Abstract
Seroepidemiology of chlamydia can offer study opportunities and insights into cumulative risk of exposure that may contribute to monitoring the frequency of, and control of, genital chlamydia–the most commonly diagnosed STI in England. We undertook retrospective anonymous population-based cross-sectional surveys using an indirect IgG ELISA for chlamydia Pgp3 antibody. Sera from 4,732 women aged 17–24 years were tested. Samples were taken at 3-yearly intervals between 1993 and 2002, a period during which other data suggest chlamydia transmission may have been increasing, and from each year between 2007 and 2010. Seroprevalence increased in 17–24 year olds over time between 1993 and 2002. Between 2007 and 2010, age-standardised seroprevalence among 17–24 year olds decreased from 20% (95% CI: 17–23) to 15% (95%CI 12–17) (p = 0.0001). The biggest drop was among 20 to 21 year olds, where seroprevalence decreased from 21% in 2007 to 9% in 2010 (p = 0.002). These seroprevalence data reflect some known features of the epidemiology of chlamydia infection, and show that exposure to antibody-inducing chlamydia infection has declined in recent years. This decline was concurrent with increasing rates of screening for asymptomatic chlamydia. Serology should be explored further as a tool for evaluation of chlamydia control, including chlamydia screening programmes.
Highlights
Chlamydia trachomatis is the most common sexually transmitted bacterium in the developed world, with a high prevalence of infection [1,2,3]
Current knowledge of the epidemiology of C. trachomatis infection in the UK relies heavily on nucleic acid amplification tests (NAATs) in which C. trachomatis DNA is amplified from genital swabs or urine
We report the results of the first population-based study of antibodies to the C. trachomatis-specific antigen Pgp3 in England using the recently developed and validated Pgp3 enzyme-linked immunosorbent assay (ELISA) and a population-based serum collection from 17–24 year old women
Summary
Chlamydia trachomatis is the most common sexually transmitted bacterium in the developed world, with a high prevalence of infection [1,2,3]. Chlamydia can give rise to chronic infection and sequelae that include pelvic inflammatory disease, chronic pelvic pain, ectopic pregnancy and tubal factor infertility [5]. Current knowledge of the epidemiology of C. trachomatis infection in the UK relies heavily on nucleic acid amplification tests (NAATs) in which C. trachomatis DNA is amplified from genital swabs or urine. These specimens tend to be available only from sexually active women. These data provide some information on current infection, but information on the prevalence of past infection or the cumulative risk of infection cannot be derived from
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