Prevalence Of Genital Chlamydial Infection Research Articles

Genital Chlamydia trachomatis infection and infertility in Malaysia

Background: Genital Chlamydia trachomatis infection can cause pelvic inflammatory disease and infertility in female by damaging cervical columnar epithelial cells. Recent reports have shown increased cases of newly reported chlamydial infection worldwide. However, at present, there is no effective vaccine available for the prevention of genital chlamydial infection. Insights into the host response of the human cervical epithelial cells against C. trachomatis infection are crucial to design a better prevention and vaccination strategy. Methods and materials: Here, we examined the prevalence of the C. trachomatis infection and the association with women's health in Malaysia. To investigate the influence of the C. trachomatis infection on human epithelial cells, we applied isobaric tags for relative and absolute quantitation (iTRAQ) labeling technique and liquid chromatography-tandem mass spectrometry (LC-MS3) analysis for elucidation of host proteome changes in the C. trachomatis-infected HeLa-229 human cervical epithelial cells. In addition, cytokine response following stimulation with multiple C. trachomatis antigens (CPAF, HSP60 and MOMP) were also examined. Results: Here, we reported that the prevalence of genital chlamydial infection among the ostetrics and gynecology patients was alarmingly high at 51.1% (92/180). Our data also showed that genital C. trachomatis infection was associated with infertility issues, inflammation in the reproductive tract (mucopurulent cervicitis or endometriosis), irregular menstrual cycles and polycystic ovarian syndrome (PCOS). Our proteomic work discovered a significant array of host proteins which participated in the early C. trachomatis infection. We highlighted involvement of eukaryotic initiation factor 2 (eIF2), mammalian target of rapamycin (mTOR), ubiquitination, clathrin-mediated endocytosis, tRNA charging and glycolysis signaling pathways in the host cells to eradicate the bacteria invasion. The bacteria infection was also associates with other complications such as increased inflammation and pro-inflammatory cytokines (TNF-α, IL-1β and IL-6) were robustly secreted following antigenic exposure. Conclusion: Our study describes a high prevalence of C. trachomatis among Malaysian O&G patients and highlights distinct ability of C. trachomatis in manipulating host proteins and triggering pro-inflammatory response.

Prevalence of plasmid-bearing and plasmid-free Chlamydia trachomatis infection among women who visited obstetrics and gynecology clinics in Malaysia.

BackgroundThe 7.5 kb cryptic plasmid of Chlamydia trachomatis has been shown to be a virulence factor in animal models, but its significance in humans still remains unknown. The aim of this study was to investigate the prevalence and potential involvement of the C. trachomatis cryptic plasmid in causing various clinical manifestations; including infertility, reproductive tract disintegrity, menstrual disorder, and polycystic ovarian syndrome (PCOS) among genital C. trachomatis–infected patients.ResultsA total of 180 female patients of child bearing age (mean 30.9 years old, IQR:27–35) with gynecological complications and subfertility issues, who visited Obstetrics and Gynecology clinics in Kuala Lumpur, Malaysia were recruited for the study. Prevalence of genital chlamydial infection among these patients was alarmingly high at 51.1 % (92/180). Of the 92 chlamydia-infected patients, 93.5 % (86/92) were infected with plasmid-bearing (+) C. trachomatis while the remaining 6.5 % (6/92) were caused by the plasmid-free (−) variant. Our data showed that genital C. trachomatis infection was associated with infertility issues, inflammation in the reproductive tract (mucopurulent cervicitis or endometriosis), irregular menstrual cycles and polycystic ovarian syndrome (PCOS). However, no statistical significance was detected among patients with plasmid (+) versus plasmid (−) C. trachomatis infection. Interestingly, plasmid (+) C. trachomatis was detected in all patients with PCOS, and the plasmid copy numbers were significantly higher among PCOS patients, relative to non-PCOS patients.ConclusionOur findings show a high incidence of C. trachomatis infection among women with infertility or gynecological problems in Malaysia. However, due to the low number of plasmid (−) C. trachomatis cases, a significant role of the plasmid in causing virulence in human requires further investigation of a larger cohort.

