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February 10, 1999

Screening Adolescent Females for Chlamydia Infection

Author Affiliations

Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor

JAMA. 1999;281(6):514-515. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-6-jac80022

To the Editor: Dr Burstein and colleagues1 are incorrect in generalizing the utility of screening recommendations for C trachomatis infection among adolescents to sites other than Baltimore, Md. The population evaluated in their study was homogeneous (98% African American) and not representative of sexually active adolescents elsewhere. The incidence rate of 28.0 cases per 1000 person-months in their study resulted in a median time to incident infection of 6 months. The authors concluded from this observation that semiannual screening should be widely adopted. This conclusion does not consider logistics or cost-effectiveness, although nearly any screening frequency in this high-incidence population would be cost saving.2 Furthermore, there is no rationale on which to base a screening strategy on the median time to incident infection.