Contrasting trends in rates of genital chlamydial infection and ectopic pregnancy in South East Thames Region, England and Uppsala County, Sweden: ecological study.

Sexually transmitted chlamydial infections are the most common preventable cause of pelvic inflammatory disease, and tubal infertility. In Sweden, falling rates of chlamydia, pelvic inflammatory disease, and ectopic pregnancy have been attributed to intensive testing, treatment and partner notification to detect asymptomatic infections, in a variety of healthcare settings since the 1980s. In Britain, routine surveillance, testing and partner notification for chlamydia currently occur only in genitourinary clinics, although an expert advisory committee of the Chief Medical OYcer has now recommended targeted opportunistic screening in other health care settings. We conducted ecological comparisons of the eVects of diVerent levels of chlamydia control on the incidence of one consequence, ectopic pregnancy, in SE Thames Region, England and Uppsala County, Sweden.