***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES To determine lower genital tract carriage rates of C. trachomatis , N. gonorrhoeae and bacterial vaginosis among women seeking termination of pregnancy . To compare two clinical management strategies for minimising the risks of infective morbidity after induced abortion . DESIGN Prevalence of infections was assessed by screening women undergoing abortion . Clinical management strategies were compared by a r and omised trial . SETTING The gynaecology departments of four hospitals in Scotl and . PARTICIPANTS 1672 women undergoing induced abortion . INTERVENTIONS Women r and omised to prophylaxis received metronidazole 1 g rectally before abortion plus doxycycline 100 mg twice daily for seven days . Women r and omised to screen- and -treat received appropriate antibiotics only if screening proved positive for one or more infection . MAIN OUTCOME MEASURES Prevalences of infections ; morbidity in the eight weeks following abortion as assessed by reported symptoms , general practitioner consultation and prescription rates and hospital re-attendances ; costs to the NHS of alternative managements . RESULTS Prevalence rates : C. trachomatis 5.6 % ; N gonorrhoeae 0.19 % ; bacterial vaginosis 17.5 % . Overall , women allocated to receive prophylaxis had lower rates of measures of short term infective morbidity than those allocated to screen- and -treat . These differences only reached statistical significance for women who were reported negative on screening . The direct costs to the NHS of prophylaxis and screen- and -treat were calculated to be 8.17 and 18.34 per woman , respectively . CONCLUSIONS Prevalences of lower genital tract infections which have been implicated in increased rates of infective morbidity after abortion are similar to those reported elsewhere . Universal antibiotic prophylaxis is at least as effective as a policy of screen- and -treat in minimising the risk of short term infective morbidity and is far more cost efficient We compared the Gen-Probe transcription-mediated amplification assay ( AMP CT ) , the Abbott LCx assay , and the Roche COBAS AMPLICOR assay for the detection of Chlamydia trachomatis in a mixed population in urine sample s. First-void urine , urethral specimens , and cervical specimens in females were obtained from 1,000 patients ( 544 males and 456 females ) visiting the outpatient sexually transmitted disease clinic of our hospital . The prevalence of C. trachomatis infection was 7.7 % as determined by tissue culture of urethral and cervical specimens . The sensitivities of LCx , COBAS AMPLICOR , and AMP CT compared to cell culture were 79 , 86 , and 78 % , respectively . Sensitivity and specificity were recalculated by using a new " gold st and ard " , i.e. , a sample was considered to be true positive if two or more techniques yielded positive results . Specimens positive only by cell culture or positive in only one commercial amplification technique were retested by a previously described in-house PCR . After discordance analysis the sensitivities of LCx , COBAS AMPLICOR , and AMP CT were 84 , 93 , and 85 % , respectively . Specificity exceeded 99 % for all three assays . With each method the sensitivity was lower for urine sample s from females compared to urine sample s from males . By application of this new gold st and ard , existing differences between methods are highlighted ; future evaluations of new techniques should be vali date d against two or more amplification assays AIM : To test a new assay for the detection of human papillomavirus ( HPV ) DNA , hybrid capture II ( HC II ) , compared with the previous commercialized hybrid capture I ( HC I ) and polymerase chain reaction ( PCR ) results on cervical scrapes from fresh cone excision biopsy sample s. METHODS : The three methods were used on cervical scrapes from 42 fresh cone excision biopsy sample s. There were nine metaplastic and inflammatory lesions , five low grade lesions , and 28 high grade lesions .  PCR was performed using the general primers GP5+/GP6 + . The viral load of high risk HPV DNA was estimated by the ratio of relative light units to positive control values in the sample s. RESULTS : The sensitivity of HC I for the detection of high grade lesions was 71.4 % , while it was 92.8 % for HC II and 96.4 % for the PCR . Considering only the absence of detectable cervical in situ neoplasia , the specificity was 88.9 % for HC I , 66.7 % for HC II , and 66.7 % for PCR . With HC II , for a ratio of cervical sample to normal control of > 200 , the sensitivity for the detection of high grade lesion was only 34.6 % with a specificity of 66.7 % . CONCLUSIONS : HPV detection with the HC II assay is more sensitive than the previous HC I and represents a more convenient and easier test than PCR for routine use . Nevertheless the viral load estimated with this test can not be a reliable predictive indicator of high grade lesions CONTEXT Treatment recommendations assume that repeated mass antibiotic distributions can control , but not eradicate or even locally eliminate , the ocular strains of chlamydia that cause trachoma . Elimination may be an important end point because of concern that infection will return to communities that have lost immunity to chlamydia after antibiotics are discontinued . OBJECTIVE To determine whether biannual treatment can eliminate ocular chlamydial infection from preschool children and to compare results with the World Health Organization-recommended annual treatment . DESIGN , SETTING , AND PARTICIPANTS A cluster-r and omized clinical trial of biannual vs annual mass azithromycin administrations to all residents of 16 rural villages in the Gurage Zone , Ethiopia , from March 2003 to April 2005 . INTERVENTIONS At scheduled treatments , all individuals aged 1 year or older were offered a single dose of oral azithromycin either annually or biannually . MAIN OUTCOME MEASURE Village prevalence of ocular chlamydial infection and presence of elimination at 24 months in preschool children determined by polymerase chain reaction , correcting for baseline prevalence . Antibiotic treatments were performed after sample collection s. RESULTS Overall , 14,897 of 16,403 eligible individuals ( 90.8 % ) received their scheduled treatment . In the villages in which residents were treated annually , the prevalence of infection in preschool children  was reduced from a mean of 42.6 % ( range , 14.7%-56.4 % ) to 6.8 % ( range , 0.0%-22.0 % ) at 24 months . In the villages in which residents were treated biannually , infection was reduced from 31.6 % pretreatment ( range , 6.1%-48.6 % ) to 0.9 % ( range , 0.0%-4.8 % ) at 24 months . Biannual treatment was associated with a lower prevalence at 24 months ( P = .03 , adjusting for baseline prevalence ) . At 24 months , no infection could be identified in 6 of 8 of those treated biannually and in 1 of 8 of those treated annually ( P = .049 , adjusting for baseline prevalence ) . CONCLUSION Local elimination of ocular chlamydial infection appears feasible even in the most severely affected areas , although it may require biannual mass antibiotic distributions at a high coverage level . