The prevalence of <it>Chlamydia trachomatis</it> infection in Australia: a systematic review and meta-analysis

• Main Authors: Lewis Dyani, Newton Danielle C, Guy Rebecca J, Ali Hammad, Chen Marcus Y, Fairley Christopher K, Hocking Jane S
• Format: Article
• Language: English
• Published: BMC 2012-05-01
• Series: BMC Infectious Diseases
• Subjects: Chlamydia; Meta-analysis; Prevalence; Systematic review
• Online Access: http://www.biomedcentral.com/1471-2334/12/113

<p>Abstract</p> <p>Background</p> <p><it>Chlamydia trachomatis</it> is a common sexually transmitted infection in Australia. This report aims to measure the burden of chlamydia infection by systematically reviewing reports on prevalence in Australian populations.</p> <p>Methods</p> <p>Electronic databases and conference websites were searched from 1997–2011 using the terms ‘<it>Chlamydia trachomatis</it>’ OR ‘chlamydia’ AND ‘prevalence’ OR ‘epidemiology’ AND ‘Australia’. Reference lists were checked and researchers contacted for additional literature. Studies were categorised by setting and participants, and meta-analysis conducted to determine pooled prevalence estimates for each category.</p> <p>Results</p> <p>Seventy-six studies met the inclusion criteria for the review. There was a high level of heterogeneity between studies; however, there was a trend towards higher chlamydia prevalence in younger populations, Indigenous Australians, and those attending sexual health centres. In community or general practice settings, pooled prevalence for women <25 years in studies conducted post-2005 was 5.0% (95% CI: 3.1, 6.9; five studies), and for men <30 years over the entire review period was 3.9% (95% CI: 2.7, 5.1; six studies). For young Australians aged <25 years attending sexual health, family planning or youth clinics, estimated prevalence was 6.2% (95% CI: 5.1, 7.4; 10 studies) for women and 10.2% (95% CI: 9.5, 10.9; five studies) for men. Other key findings include pooled prevalence estimates of 22.1% (95% CI: 19.0, 25.3; three studies) for Indigenous women <25 years, 14.6% (95% CI: 11.5, 17.8; three studies) for Indigenous men <25 years, and 5.6% (95% CI: 4.8, 6.3; 11 studies) for rectal infection in men who have sex with men. Several studies failed to report basic demographic details such as sex and age, and were therefore excluded from the analysis.</p> <p>Conclusions</p> <p><it>Chlamydia trachomatis</it> infections are a significant health burden in Australia; however, accurate estimation of chlamydia prevalence in Australian sub-populations is limited by heterogeneity within surveyed populations, and variations in sampling methodologies and data reporting. There is a need for more large, population-based studies and prospective cohort studies to compliment mandatory notification data.</p>