Genital infection by Chlamydia trachomatis in Lisbon: prevalence and risk markers.
ABSTRACT There is little information about the prevalence and risk markers for Chlamydia trachomatis infections in Portugal.
Our aim was to assess the prevalence of C. trachomatis genital infection and to study variables associated with this infection in a group of sexually active women aged < or =30 years living in the Lisbon area and to estimate the prevalence of C. trachomatis infection among partners of infected patients.
A systematic sample of women observed in general practice family planning and teenager clinics was collected. A questionnaire was administered, followed by a pelvic examination. A first-catch urine sample was taken for polymerase chain reaction (PCR) Amplicor assay. When a sample tested positive, the woman was invited to obtain a urine sample from her partner. Socio-demograhic, behavioural and clinical variables were studied and their association with the PCR Amplicor result was assessed.
A total of 1108 women, aged between 14 and 30 years, were studied. Fifty-one women (4.6% of total sample) tested positive for C. trachomatis. The prevalence of infection was slightly higher in patients aged < or =19 years (5.3%) than in age groups 20-25 (4.8%) and 26-30 years (3.9%). African ethnicity was related to a higher percentage of infection than European ethnicity: 9.8% versus 3.8%, P= 0.0067. Use of condoms "sometimes/never" was associated with a higher prevalence of infection: 5.2% versus 2.3% in those responding "always/almost always" (P= 0.0447). An altered cervix was associated with a higher prevalence of infection: 7.3% versus 3.7% with a normal cervix (P= 0.0106). Urine samples were obtained from 16 partners of infected patients. Six partners (37.5%) tested positive for C. trachomatis.
A 4.6% prevalence of C. trachomatis genital infection was found. African ethnicity, using condoms "sometimes/never" and an altered cervix were associated with C. trachomatis infection, but showed low positive predictive value for C. trachomatis infection. Younger age may be associated with a slight increase in risk. Contact tracing for diagnosis and treatment remains a difficult issue to approach effectively.
Full-textDOI: · Available from: João Paulo Gomes, Apr 28, 2015
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ABSTRACT: Genital Chlamydia trachomatis (CT) infections have been identified as a major health problem concern. CT is associated with adverse effect on women reproduction and also associated with cervical hypertrophy and induction of squamous metaplasia, providing a possible relationship with human papillomavirus (HPV) infection. Infection by high-risk HPV types is crucial to the pathogenesis of invasive cervical cancer (ICC), but other co-variants/cofactors must be present for the development of malignancy. CT biological effect may damage the mucosal barrier, improving HPV infection, or may interfere in immune response and viral clearance supporting the persistence of HPV infection. Moreover, CT-related chronic cervical inflammation, decrease of lower genital tract antigen-presenting cells, inhibition of cell-mediated immunity, and anti-apoptotic capacity may influence the natural history of HPV infection, namely persistence progression or resolution. Although several epidemiological studies have stated a positive association involving CT and HPV-related cervical neoplastic lesions and/or cervical cancer (CC), the specific role of this bacterium in the pathogenesis of cervical neoplasia has not been completely clarified. The present review summarizes several studies on CT role in cervical cancer and suggests future research directions on HPV and CT interaction.Archives of Gynecology 12/2013; 289(4). DOI:10.1007/s00404-013-3122-3 · 1.28 Impact Factor
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ABSTRACT: Sexually transmitted infections (STIs) represent a major global health problem leading to morbidity, mortality and stigma. Prior to this study there was no information on the prevalence and knowledge of STIs in Faisalabad, Pakistan. Prospective, cross-sectional study in patients attending STI clinics from July 2006 to September 2009. After obtaining consent, patients completed structured questionnaires used for behavioral surveys. Blood and urethral swabs were collected and tested for syphilis, gonococcus, genital herpes, chlamydia and chancroid. Mean (standard deviation) age of the 1532 participants was 38.9 (9.4) years, including 37.8 (10.2) years for males and 35.5 (6.3) years females. Male gender (n=1276, 83.3%), low socioeconomic class (n=1026, 67.0%) and residence in rural suburbs (n=970, 63.3%) were more common. Most (n=913, 59.6%) were aware of the modes of transmission of STIs and the associated complications, 20% (n=306) were condom users, and 21.2% (n=324) had knowledge of safe sex. Opposite-sex partners were preferred by 972 (63.4%) patients, while 29.9% (n=458) had both homosexual and heterosexual sex partners. Syphilis was present in 29.5% of patients (n=452); gonorrhea, in 13% (n=200), HSV-2, in 3.2% (n=49), chlamydia, in 4.7% (n=72) and chancroid, in 1.3% (n=20). This report establishes baseline local prevalence rates for STIs. Syphilis emerged as the most prevalent STI in Faisalabad. Population-based studies are required to study the epidemiology of STIs, along with initiation of national health-education campaign.Annals of Saudi medicine 03/2011; 31(3):263-9. DOI:10.4103/0256-4947.81541 · 0.71 Impact Factor
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ABSTRACT: Pregnant adolescents have a high incidence of sexually transmitted infections and higher risk of adverse birth outcome. To assess the prevalence of sexually transmitted infections in pregnant adolescents and the associations between these infections and adverse birth outcome. A prospective study with a face-to-face interview to pregnant adolescents was followed by first-void urine and cervical swabs collection for polymerase chain reaction testing for Chlamydia trachomatis and Neisseria gonorrhoeae. After child delivery, clinical files were also reviewed for serological and microbiological results for other infections and data concerning maternal-foetal morbidity. A 5% level of significance was used. The inclusion criteria were fulfilled by 204 pregnant adolescents, and the prevalence of C. trachomatis was 11.8% and of N. gonorrhoeae was 4.9%, with the majority being asymptomatic. No antibodies for syphilis or human immunodeficiency virus were found. Maternal morbidity occurred in 3.4%, prematurity was observed in 11.8% of the newborns and low birth weight in 9.8%. Statistically significant associations were observed between maternal morbidity and the presence of gonorrhoea, younger adolescents and severe prematurity and between infection with C. trachomatis and/or N. gonorrhoea and low birth weight. Sexually transmitted infections are frequently asymptomatic and cause maternal-foetal morbidity. The opportunity that pregnancy offers for screening and counselling should not therefore be missed, especially in adolescents.Journal of the European Academy of Dermatology and Venereology 07/2011; 26(8):972-5. DOI:10.1111/j.1468-3083.2011.04194.x · 3.11 Impact Factor