Chlamydia trachomatis infection in males in a juvenile detention facility in Switzerland
QUESTIONS UNDER STUDY: Young offenders represent a group for which Chlamydia trachomatis infection screening is recommended in the US. In the absence of local epidemiological data it is difficult to assess whether such recommendations apply to the Swiss context. Our aim was to obtain local prevalence data for Chlamydia trachomatisinfection among young male offenders as a basis for screening strategies in Swiss juvenile detention centres.
METHODS: This cross-sectional study was conducted in a juvenile detention facility in Geneva, Switzerland. Adolescent males aged 15–18 years admitted to the detention facility were invited to participate during a consultation with a nurse conducted within 48 hours of admission. Participants were asked to provide a first void urine sample for PCR detection of Chlamydia trachomatis infection and to complete a questionnaire on reproductive health behaviours.
RESULTS: 72 males were considered for participation in the study. 13 were excluded (mainly due to the language barrier or a shorter than 3 days’ stay in the facility) and 9 (15%) declined participation. Not being sexually active was the most common reason for declining participation. Most participants originated from Switzerland or the European Union and 68% reported having ≥2 sexual partners in the past year. Only one participant (18 years, asymptomatic) had Chlamydia trachomatis infection (2%; 95%CI: 0–6%).
CONCLUSIONS: This study does not support screening for Chlamydia trachomatis among young offenders admitted to detention centres in Switzerland. Studies in other European detention centres should document the extent to which our findings are generalisable to the European context.
- World Health Organization. Global prevalence and incidence of selected curable sexually transmitted infections. Overview and estimates Geneva: WHO2001.
- Scholes D, Stergachis A, Heidrich FE, Andrilla H, Holmes KK, Stamm WE. Prevention of pelvic inflammatory disease by screening for cervical chlamydial infection. N Engl J Med. 1996;334(21):1362–6.
- Gonzales GF, Munoz G, Sanchez R, Henkel R, Gallegos-Avila G, Diaz-Gutierrez O, et al. Update on the impact of Chlamydia trachomatis infection on male fertility. Andrologia. 2004;36(1):1–23.
- Burstein GR, Gaydos CA, Diener-West M, Howell MR, Zenilman JM, Quinn TC. Incident Chlamydia trachomatisinfections among inner-city adolescent females. JAMA. 1998;280(6):521–6.
- Kahn RH, Mosure DJ, Blank S, Kent CK, Chow JM, Boudov MR, et al. Chlamydia trachomatis and Neisseria gonorrhoeaeprevalence and coinfection in adolescents entering selected US juvenile detention centers, 1997-2002. Sex Transm Dis. 2005;32(4):255–9.
- Aalsma MC, Wiehe SE, Blythe MJ, Tong Y, Harezlak J, Rosenman MB. Mental health screening and STI among detained youth. J Community Health. 2011;36(2):300–6.
- Joesoef MR, Kahn RH, Weinstock HS. Sexually transmitted diseases in incarcerated adolescents. Curr Opin Infect Dis. 2006;19(1):44–8.
- Mrus JM, Biro FM, Huang B, Tsevat J. Evaluating adolescents in juvenile detention facilities for urogenital chlamydial infection: costs and effectiveness of alternative interventions. Arch Pediatr Adolesc Med. 2003;157(7):696–702.
- NSW Young People in Custody Health Survey. Key Findings Report. New South Wales: Department of Juvenile Justice 2003.
- Menon-Johansson AS, Winston A, Matthews G, Portsmouth S, Daniels D. The first point prevalence study of genital Chlamydia trachomatis infection in young male inmates in the UK. Int J STD AIDS. 2005;16(12):799–801.
- Poulin C, Alary M, Ringuet J, Frappier JY, Roy E, Lefebvre J. Prevalence of chlamydial infection and frequency of risk behaviours for STDs and HIV infection among adolescents in public juvenile facilities in the province of Quebec. Can J Public Health. 1997;88(4):266–70.
- Steiner A, Haller D, Elger B, Sebo P, Gaspoz JM, Wolff H. Chlamydia trachomatis infection in a Swiss prison: a cross sectional study. Swiss Medical Weekly. in press.
- Baud D, Jaton K, Bertelli C, Kulling JP, Greub G. Low prevalence of Chlamydia trachomatis infection in asymptomatic young Swiss men. BMC Infect Dis. 2008;8:45.
- Bland M. An introduction to medical statistics. In: oxford medical p, editor. Oxford: Oxford University Press; 2000. p. 343–4.
- Narring F, Tschumper A, Inderwildi Bonivento L, Jeannin A, Addor V, Butikofer A, et al. SMASH 2002: Santé et styles de vie des adolescents agés de 16 à 20 ans en Suisse (2002). Lausanne: IUMSP; 2003.