Longitudinal association of gonorrhea and bacterial vaginosis with repeat chlamydia diagnoses among U.S. Army women: A retrospective cohort analysis

作     者：Christian TBautista Eyako KWurapa Warren BSateren Bruce PHollingsworth Jose LSanchez 

作者机构：Division of Health ResearchLancaster UniversityLancasterUK Walter Reed Army Institute of ResearchSilver SpringMDUSA Senior Research ConsultantWashingtonDCUSA Armed ForcesHealth Surveillance BranchPublic Health DivisionDefense HealthAgencySilver SpringMDUSA. 

出 版 物：《Military Medical Research》 (军事医学研究（英文版）)

年 卷 期：2019年第6卷第2期

页      面：128-134页

核心收录：

学科分类：1002[医学-临床医学] 1009[医学-特种医学] 10[医学] 

基　　金：funded by the AFHSB and its Global Emerging Infectious Surveillance section 

主　　题：Gonorrhea Bacterial vaginosis Chlamydia Sexually transmitted infection Military 

摘      要：Background: Historically, sexually transmitted infections have affected the health of the U.S. military. To determine whether gonorrhea, bacterial vaginosis, genital herpes, and trichomoniasis are predictors of repeat chlamydia diagnoses among U.S. Army women, medical data reported into the Defense Medical Surveillance System during the 2006–2012 period were ***: For all inpatient and outpatient medical records, the first and second International Classification of Diseases,version 9(ICD-9) diagnostic positions were reviewed for each chlamydia case to determine the occurrence of repeat diagnoses. The Andersen-Gill regression model, an extension of the Cox model for multiple failure-time data, was used to study associations between predictors and repeat chlamydia ***: Among 28,201 women with a first chlamydia diagnosis, 5145(18.2%), 1163(4.1%), 267(0.9%), and 88(0.3%)had one, two, three, and four or more repeat diagnoses, respectively. Overall, the incidence of repeat chlamydia was8.31 cases per 100 person-years, with a median follow-up time of 3.39 years. Gonorrhea(hazard ratio(HR)=1.58, 95%CI: 1.44–1.73) and bacterial vaginosis(HR=1.40, 95% CI: 1.09–1.79) were significant predictors for repeat *** estimated hazard ratios were attenuated, but remained significant, after controlling for age, race/ethnicity,marital status, and military rank. No significant association was found for genital herpes(HR=1.13, 95% CI: 0.55–2.29)and trichomoniasis(HR=1.43, 95% CI: 0.43–4.68).Conclusions: This large cohort study suggests that gonorrhea and bacterial vaginosis were associated with repeat chlamydia diagnoses among U.S. Army women. These findings can be used in formulating new interventions to prevent repeat chlamydia diagnoses.