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00221364 Background Screening and active case finding for Chlamydia trachomatis ( CT ) is recommended to prevent reproductive morbidity . However insight in community prevalence of gonococcal infections and co-infections with Neisseria gonorrhoea ( NG ) is lacking . Methods Nested study within a large population -based Chlamydia Screening Pilot among 21.000 persons 15–29 year . All CT-positive ( 166 ) and a r and om sample of 605 CT-negative specimens were as well tested for gonococcal infection . Results Overall Chlamydia prevalence in the Pilot was 2.0 % ( 95 % CI : 1.7–2.3 ) , highest in very urban setting s ( 3.2 % ; 95 % CI : 2.4–4.0 ) and dependent of several risk factors . Four gonococcal infections were found among 166 participants with CT infection ( 4/166 = 2.4 % ; 95 % CI : 0.1%–4.7 % ) . All four had several risk factors and reported symptoms . Among 605 CT-negative persons , no infection with NG could be confirmed . Conclusion A low rate of co-infections and a very low community prevalence of gonococcal infections were found in this population based screening programme among young adults in the Netherl and s. Population screening for asymptomatic gonococcal infections is not indicated in the Netherl and s. Although co-infection with gonorrhoea among CT-positives is dependent on symptoms and well-known algorithms for elevated risks , we advise to test all CT-positives also for NG , whether symptomatic or asymptomatic In a prospect i ve study , the Gen-Probe PACE 2 ( GP ) assay was compared with Abbott Laboratories ' ligase chain reaction ( LCR ) assay for the detection of Chlamydia trachomatis . A total of 493 female patients consented to collection of two cervical sample s ; a first-void urine ( FVU ) sample was collected also from 446 of the participants . Cervical sample s were tested by both GP and LCR ; 16 sample s ( 3.1 % ) tested positive by both methods and no discrepant results were observed . All but one of the FVU sample s collected from patients with a positive cervical sample was positive for C. trachomatis by LCR . The stability of FVU sample s over time in the LCR test was also evaluated and proved to be significantly longer than the 4 days stated by the manufacturer . While LCR proved to be highly sensitive in detecting chlamydial infection in FVU sample s , no difference was noted between LCR and GP in the detection of cervical C. trachomatis infection in this study population Two antigen detection systems ( MicroTrak [ MT ] , Syva Co. , Palo Alto , Calif. ; and Chlamydiazyme [ CZ ] , Abbott Laboratories , North Chicago , Ill. ) were compared with semiquantitative culture for diagnosis of chlamydial infection in 1,059 patients . Cultures were done on microtiter plates and blind passaged once . Culture-negative but CZ- or MT-positive specimens were recultured . True positives were positive by either initial or repeat cultures . Of 827 nonpregnant and 231 pregnant patients , 9.1 and 12.1 % , respectively , had positive cultures . Overall sensitivity of the initial culture was 48.5 % without passage and 86.4 % with passage . The sensitivity of CZ was 67 % . The sensitivity of MT in our laboratory was 50 % ; however , further review of these specimens by Syva employees gave a combined sensitivity of 71.6 % . MT and CZ were more sensitive for pregnant patients ( MT , 84.6 % ; CZ , 85.7 % ) than for nonpregnant patients ( MT , 65.5 % ; CZ , 60.0 % ) . All the tests had specificities above 95 % . Of the specimens that were positive after initial culture without subculture , MT-negative specimens had a mean of 3.7 inclusion s in culture , and MT-positive specimens had a mean of 24.8 ( P = 0.002 ) ; CZ-negative specimens had a mean of 4.3 inclusion s , and CZ-positive specimens had a mean of 20.0 ( P = 0.026 ) . In addition , cultures of specimens from pregnant patients had more inclusion s than did those from gynecology patients , but this was not statistically significant ( P = 0.096 ) . No method is ideal ; however , MT and CZ were less sensitive than was this culture system for detecting chlamydial  infection in patients in gynecology clinics and were of comparable sensitivity for pregnant patients Objectives : Chlamydia trachomatis ( Chlamydia ) is the most prevalent sexually transmitted bacterial infection and can cause considerable reproductive morbidity in women .  Chlamydia screening programmes have been considered but policy recommendations are hampered by the lack of population based data . This paper describes the prevalence of Chlamydia in 15–29 year old women and men in rural and urban areas , as determined through systematic population based screening organised by the Municipal Public Health Services ( MHS ) , and discusses the implication s of this screening strategy for routine implementation . Methods : Stratified national probability survey according to “ area address density ” ( AAD ) . 21 000 r and omly selected women and men in four regions , aged 15–29 years received a home sampling kit . Urine sample s were returned by mail and tested by polymerase chain reaction ( PCR ) . Treatment was via the general practitioner , STI clinic , or MHS clinic . Results : 41 % ( 8383 ) responded by sending in urine and question naire . 11 % ( 2227 ) returned a refusal card . Non- 
    Output:
    
The risk of developing late complications after chlamydia lower genital tract infection appears low .
In screening programmes , chlamydia antibody testing , as an intermediate marker for potential adverse sequelae , might enable more precise estimates