{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T15:41:32Z","timestamp":1791214892595,"version":"4.1.0"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"Supplement_2","license":[{"start":{"date-parts":[[2021,8,15]],"date-time":"2021-08-15T00:00:00Z","timestamp":1628985600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,8,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pelvic inflammatory disease (PID) is an outcome measure for the evaluation of chlamydia screening programs. We explore PID diagnoses in specialist sexual health services (SSHSs) in England to inform the evaluation of the National Chlamydia Screening Programme, which was implemented nationally in 2008.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted descriptive analyses using data on diagnoses of PID\u2014with and without Chlamydia trachomatis (CT) and\/or Neisseria gonorrhoeae (GC)\u2014by age and year of birth, in SSHSs between 2009 and 2019 from the GUMCAD STI Surveillance System database. Rates were calculated per 100 000 females residing in England.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>CT screening activity peaked in 2010. The rates of all PID diagnoses decreased between 2009 and 2019 by 39%. CT-associated PID (CT-PID) declined by 58%, and nonspecific PID declined by 37%. GC-PID increased by 34%. CT-PID decreased across all age groups with the highest observed decline, 71%, in 15- to 19-year-olds. A dose-response relationship was observed between CT-PID rates and screening, with rates lowest in those with the greatest exposure to screening.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There was a marked decline in diagnoses of CT-PID, and nonspecific PID, at SSHSs after the introduction of widespread chlamydia screening, whereas GC-PID diagnoses increased. This ecological trend was broadly consistent with what we would have expected to see if widespread screening reduced the incidence of chlamydia-associated PID (and of nonspecific PID), as has been observed in randomized controlled trials of screening.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/infdis\/jiab175","type":"journal-article","created":{"date-parts":[[2021,3,31]],"date-time":"2021-03-31T15:09:45Z","timestamp":1617203385000},"page":"S113-S120","source":"Crossref","is-referenced-by-count":18,"title":["What Do Diagnoses of Pelvic Inflammatory Disease in Specialist Sexual Health Services in England Tell Us About Chlamydia Control?"],"prefix":"10.1093","volume":"224","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3544-8003","authenticated-orcid":false,"given":"Grahame S","family":"Davis","sequence":"first","affiliation":[{"name":"Blood Safety, Hepatitis, Sexually Transmitted Infections and HIV Service, Public Health England, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick J","family":"Horner","sequence":"additional","affiliation":[{"name":"Population Health Sciences, University of Bristol, Bristol, United Kingdom"},{"name":"National Institute for Health Research, Health Protection Research Unit in Behavioural Science and Evaluation at University of Bristol, Bristol, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malcolm J","family":"Price","sequence":"additional","affiliation":[{"name":"Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom"},{"name":"National Institute for Health Research, Birmingham Biomedical Research Centre, University Hospitals Birmingham National Health Service Foundation Trust and University of Birmingham, Birmingham, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holly D","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Blood Safety, Hepatitis, Sexually Transmitted Infections and HIV Service, Public Health England, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Soldan","sequence":"additional","affiliation":[{"name":"Blood Safety, Hepatitis, Sexually Transmitted Infections and HIV Service, Public Health England, London, United Kingdom"},{"name":"National Institute for Health Research, Health Protection Research Unit in Behavioural Science and Evaluation at University of Bristol, Bristol, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,8,16]]},"reference":[{"key":"2021081606003922800_CIT0001","doi-asserted-by":"crossref","first-page":"2039","DOI":"10.1056\/NEJMra1411426","article-title":"Pelvic inflammatory disease","volume":"372","author":"Brunham","year":"2015","journal-title":"N Engl J Med"},{"key":"2021081606003922800_CIT0002","author":"British