Prevalence of genital chlamydial infection among a community sample of young international backpackers in Sydney, Australia

We conducted a chlamydia prevalence study from January to June 2009 among a community sample of young international backpackers by recruiting at hostels in Sydney, Australia. Participants completed a questionnaire; men provided a urine sample and women provided a self-collected vaginal swab, which were tested for Chlamydia trachomatis DNA by strand displacement amplification. We recruited 225 men (median age 24 years) and 207 women (median age 23 years). Most (87%) of the travellers came from Europe. A new sexual partner during travel was reported by 67%, and 51% had more than one new sexual partner. Of those reporting a new sexual partner, 40% always used condoms. Prevalence of chlamydia was 3.5% (3.1% in men, 3.9% in women). Previous testing for chlamydia was reported by 40%. Drinking alcohol at hazardous levels was reported by 58% of men and 29% of women. Despite the reporting of new sexual partners and inconsistent condom use, the prevalence of chlamydia in these backpackers was not higher than that found in more general populations, and may relate to good health-care seeking behaviour. Young travellers need education about sexual risks and promotion of condom use prior to travel, and access to public sexual health services.

Prevalence of Chlamydia trachomatis and its association with other sexually transmitted infections in a tertiary care center in North India

The asymptomatic nature of chlamydial genital infections coupled with the occurrence of severe sequelae in untreated patients, makes the laboratory evaluation of great importance in the diagnosis of the disease. Genital chlamydial infections are the leading cause of preventable sexually transmitted infections (STIs) worldwide, with 43 million new cases in Southeast Asia. The present study was designed to determine the prevalence of genital chlamydial infection in women attending a sexually transmitted disease (STD) outpatient department and to determine the association of the disease with other STIs. A total of 276 female patients with a complaint of genital discharge or ulcer were enrolled for the study. Genital discharge specimens (endocervical, vaginal, and urethral swabs) were collected from all the patients. The patients were investigated for the presence of antigen and antibody of Chlamydia trachomatis with the help of the Direct fluorescent Antibody test (DFA) and the Enzyme Linked Immunosorbant Assay (ELISA), respectively. Investigations for aetio-pathogens of other STIs were carried out using the standard methods. Chlamydial infection was found in 19.9% of the patients (10.1% by DFA technique and 10.9% by ELISA). Both the antigen and antibody were positive in only three (1.1%) cases. The overall incidence of other aetio-pathogens was low. In two (0.7%) cases multiple infections were seen. Chlamydia trachomatis was found to be most commonly associated with Candida albicans . However, there was no co-infection of Chlamydia trachomatis with Neisseria gonorrhoeae .

The role of genital chlamydial infection in acute pelvic inflammatory disease

The polymicrobial nature of pelvic inflammatory disease (PID) underscores the need for a clearer understanding of the pathogenesis and etiology of PID especially among core groups most at risk. This study was designed to determine the role of specific microbial infections in leading to PID among women. Prevalence of genital chlamydial infection and other reproductive tract infections were determined in 100 women presenting at a health facility at Port Harcourt, Rivers State, Nigeria. The result showed that 11.1 per cent of women with acute PID were infected with Chlamydia trachomatis as compared to 4.3 per cent in the control group (odds ratio 2.75: 95% confidence interval (CI), 0.7-11.7). Neiserria gonorrhoeae was not detected in either of the two groups. Trichomoniasis (10% in PID cases and no case in control group) and bacterial vaginosis (17.5% and 4.3% in PID and control group respectively: Odds ratio 4.7, 95% CI, 1.0-21.1) were also significantly associated with the clinical picture suggestive of acute PID. It is recommended that where resources are limited, patients presenting with acute PID be treated empirically for Chlamydia trachomatis, trichomoniasis, bacterial vaginosis and gonorrhoea. Keywords: : Pelvic inflammatory disease, Chlamydia trachomatis, Neiserria gonorrhoeae, Bacteria vaginosis, Trichomoniasis African Journal of Clinical and Experimental Microbiology Vol. 8 (1) 2007: pp. 23-27

