PROM and SGA babies were twice as common in the untreated group compared with the treated and uninfected groups. There was also a four-fold improvement in perinatal mortality in the treated compared to the untreated group. In all these positive studies, the main value of screening may have been due to other effects of erythromycin and not necessarily the eradication of chlamydia. Contact Tracing Contact tracing is an integral part of attempts at chlamydia control. However, given the efficiency of transmission, and despite difficulties in tracing partners, treatment of contacts may be more cost effective than screening.
Economic evaluations support chlamydial screening of asymptomatic persons under specific conditions.
Sensitivity analysis showed that the two most important factors in cost savings were the probability of developing PID and the cost of the test. These recommendations are currently being reviewed. Children recommended for screening by this committee included sexual contacts of people with proven or suspected urethritis or other STDs, sexual contacts of high-risk adults, pregnant adolescents, male and female prostitutes, street youth, users of illicit drugs, young women undergoing therapeutic abortion, those with a history of previous STDs, children and siblings of children who have been sexually abused, and neonates with one or both parents known to have urethritis, cervicitis, PID, epidydimitis or other STDs. Although there is sufficient evidence linking chlamydial infections to many complications, there is currently insufficient evidence in males and non-pregnant females to show that screening is effective in preventing these complications. A prospective, well designed randomized community trial of screening for chlamydial infections in two similar asymptomatic populations for development of complications is warranted.