Chlamydia trachomatis: common misperceptions and misunderstandings

Prevalence of Chlamydia and Gonorrhea Among Pregnant Adolescents Screened in the Third Trimester Using a Urine PCR Test: A Retrospective Review

OBJECTIVE

Our study assessed the rate of new and recurrent Chlamydia trachomatis and Neisseria gonorrhoeae infections in the third trimester at an adolescent obstetrics clinic.

METHOD

Between October 2016 and June 2020, routine third-trimester screening for C. trachomatis and N. gonorrhoeae was implemented according to new Canadian recommendations. Urine nucleic acid amplification was performed. Patient records were reviewed retrospectively, and demographic data; pregnancy and delivery characteristics; and information on screening at presentation to care, third-trimester screening (33-38 weeks), and other STI testing was recorded.

RESULTS

A total of 115 adolescents (mean age 17.90 ± 1.43 y) with 125 pregnancies presented for care. Twenty-three pregnancies were excluded (12 transferred out and 11 experienced a pregnancy loss). At presentation, screening was performed in 100 of 102 pregnancies: 64 of 100 at <13 weeks, 32 of 100 at 13-27 weeks, and 4 of 100 at 28-30 weeks. Nine tested positive for C. trachomatis and none tested positive for N. gonorrhoeae. In the third trimester, there were 3 positive C. trachomatis tests, but all were indicated: test of cure was due for 1 patient, 1 patient had a new sexual partner, and 1 patient presented with symptoms. The remaining 89 of 102 pregnancies were screened (with no other indication) and none were positive for C. trachomatis or N. gonorrhoeae. Ten patients could not be sampled (5 missed, 4 pre-term deliveries, and 1 non-compliant with testing).

CONCLUSION

No cases of C. trachomatis or N. gonorrhoeae infection were identified on third-trimester screening in our study. Adolescent obstetrics providers implementing Canadian screening guidelines may want to monitor their screening results to determine whether their yield warrants universal implementation.

Prevalence of Chlamydia trachomatis, Trichomonas vaginalis and Neisseria gonorrhoeae Based on Data Collected by a Network of Clinical Microbiology Laboratories, in Italy

Bacterial and protozoal sexually transmitted infections (STIs), such as Chlamydia trachomatis, Trichomonas vaginalis and Neisseria gonorrhoeae, may cause acute symptoms, chronic infections and severe long-term complications. The complications of these infections in women include pelvic inflammatory disease, chronic pelvic pain, tubal infertility, ectopic pregnancy, and infertility. Moreover, infection during pregnancy is associated with premature rupture of the membranes, low birth weight and miscarriage.In Italy, Chlamydia trachomatis and Trichomonas vaginalis infections are not subject to mandatory reporting; while gonorrhoea is subject to mandatory reporting.To extend surveillance to STIs that are widespread yet often asymptomatic and to improve the knowledge on the epidemiology of these infections in Italy, in 2009 the "Centro Operativo AIDS of the Istituto Superiore di SanitÁ", in collaboration with the Association of Italian Clinical Microbiologists (AMCLI, Associazione Microbiologi Clinici Italiani), launched the sentinel STIs surveillance system based on a network of 13 clinical microbiology laboratories.The main objective of the surveillance was to assess the prevalence and risk factors associated with Chlamydia trachomatis, Trichomonas vaginalis and Neisseria gonorrhoea infections among individuals attending microbiology laboratories in Italy.

[Sero-epidemiological study of three sexually transmitted infections: Chlamydia Trachomatis, Hepatitis B, Syphilis. A case study conducted at the Nkoldongo District Hospital in Yaoundé]

Introduction

Les infections sexuellement transmissibles sévissent toujours dans les pays en voie de développement et particulièrement au Cameroun. Le but de notre étude est de déterminer la distribution des infections sexuellement transmissibles suivantes: l’hépatite virale B, le Chlamydia trachomatis et de la syphilis dans une population de femmes venant consulter spontanément à l’Hôpital de District de Nkoldongo à Yaoundé, d’évaluer d’éventuelles coïnfections entre ces trois affections et de ressortir les connaissances de ces femmes sur leur mode de transmission sexuelle.