Chlamydia screening in a rural population: access, outcomes and health-care planning

During the first year of a screening programme in Cornwall, a rural area of southwest England, 5024 young people were screened for genital Chlamydia trachomatis infection. We used mapping software to assess the prevalence of genital chlamydial infection and access to genitourinary medicine services among 16-25 year olds. Using this data, we calculated that attendance at genitourinary medicine clinics in Cornwall varies between 20/1000 and 83/1000 in this age group. Similarly, the rate of positive results varies between 2.9 and 27.4%, depending on place of residence and testing site. The highest rates of infection were noted in two areas with poor access to existing genitourinary medicine clinics. This information can be used to better plan sexual health services.

58. CHLAMYDIA SCREENING OF ANTENATAL WOMEN IN MELBOURNE BETWEEN 16-25 YEARS

Objective: Routine chlamydia screening of pregnant women is not widely practiced in Australia and limited data are available on the prevalence of infection in this population. This cross-sectional study sought to determine the prevalence of genital chlamydial infection among pregnant women aged 16-25 attending antenatal clinics in Melbourne. Methods: Consecutive women attending 4 major maternity services covering northern, western, eastern and south-eastern Melbourne were approached between October 2006 and May 2007. Of 931 eligible women (those aged 16-25 who had not already been tested for chlamydia) attending the clinics at the time of recruitment, 882 (95%) were approached and 845 (96%) agreed to participate. Participants completed a questionnaire which was translated into Chinese, Vietnamese and Arabic, and provided first-void urine which was tested for Chlamydia trachomatis using polymerase chain reaction. Results: Eighteen percent of women had a preferred language other than English. Of the 826 tests which were non assessable, 30 were positive representing a prevalence rate of 3.6% (95% CI: 2.5-5.1%). However, among women aged 16-20, 14 of 203 women were infected, representing a prevalence rate of 6.9% (95% CI: 3.8-11.3%). All infected women received treatment with azithromycin and all who have had repeat chlamydia tests to date have been negative. Conclusion: In this study of a wide cross-section of pregnant Melbourne women, chlamydial infection was common, particularly among teenagers. Screening was highly acceptable, with the great majority of women approached agreeing to be screened.

Chlamydia trachomatis Testing Patterns and Prevalence of Genital Chlamydial Infection Among Young Men and Women in Central Norway 1990–2003: A Population-Based Registry Study

The study objective was to investigate Chlamydia trachomatis (CT) testing patterns, prevalence, and incidence among men and women in Sør-Trøndelag county, central Norway, 1990-2003. The goal of this study was to obtain data for recommendations regarding CT screening. Laboratory data on CT tests for persons 15 to 24 years old were retrieved and analyzed. Four percent of men and 44% of women had been CT tested at least once by the age of 20. By the age of 25, 44% of men and 84% of women had been tested. Prevalence at first test was at its peak in 2000-2002 (men: 15-19 years 18%, 20-24 years 23%; women: 15-19 years 11%, 20-24 years 9%). Incidence estimates were higher for persons with a positive first test than for persons with a negative first test. More men and more female teenagers need to be tested. Repeat testing is particularly important among people who have been diagnosed with CT.

The prevalence of genital Chlamydia trachomatis in Australia 1997 - 2004: a systematic review

