Re-evaluating Selective Screening Criteria for Chlamydial Infection Among Women in the U.S. Pacific Northwest

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Abstract
Screening women for Chlamydia trachomatis (CT) infection using selective screening criteria has been operational in the northwestern United States (Region X) since 1988. Changes in the field, including declines in CT prevalence, introduction of sensitive laboratory tests, and budgetary pressures necessitate reevaluating the selective screening approach to ensure program credibility and efficiency. The goals of this study were to assess 1) performance of screening criteria in Region X, 2) predictors of CT infection, and 3) optimization of these criteria. We conducted cross-sectional analysis of 409,882 CT test records of women from 1998 to 2000 using multivariate logistic regression and sensitivity and efficiency analyses. Young age (90% of infections. Evaluating selective screening criteria can result in modifications that could increase screening efficiency.