Association for Sexual Health and HIV","year":"2018"},{"key":"2021081606003922800_CIT0003","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1093\/infdis\/jiw178","article-title":"Proportion of pelvic inflammatory disease cases caused by Chlamydia trachomatis: consistent picture from different methods","volume":"214","author":"Price","year":"2016","journal-title":"J Infect Dis"},{"key":"2021081606003922800_CIT0004","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1097\/QCO.0b013e3282f3d9ac","article-title":"Evidence for a role of Mycoplasma genitalium in pelvic inflammatory disease","volume":"21","author":"Haggerty","year":"2008","journal-title":"Curr Opin Infect Dis"},{"key":"2021081606003922800_CIT0005","doi-asserted-by":"crossref","first-page":"2719","DOI":"10.1093\/cid\/ciaa419","article-title":"Incidence of pelvic inflammatory disease associated with Mycoplasma genitalium infection: evidence synthesis of cohort study data","volume":"71","author":"Lewis","year":"2020","journal-title":"Clin Infect Dis"},{"key":"2021081606003922800_CIT0006","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3310\/hta20220","article-title":"The natural history of Chlamydia trachomatis infection in women: a multi-parameter evidence synthesis","volume":"20","author":"Price","year":"2016","journal-title":"Health Technol Assess"},{"key":"2021081606003922800_CIT0007","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1136\/sextrans-2011-050205","article-title":"Chlamydia infection, pelvic inflammatory disease, ectopic pregnancy and infertility: cross-national study","volume":"87","author":"Bender","year":"2011","journal-title":"Sex Transm Infect"},{"key":"2021081606003922800_CIT0008","doi-asserted-by":"crossref","first-page":"20981","DOI":"10.2807\/1560-7917.ES2014.19.48.20981","article-title":"Improving surveillance of sexually transmitted infections using mandatory electronic clinical reporting: the genitourinary medicine clinic activity dataset, England, 2009 to 2013","volume":"19","author":"Savage","year":"2014","journal-title":"Euro Surveill"},{"key":"2021081606003922800_CIT0009","author":"Public Health England. GUMCAD: clinical guidelines","year":"2019"},{"key":"2021081606003922800_CIT0010","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1136\/sextrans-2012-050495","article-title":"Repeat infection with gonorrhoea in Sheffield, UK: predictable and preventable?","volume":"89","author":"Hughes","year":"2013","journal-title":"Sex Transm Infect"},{"key":"2021081606003922800_CIT0011","author":"Office for National Statistics","year":"2019"},{"key":"2021081606003922800_CIT0012","author":"British Association for Sexual Health and HIV","year":"2005"},{"key":"2021081606003922800_CIT0013","author":"British Association for Sexual Health and HIV","year":"2011"},{"key":"2021081606003922800_CIT0014","doi-asserted-by":"crossref","first-page":"j5395","DOI":"10.1136\/bmj.j5395","article-title":"Sexual health services on the brink","volume":"359","author":"White","year":"2017","journal-title":"BMJ"},{"key":"2021081606003922800_CIT0015","author":"Mitchell","year":"2020"},{"key":"2021081606003922800_CIT0016","article-title":"A health promoting NHS: transforming sexual health services","author":"Department of Health, United Kingdom","year":"2004"},{"key":"2021081606003922800_CIT0017","first-page":"247","article-title":"Trends in diagnosis of pelvic inflammatory disease in an Australian sexual health clinic, 2002-16: before and after clinical audit feedback","volume":"16","author":"Goller","year":"2019","journal-title":"Sex Health"},{"key":"2021081606003922800_CIT0018","doi-asserted-by":"crossref","first-page":"1517","DOI":"10.1093\/cid\/ciz429","article-title":"Chlamydia trachomatis and the risk of pelvic inflammatory disease, ectopic pregnancy, and female infertility: a retrospective cohort study among primary care patients","volume":"69","author":"den Heijer","year":"2019","journal-title":"Clin Infect Dis"},{"key":"2021081606003922800_CIT0019","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1016\/S1473-3099(16)30092-5","article-title":"Risk of reproductive complications following chlamydia testing: a population-based retrospective cohort study in Denmark","volume":"16","author":"Davies","year":"2016","journal-title":"Lancet Infect Dis"},{"key":"2021081606003922800_CIT0020","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.1016\/S0140-6736(18)31816-6","article-title":"Population effectiveness