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article imagePelvic Inflammatory Disease linked to STDs

By Sarah Curran Ragan     May 5, 2014 in Health
A new study has linked the sexually transmitted diseases (STD) chlamydia and gonorrhoea with an increased risk of hospitalisation due to pelvic inflammatory disease (PID)
PID is a common condition in women of reproductive age leading to infertility, ectopic pregnancy, further PID and chronic pelvic pain.
In young women it is commonly a result of sexually transmitted Chlamydia trachomatis (chlamydia) or Neisseria gonorrhoea (gonorrhoea) infections moving from the cervix to the upper genital tract.
A new study published in the journal PLOS ONE, aimed to estimate and compare the incidence of PID hospitalisation in relation to diagnosis of chlamydia and gonorrhoea in women of reproductive age.
These STDs are the two most commonly reported in Australia and in many countries. It was previously thought that the presence and severity of PID vary depending on cause but to date there has few data available.
Data was collected from four registries collating medical information in New South Wales, Australia were used to select women between 15 and 45 years of age with a diagnosis of either STD between 01 July 2000 and 31 December 2008. Patients were followed by records for up to one year after their diagnosis for hospitalisations for PID. Incidence ratios were calculated to compare the incidence of PID hospitalisations to age equivalent NSW populations without either STD.
Of the 38,193 women who had a diagnosis of chlamydia, 483 were hospitalised for PID. In contrast, 1,015 were diagnosed with gonorrhoea, with 45 hospitalisations for PID. The annual incidence of PID hospitalisation related to either diagnosis was 27 and 96.6 times greater for chlamydia and gonorrhoea respectively, than the age equivalent NSW female population. Younger age, socio-economic disadvantage having a diagnosis prior to 2005 and having a prior birth were also linked with being hospitalised for PID.
In Australia, chlamydia is 10 times more commonly diagnosed than gonorrhoea, but the potential for relative increase in PID hospitalisations with gonorrhoea, is outweighed by greater numbers of chlamydia diagnosis.
However, the findings have particular implications in countries such as USA where gonorrhoea infection in men and women are more common, as well as in Aboriginal and Torres Strait islander populations in remote Australia, where prevalence of both STDs are roughly equal.
Results clearly show that chlamydia and gonorrhoea are both associated with increases in the risk of PID hospitalisation say the authors.
It has been previously documented that women with chlamydia infection are an increased risk of diagnosis of PID, although estimates of size of risk have differed with a number of studies.
The data suggest that risk is much higher for gonorrhoea than for chlamydia, however further research is needed, say the authors.
Hospitalisations for Pelvic Inflammatory Disease Temporally Related to a Diagnosis of Chlamydia or Gonorrhoea: A Retrospective Cohort Study
Joanne Reekie, Basil Donovan,Rebecca Guy,Jane S. Hocking,Louisa Jorm,John M. Kaldor, Donna B. Mak,David Preen,Sallie Pearson,Christine L. Roberts,Louise Stewart,Handan Wand,James Ward,Bette Liu
Published: April 17, 2014
DOI: 10.1371/journal.pone.009436
More about Std, PID, Pelvic inflammatory disease, Chalmydia, gonnorrheoa
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