia Test). In-clinic identification of chlamydia infection decreases the risk for transmission by allowing immediate treatment and potentially bettering partner notification and tracing. However, the Rapid Test's positive predictive value of 86% means that some cases will be missed....Positive predictive value is defined as the probability that a person with a positive test result has, or will develop, a disease or condition. The test's overall advantages, combined with its ease of performance, could improve chlamydia screening in many settings — especially when PCR is unavailable.

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