of opportunistic chlamydia testing in primary care in Australia: a cluster-randomised controlled trial","volume":"392","author":"Hocking","year":"2018","journal-title":"Lancet"},{"key":"2021081606003922800_CIT0021","volume-title":"Chlamydia control in Europe: literature review","author":"European Centre for Disease Prevention and Control","year":"2014"},{"key":"2021081606003922800_CIT0022","article-title":"HIV-STIs: further increase in chlamydia screeing coverage in 2010\/11","volume":"5","author":"Health Protection Agency","year":"2011","journal-title":"Health Protect Rep"},{"key":"2021081606003922800_CIT0023","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1136\/sextrans-2012-050696","article-title":"Chlamydia screening, retesting and repeat diagnoses in Cornwall, UK 2003\u20132009","volume":"89","author":"Turner","year":"2013","journal-title":"Sex Transm Infect"},{"key":"2021081606003922800_CIT0024","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1093\/aje\/kws583","article-title":"Risk of pelvic inflammatory disease following Chlamydia trachomatis infection: analysis of prospective studies with a multistate model","volume":"178","author":"Price","year":"2013","journal-title":"Am J Epidemiol"},{"key":"2021081606003922800_CIT0025","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1136\/sextrans-2015-052195","article-title":"Population attributable fraction of pelvic inflammatory disease associated with chlamydia and gonorrhoea: a cross-sectional analysis of Australian sexual health clinic data","volume":"92","author":"Goller","year":"2016","journal-title":"Sex Transm Infect"},{"key":"2021081606003922800_CIT0026","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1258\/ijsa.2008.008489","article-title":"Further observations, mainly serological, on a cohort of women with or without pelvic inflammatory disease","volume":"20","author":"Taylor-Robinson","year":"2009","journal-title":"Int J STD AIDS"},{"key":"2021081606003922800_CIT0027","doi-asserted-by":"crossref","DOI":"10.1093\/infdis\/jiab088","article-title":"Is there a hidden burden of disease as a result of epigenetic epithelial-to-mesenchymal transition following Chlamydia trachomatis genital tract infection?","author":"Horner","year":"2021","journal-title":"J Infect Dis"},{"key":"2021081606003922800_CIT0028","doi-asserted-by":"crossref","first-page":"611.e1","DOI":"10.1016\/j.ajog.2014.11.043","article-title":"Colonization of the upper genital tract by vaginal bacterial species in nonpregnant women","volume":"212","author":"Mitchell","year":"2015","journal-title":"Am J Obstet Gynecol"},{"key":"2021081606003922800_CIT0029","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1136\/sextrans-2016-052597","article-title":"Chlamydia sequelae cost estimates used in current economic evaluations: does one-size-fit-all?","volume":"93","author":"Ong","year":"2017","journal-title":"Sex Transm Infect"},{"key":"2021081606003922800_CIT0030","doi-asserted-by":"crossref","first-page":"e399","DOI":"10.1016\/S1473-3099(18)30159-2","article-title":"Advancing the public health applications of Chlamydia trachomatis serology","volume":"18","author":"Woodhall","year":"2018","journal-title":"Lancet Infect Dis"},{"key":"2021081606003922800_CIT0031","doi-asserted-by":"crossref","DOI":"10.1093\/infdis\/jiab047","article-title":"What can serology tell us about the burden of infertility in women caused by chlamydia?","author":"Horner","year":"2021","journal-title":"J Infect Dis"}],"container-title":["The Journal of Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jid\/article-pdf\/224\/Supplement_2\/S113\/39734323\/jiab175.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jid\/article-pdf\/224\/Supplement_2\/S113\/39734323\/jiab175.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,22]],"date-time":"2022-12-22T20:54:25Z","timestamp":1671742465000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jid\/article\/224\/Supplement_2\/S113\/6352149"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,15]]},"references-count":31,"journal-issue":{"issue":"Supplement_2","published-online":{"date-parts":[[2021,8,16]]},"published-print":{"date-parts":[[2021,8,16]]}},"URL":"https:\/\/doi.org\/10.1093\/infdis\/jiab175","relation":{},"ISSN":["0022-1899","1537-6613"],"issn-type":[{"value":"0022-1899","type":"print"},{"value":"1537-6613","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,8,15]]},"published":{"date-parts":[[2021,8,15]]}}}