To determine by systematic review the prevalence of genital chlamydial infection in Australia between 1997 and 2004. Electronic literature databases, reference lists, and conference proceedings were searched and health agencies and jurisdictions were contacted for published and unpublished reports. Studies were eligible if they offered a diagnostic nucleic acid amplification test to consecutive individuals presenting during the study period. As a summary measure of the available data, mean prevalence rates, weighted by sample size and irrespective of participant age, were calculated for the population sub-groups. 40 studies of 50 populations and 40,587 individuals met the inclusion criteria, but only one of these was population-based. The use of non-systematic methodologies prevented an assessment of time trends and a statistical comparison of population sub-groups. The mean overall prevalence of genital chlamydial infection was 4.6% (95% CI 4.4-4.8%), reflecting over-sampling of high-risk groups. The mean community-based rates were 7.5% (95% CI 6.4-8.6%) and 8.7% (95% CI 7.9-9.7%) for Indigenous men and women, and 1.5% (95% CI 1.1-1.9%) and 1.4% (95% CI 0.9-2.0%) for non-Indigenous men and women. The overall mean estimates for other groups were 3.3% (95% CI 3.0-3.7%) for female attendees of sexual health and related clinics, 5.6% (95% CI 4.9-6.4%) for adolescents and young adults, 3.3% (95% CI 2.8-3.9%) for sex workers, and 1.6% (95% CI 1.2-2.0%) for urethral infection in men who have sex with men. Clinic-based estimates were generally, although not consistently, higher than community-based estimates. There is no serial population-based data for sexually active young men and women, but the available age-specific rates suggest under-ascertainment by the routine surveillance systems. The prevalence of genital chlamydial infection in Indigenous Australians and young adults is unacceptably high and quality epidemiological studies are urgently required to supplement the routinely collected national notification data.

Chlamydia trachomatis genital infection in apparently healthy adult population of Tamil Nadu, India: a population-based study.

Since the epidemiology of Chlamydia trachomatis infection in apparently healthy population has not been studied in India, a population-based study was conducted in the state of Tamil Nadu, India in order to analyse the prevalence of genital chlamydial infections in the community and to implement control programmes. A representative sample was taken from three randomly selected districts by using the 'probability proportional to size' cluster survey method. Households were the basic units of clusters. Adults aged 15-45 years, pre-identified from the selected households were enrolled during the medical camps conducted for a major study on community prevalence of sexually transmitted diseases in Tamil Nadu. Blood and urine samples collected from the study subjects were tested by enzyme-linked immunosorbent assay (ELISA) for anti-chlamydial IgM antibodies and by the commercial Amplicor polymerase chain reaction (PCR) test for chlamydial DNA. The prevalence of anti-C. trachomatis antibodies determined by IgM-ELISA was 2.4% (95% CI 1.6%-3.2%). The prevalence of genital chlamydial infection determined by PCR was 1.1% (95% CI 0.5%-1.7%). Majority of the detected infections (68.8%) were asymptomatic. This is the first Indian report on the prevalence of genital chlamydial infections in the general population. It is concluded that this study provides evidence for a substantial burden of approximately 10 million asymptomatic genital chlamydial infection cases in the sexually active age groups in the general population of India.

Prevalence of genital chlamydial infection in symptomatic and asymptomatic Jordanian patients

Objective: To detect Chlamydia trachomatis infection among 230 patients, 130 with signs or symptoms associated with urethritis, and 100 asymptomatic patients, attending the Jordan University Hospital urology clinic. Methods: Routine urine examination and the leukocyte esterase test were done for each patient. C. trachomatis infection was detected using first-void urine specimens and a cryptic plasmid-based PCR technique specific for C. trachomatis. Results: The prevalence of chlamydial infection was 4.6% among symptomatic patients with urethritis. The difference in prevalence was statistically insignificant (P > 0.05) between males and females, as well as in relation to their marital status. Two-thirds of the Chlamydia-positive patients also had urine positive for leukocyte esterase. Conclusion: The low prevalence of chlamydial infection in association with urethritis among Jordanian patients might be due to the conservative behavior of the Jordanian society towards free sexuality.

Urine based screening for asymptomatic/undiagnosed genital chlamydial infection in young people visiting the accident and emergency department is feasible, acceptable, and can be epidemiologically helpful

Objective: To assess the acceptability and the feasibility of urine based Chlamydia trachomatis screening in asymptomatic young people aged 16–35 years attending an inner city accident and emergency (A&E) department....

Provision of chlamydia testing in a nationwide service offering termination of pregnancy: with data capture to monitor prevalence of infection

Objectives: To establish a methodology by which all women attending for termination of pregnancy (TOP) at British Pregnancy Advisory Service (BPAS) branches may be approached to participate in Chlamydia trachomatis...

Prevalence of genital chlamydial infection in young women entering a national job training program, 1990-1997.

