How can chlamydia diagnoses increase when their complications are declining?

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Abstract
Chen and colleagues present, in this issue of STI (p 318), some apparently paradoxical data about the recent epidemiology of chlamydial infection in New South Wales, Australia—hospital admissions for pelvic inflammatory disease declined in women and rates of epididymo-orchitis remained constant during a period when notifications of chlamydia increased substantially. Their findings differ from the well documented fall in chlamydia complication rates that accompanied reductions in chlamydia notifications in Sweden1, 2 and the United States.3

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