Redmond, ShelaghShelaghRedmondAlexander-Kisslig, KarinKarinAlexander-KissligWoodhall, Sarah CSarah CWoodhallvan den Broek, IngridIngridvan den Broekvan Bergen, Jan EAMJan EAMvan BergenWard, HelenHelenWardUusküla, AnneliAnneliUuskülaHerrmann, BjörnBjörnHerrmannAndersen, BeritBeritAndersenGötz, Hannelore MHannelore MGötzSfetcu, OtiliaOtiliaSfetcuLow, NicolaNicolaLow0000-0003-4817-89862024-10-232024-10-232015-01-23https://boris-portal.unibe.ch/handle/20.500.12422/127469Background: Accurate information about the prevalence of Chlamydia trachomatis is needed to assess national prevention and control measures. Methods: We systematically reviewed population-based cross-sectional studies that estimated chlamydia prevalence in European Union/European Economic Area (EU/EEA) Member States and non-European high income countries from January 1990 to August 2012. We examined results in forest plots, explored heterogeneity using the I2 statistic, and conducted random effects meta-analysis if appropriate. Metaregression was used to examine the relationship between study characteristics and chlamydia prevalence estimates. Results: We included 25 population-based studies from 11 EU/EEA countries and 14 studies from five other high income countries. Four EU/EEA Member States reported on nationally representative surveys of sexually experienced adults aged 18-26 years (response rates 52-71%). In women, chlamydia point prevalence estimates ranged from 3.0-5.3%; the pooled average of these estimates was 3.6% (95% CI 2.4, 4.8, I2 0%). In men, estimates ranged from 2.4-7.3% (pooled average 3.5%; 95% CI 1.9, 5.2, I2 27%). Estimates in EU/EEA Member States were statistically consistent with those in other high income countries (I2 0% for women, 6% for men). There was statistical evidence of an association between survey response rate and estimated chlamydia prevalence; estimates were higher in surveys with lower response rates, (p=0.003 in women, 0.018 in men). Conclusions: Population-based surveys that estimate chlamydia prevalence are at risk of participation bias owing to low response rates. Estimates obtained in nationally representative samples of the general population of EU/EEA Member States are similar to estimates from other high income countries.en600 - Technology::610 - Medicine & healtharticle10.7892/boris.601242561557410.1371/journal.pone.0115753