Chlamydia (Genital Infections) 2003

Table 1. Chlamydia Cases by Race and Sex, Indiana, 2003

  2003 1999-2003
Cases Rate* Cases
Total 16,836 272 75,299
   White 6,363 116 27,861
   Black 6,814 1,286 30,872
   Other 691 437 3,012
   Not Reported 2,968 - 13,554
   Male 3,760 123 16,566
   Female 12,933 411 58,432
   Not Reported 143 - 301

*Rate per 100,000 population based on the U.S. Census Bureau’s population data as of July 1, 2003

In 2003, the Indiana State Department of Health (ISDH) received 16,836 reports of patients testing positive for Chlamydia trachomatis, the causative agent of chlamydia. Of all the reportable diseases in Indiana, chlamydia is the most commonly reported. In 2003, the incidence rate of chlamydia was 272 cases per 100,000 population, over a
3 percent decrease from 2002 (281). Figure 1 shows the number of cases from 1999-2003. Consistent with previous years’ distribution by age, the preponderance of cases was among adolescents and young adults (Figure 2). In 2003, over 89 percent of reported cases were among those 10-29 years of age. The age-specific rate for those 10-19 years of age was 685 per 100,000, while the rate among those 20-29 years of age was 1009 per 100,000.

Women are overrepresented among those diagnosed with chlamydia. Known female infections (12,933) exceeded those among males (3,760) by over three-fold. Chlamydia screening programs preferentially test females, because untreated infections cause reproductive sequelae. Pelvic inflammatory disease, a substantial proportion of which is caused by infection with C. trachomatis, is the primary cause of preventable infertility. Federally funded efforts of the Indiana Sexually Transmitted Disease (STD) Program and the Indiana Family Health Council resulted in selective screening of at-risk young women. Further, male chlamydia infections are often diagnosed as non-gonococcal urethritis, which is not reportable. Because these men do not receive pathogen-specific testing, chlamydia morbidity among males is understated. Therefore, the difference between genders reflects a difference in screening practices rather than greater prevalence among females.
The four counties with the greatest number of reported cases were Marion (6,425), Lake (1,512), Allen (1,279), and St. Joseph (1,072). Adjusting for population size, Marion County had the highest incidence rate (744), followed by St. Joseph County (402), Allen County (376), and Vanderburgh County (354). Figure 3 shows Indiana counties with five or more reported cases of chlamydia in 2003.
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