Screening

Systematic reviews that have examined the effectiveness of register-based and opportunistic chlamydia screening interventions found limited supporting evidence and identified a need for higher-quality studies.[34][35][36][37] In addition, one randomised controlled trial that recruited more than 2500 women between the ages of 16 and 27 years did not provide a clear answer as to whether screening for Chlamydia trachomatis is effective in reducing the incidence of PID.[38]

However, a re-appraisal of evidence from randomised controlled trials of screening and controlled observational studies suggested that annual screening could prevent 61% of C trachomatis-related PID in women who became infected with C trachomatis.[39]

The US Preventive Services Task Force (USPSTF) recommends that all sexually active women who are 24 years and younger, including those who are pregnant, should be screened for gonorrhoea and chlamydia. Women who are 25 years or older should be screened if they have an increased risk for infection. This includes women from a high-morbidity community (as defined by an increased prevalence) or those with individual risk factors (such as multiple recent sex partners, a history of an STI, a partner with an STI), and those connected to networks with incarcerated people, to the commercial sex trade, or to drug use.

There is minimal evidence on the effectiveness of screening for gonorrhoea or chlamydia in low-risk women.[21]

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