Dépistage des anticorps anti- Chlamydia trachomatis chez l’adolescent scolarisé au Congo

Abstract

Chlamydia trachomatis (CT) est le microorganisme sexuellement transmissible le plus fréquemment responsable d’infection génitale. Si la fréquence de l’infection à CT est connue chez la femme enceinte et chez la femme à risque de maladies sexuellement transmissibles, peu de données existent chez l’adolescente non exposée en milieu africain. Nous avons étudié la prévalence des anticorps anti-CT dans une population de 295 adolescents (154 filles, 141 garçons) scolarisés âgés de 13 à 19 ans, parallèlement à celle d’un groupe témoin constitué de 190 enfants âgés de 6 à 12 ans. Les anticorps anti-CT apparaissent vers l’âge de 15 ans. La prévalence est de 6,1% dans cette population et elle prédomine davantage chez la fille (10,4%) que chez le garçon (1,4%). Les données suggèrent que l’adolescent apparemment asymptomatique est concerné par l’infection à CT et que les sujets doivent être dépistés et traités. La fréquence chez l’adolescente mérite toute l’attention car le jeune organisme est davantage prédisposé à des infections récidivantes et à leurs complications. Chlamydia trachomatis genital infection is the most common sexually transmitted disease. C. trachomatis can persist for a long time and may result in serious sequelae, such as salpingitis leading to subsequent ectopic pregnancy, infertility, or chronic pelvic pain. Most studies are performed among women seen at clinics dealing with antenatal care, family planning, sexually transmitted diseases, or gynecology. The purpose of this study was to determine the prevalence of C. trachomatis in teenagers in Congo. We studied the prevalence of C. trachomatis antibodies in 295 school teenagers, between 13 and 19 years of age (154 females and 141 males) and compared it with that of 190 children between 6 and 12 years of age. IgG, IgM, and IgA were studied by micro-immuno-fluorescence, using three strains: LB1/L2 (C. trachomatis), IOL-207 (C. pneumoniae), and Loth (C. psittaci). C. trachomatis IgG antibodies were detected in patients 15 years of age or more. The prevalence was 6.1%. It was more predominant in females (10.4%) than in males (1.4%). IgA were detected in six cases (five females, one male) associated with IgG. No IgM was found. In comparison the prevalence of C. pneumoniae antibodies was high (67.8%). This data suggests that unexposed teenagers may be concerned by C. trachomatis infection which can be screened and treated. The major goal of Chlamydia trachomatis control is the prevention of salpingitis and their sequelae. We therefore conclude that Chlamydia screening should be considered in sexually active teenagers in Congo.