{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T20:45:35Z","timestamp":1777927535119,"version":"3.51.4"},"reference-count":26,"publisher":"SAGE Publications","issue":"13","license":[{"start":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T00:00:00Z","timestamp":1752537600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J STD AIDS"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Tubal infertility and ectopic pregnancies are serious, but rare, complications of chlamydia infections. It is unclear whether chlamydia screening in women has an impact on these complications. Chlamydia incidence rates between European countries vary by orders of magnitude, which largely reflects different intensities of screening.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used chlamydia diagnoses rates as a proxy for chlamydia screening rates to assess if differences in screening intensity were associated with differences in the frequency of ectopic pregnancy and the prevalence of infertility in women. We used mixed effects linear regression to assess for an association between chlamydia screening intensity in European countries and two outcomes: (1) the incidence of ectopic pregnancy and (2) the prevalence of infertility in women, while controlling for year, income and quality of health services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The number of countries with available data increased from 3 in 1990 to 23 in 2019, before slightly declining to 22 in 2020. CT incidence varied across countries, from a median of 207 cases per 100,000 in 1990 (IQR: 59\u2013313) to 33 cases per 100,000 in 2021 (IQR: 3\u2013179). There was less variation in ectopic pregnancy incidence (median: 208 and 33 per 100,000 in 1990 and 2021, respectively), and female infertility prevalence (median 1,224 and 1,587 per 100,000 in 1990 and 2021, respectively). No association was found between screening intensity and ectopic pregnancy incidence or infertility prevalence after adjusting for year, GDP per capita, and universal health coverage index.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our results are compatible with other types of data that suggest that the intensity of screening for chlamydia is not associated with a large effect on the population-level frequency of all ectopic pregnancies and female infertility.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/09564624251361294","type":"journal-article","created":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T10:12:43Z","timestamp":1752574363000},"page":"939-945","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Number of chlamydia diagnoses per capita not associated with rates of ectopic pregnancies and female infertility \u2013 An ecological study"],"prefix":"10.1177","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5541-6041","authenticated-orcid":false,"given":"Vanbaelen","family":"Thibaut","sequence":"first","affiliation":[{"name":"Institute of Tropical Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8421-5137","authenticated-orcid":false,"given":"Sheeba","family":"Manoharan-Basil","sequence":"additional","affiliation":[{"name":"Institute of Tropical Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2557-8998","authenticated-orcid":false,"given":"Kenyon","family":"Chris","sequence":"additional","affiliation":[{"name":"Institute of Tropical Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,7,15]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2021-054992"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(23)00356-0"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanepe.2023.100743"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.07.050112"},{"key":"e_1_3_5_6_2","first-page":"000389599000016","article-title":"Screening for genital chlamydia infection","volume":"9","author":"Low N","year":"2016","unstructured":"Low N, Redmond S, Uuskula A, et al. Screening for genital chlamydia infection. Cochrane Database of Systematic Reviews 2016; 9, 000389599000016.","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31816-6"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e4316"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanepe.2024.101027"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0b013e31815e41a3"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1086\/652399"},{"key":"e_1_3_5_12_2","unstructured":"Soaaids NL. Nieuwe inzichten chlamydia: GGD past testbeleid aan. 10\/07\/2024. https:\/\/www.soaaids.nl\/nl\/professionals\/actueel\/nieuwsbericht\/nieuwe-inzichten-chlamydia-ggd-past-testbeleid-aan"},{"key":"e_1_3_5_13_2","volume-title":"Sexually transmitted infections and screening for Chlamydia in England","author":"Mitchell H","year":"2019","unstructured":"Mitchell H, Allen H, Sonubi H, et al. Sexually transmitted infections and screening for Chlamydia in England. London: Public Health England, 2019."},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)61947-9"},{"key":"e_1_3_5_15_2","volume-title":"Changes to the national Chlamydia screening Programme public sector equality duty assessment","author":"Public Health England","year":"2021","unstructured":"Public Health England. Changes to the national Chlamydia screening Programme public sector equality duty assessment. Wellington: Public Health England, 2021."},{"key":"e_1_3_5_16_2","volume-title":"Epidemiological report for Chlamydia 2023","author":"European Centre for Disease Prevention and Control","year":"2025","unstructured":"European Centre for Disease Prevention and Control. Epidemiological report for Chlamydia 2023. Stockholm: ECDC, 2025."},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-021-06646-y"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2017-053478"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2009.038752"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0115753"},{"key":"e_1_3_5_21_2","volume-title":"Prevalence of chlamydia, gonorrhoea, trichomoniasis, and syphilis in Europe: a systematic review and meta-analysis to inform prevention and control of sexually transmitted infections in Europe","author":"Pentz R","year":"2025","unstructured":"Pentz R, Mik\u0161ov\u00e1 D, Schwarz T, et al. Prevalence of chlamydia, gonorrhoea, trichomoniasis, and syphilis in Europe: a systematic review and meta-analysis to inform prevention and control of sexually transmitted infections in Europe. 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