Chlamydia control in Europe: literature review
This report brings together published evidence about the prevalence and reproductive tract complications of chlamydia infection, and about the effectiveness and cost-effectiveness of chlamydia screening interventions.
The review concludes that chlamydia prevalence estimates from surveys in EU/EEA Member States are very heterogeneous and vary by country, sex, age group, national coverage and inclusion of all or only sexually experienced participants. In sexually experienced women aged 15–24 years and representative of the general population, chlamydia prevalence estimates range from 3.0% (18–24 year olds in UK) to 4.7% (18–24 year olds in Slovenia). Similarly, prevalence estimates in men aged 15–24 years ranged from 0.4% (16–17 year olds in Germany) to 4.7% (18–24 year olds in Slovenia).
These variations could be explained with differences in sexual behaviours, practices and mixing, health care seeking behaviours and self-medication, as well as access to health care, testing and chlamydia control activities. Additionally, the diversity of surveys and studies’ designs make it difficult to carry out direct comparisons or to aggregate their results.
Reproductive tract complications of chlamydia infection
The ECDC review estimates the probability of pelvic inflammatory disease in women with untreated chlamydia infection after 12 month to be 9%, which is lower than estimates from studies conducted in clinic settings. Both symptomatic and asymptomatic chlamydia infection in women were found to be strongly associated with pelvic inflammatory disease.
The review suggests a low risk of developing ectopic pregnancy and tubal infertility, the reproductive sequelae in the final stages of chlamydial disease. This low probability of tubal factor infertility might explain the lack of association observed in the few studies that have examined long term reproductive tract outcomes in women with chlamydia or pelvic inflammatory disease.
Chlamydia screening: effectiveness and cost-effectiveness
The findings of this review suggest that there is a window of opportunity in which treatment for screen-detected chlamydia can interrupt tubal pathology. However, untreated or inadequately treated partners can limit the effectiveness of screening and favour re-infections or can leave other partners in a sexual network untreated.
Most studies concluded that at least one strategy for chlamydia screening is cost-effective. These conclusions were often based on studies of women in clinical settings or in high-risk groups, making them less applicable to current practice and in favour of screening.
Surveillance of COVID-19 in long-term care facilities in the EU/EEA
29 Nov 2021 - ECDC has worked with EU/EEA countries to develop a methodology for regular national reporting of existing national surveillance data on COVID-19 in LTCFs, aiming for maximum feasibility. This is to enable ECDC to communicate timely information on epidemiological trends of COVID-19 in LTCFs, in support of national and EU/EEA-level preparedness and response activities.
Assessment of electronic health records for infectious disease surveillance
19 Nov 2021 - This is the final report for the mapping study ‘Assessment of electronic health records (EHRs) for infectious disease surveillance, prevention and control’. The study was commissioned by ECDC and was delivered by RAND Europe. The objective of the project is to investigate the current status of EHR systems in the European Union and European Economic Area (EU/EEA) and the potential capacity for the use of these data for surveillance of infectious diseases within ECDC’s remit.
Digital technologies for the surveillance, prevention and control of infectious diseases - A scoping review of the research literature
16 Nov 2021 - The objective of this scoping review is to obtain an estimate of the size and nature of the scientific literature available on digital technologies with the potential to benefit or disrupt key public health functions, focusing on infectious disease surveillance, prevention and control.