This analysis describes trends in the prevalence of genital chlamydial infection in economically disadvantaged young women entering a national job training program. We examined chlamydia test data for May 1990 through June 1997 for women aged 16 to 24 years who enrolled in the program. The significance of trends was evaluated with the chi 2 test for trend. Prevalence of chlamydial infection declined 32.9%, from 14.9% in 1990 to 10.0% in 1997 (P < .001). Prevalence decreased significantly in all age groups, racial/ethnic groups, and geographic regions. The decrease in prevalence of chlamydial infection suggests that prevention activities have reached disadvantaged women across the United States; however, prevalence of chlamydial infection remains high, and enhanced prevention efforts in disadvantaged communities are urgently needed.

Gynaecological and microbiological findings in women attending for a general health check-up

Two hundred apparently healthy sexually active women, 17-34 years of age, who had presented for a general health check-up at the Clinic of Dermatology and Venereology, Medical University, Plovdiv, Bulgaria, were asked about genital symptoms, sexual behaviour, contraceptive use and smoking habits, and examined for signs of genital infections. They were searched for genital chlamydial infection, gonorrhoea, trichomoniasis, bacterial vaginosis (BV) and vulvovaginal candidosis, syphilis and HIV. Polymerase chain reaction (PCR) was used for detection of Chlamydia trachomatis and Neisseria gonorrhoeae in urine samples and the results were compared with direct immunofluorescence (DFA) and enzyme immunoassays (EIA) for C. trachomatis in urethral, cervical and urine samples. In 56 (28%) women, an STD and/or an STD-related condition were diagnosed. The prevalence of genital chlamydial infection, trichomoniasis, BV and vulvovaginal candidosis was 4.5%, 0.5%, 17.5% and 7.5% respectively. On direct questioning 39 (19.5%) women reported symptoms suggestive of an infection, while 58 (29%) had signs that may have been caused by genital infection. In urine the PCR tests detected more (3.5%) chlamydia-positive women than the DFA (2.5%) and EIA tests (1.5%). The urine PCR test was as sensitive as the DFA when testing cervical samples. The chlamydia-positive women and women with BV were less likely to have a steady partner than the controls. No woman had syphilis or HIV infection. The women with BV were more frequent users of an intrauterine device and were more likely to smoke heavily compared with other women. STDs and STD-related conditions are common among adult women who consider themselves gynaecologically healthy. Screening for genital infections among women in reproductive age attending for health check-up could improve women's reproductive health.

Prevalence of genital Chlamydia trachomatis infection among women in a Swedish primary health care area.

The objective of this study was to estimate the prevalence of genital chlamydial infection in an unselected population of young women by offering a screening investigation to all women between the ages of 15 and 34 in a primary health care area. Specimens were taken from both the urethra and the cervix in all participating women, and data regarding the participants' symptoms, sexual habits, contraceptive use and socioeconomic factors were also collected. The specimens were analyzed with a primary enzyme immunoassay (Syva MikroTrak) and a confirmatory direct immunofluorescence test (Syva MikroTrak). A total of 543 women were invited to the study and 374 women (68.9%) participated. 10/374 women (2.7%) were chlamydia positive and only 2 of these 10 chlamydia infected women were less than 25 years of age. The chlamydia infected women had positive tests either from the urethra (4 women) or from the cervix (6 women), and in no case the tests were positive from both locations. No statistically significant differences between the chlamydia positive and negative women were found concerning any clinical or anamnestic factor.

Screening for Chlamydia Trachomatis Genital Infection in Young Men in Stockholm

The purpose of this study was to investigate the prevalence of genital chlamydial infection in male military recruits in Stockholm, Sweden. Two hundred and thirty-eight men who admitted to sexual experience were included in the study. One hundred and five (44%) of these 238 men consented to a specimen being taken for chlamydial culture. Eleven (10%) of these 105 men had a positive chlamydial culture. All 11 men were 17-18 years old and 10 were asymptomatic. In order to decrease the prevalence of chlamydial infection, screening of young men is as essential as screening of women.