Méthodes

Notre étude prospective et descriptive a porté sur 182 femmes dont l’âge variait entre 18 et 48 ans. Les femmes ont été testées sérologiquement pour le Chlamydia trachomatis par une méthode ELISA (kit des laboratoires General Biological Corp). L’hépatite virale B a été dépistée par une méthode immunochromatographique (kit des laboratoires Human) et la syphilis par une méthode d’agglutination en ce qui concerne le RPR (Kit des laboratoires Biocentric) et le TPHA (kit des laboratoires Human).

Résultats

Nos résultats ont montré que: la distribution du Chlamydia trachomatis , de l’hépatite virale B et la syphilis a été respectivement de 22,52%, 4,39%, 0,54%.De plus, nous avons observé une coinfection Chlamydia trachomatis hépatite virale B avec un taux de 2,74%. Par ailleurs la réinfection au Chlamydia trachomatis a été rencontrée dans 4,94% de cas. S’agissant du mode de transmission de ces affections 67,57% et 70,87% de femmes ne connaissaient pas la voie de transmission sexuelle pour le Chlamydia trachomatis et pour l’hépatite virale B respectivement, tandis que 91,2 % des femmes connaissaient la voie de transmission sexuelle pour la syphilis.

Conclusion

Le diagnostic d’une infection à Chlamydia trachomatis chez une patiente doit susciter le dépistage de l’hépatite virale B.

Introduction

Sexually transmitted infections are still frequent in developing countries and particularly in Cameroon. The aim of this study was to determine the distribution of the following sexually transmitted infections: viral hepatitis B, Chlamydia trachomatis and syphilis in a population of women spontaneously visiting the Nkoldongo District Hospital in Yaoundé as well as to evaluate possible co-infections among these three conditions and to bring out women’s prior knowledge of how sexual transmission occurs.

Methods

We conducted a prospective and descriptive study including 182 women aged between 18 and 48 years. These women underwent serologic testing for Chlamydia trachomatis with ELISA (General Biological Corp laboratory test kit. Hepatitis B virus was detected using immunochromatographic method (Human laboratory kit) while syphilis was detected using RPR agglutination (Biocentric Laboratories kit )and TPHA agglutination (Human laboratory kit) method.

Results

Our results showed that the distribution of Chlamydia trachomatis, viral hepatitis B and syphilis was 22.52%, 4.39%, 0.54% respectively. Moreover, we reported a Chlamydia trachomatis and Viral hepatitis B coinfection rate of 2.74%. In addition, Chlamydia trachomatis reinfection was detected in 4.94% of cases. Regarding the mode of transmission of these infections, 67.57% and 70.87% of women didn’t know how Chlamydia trachomatis and viral hepatitis sexual transmission could occur respectively, while 91.2% of women knew how was syphilis spread.

Conclusion

The diagnosis of chlamydia trachomatis infection should prompt screening for viral hepatitis B.

Feasibility and utility of screening adolescent mothers for Chlamydia at their children's health care visits

PURPOSE

Assess the feasibility of offering and barriers to accepting urine-based screening for Chlamydia trachomatis (CT) among asymptomatic adolescent mothers during their children's health care visits.

METHOD

Providers were automatically cued to offer CT-screening to 13 through 21 year old mothers when they opened the child's medical record. Recording the mothers' screening decisions removed the flag for 6 months. Providers were also prompted to assess the perceived importance of CT prevention, likelihood of having CT, and the worst aspect of having CT.

RESULTS

Mothers usually brought their children to the clinic. Hence, providers could act on 97% of the 318 flags they saw. They responded appropriately 75% of the time. Only 96 (42%) of the 229 mothers who were asked agreed to screening. The primary reasons for declining were "monogamous" and "tested within 6 months". Almost everyone said CT was a top preventive health priority, but that they would be surprised if they were infected. Mothers who agreed to screening were less likely to have a child less than 6 months of age (26.0% vs. 57.1%; P < 0.0001). They were also more likely to rate knowledge of partner infidelity (39.4% vs. 13.6%; P = 0.03) and less likely to rate medical problems (15.2% vs. 40.9%; P = 0.01) the worst aspect of having CT. None of the 21 urine samples obtained within 6 months of delivery were positive for CT. Thereafter, 5 (9.1%) of the 55 urines were positive.

CONCLUSIONS

It is feasible and useful to screen adolescent mothers for CT at their children's health care visits. The best way to increase the efficacy and strengthen the impact of urine-based CT-screening in this setting is to initiate testing after the 6th postpartum month and heighten awareness of STD-risk among adolescent mothers.