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Van Der Pol B, Gaydos CA. A profile of the binx health io® molecular point-of-care test for chlamydia and gonorrhea in women and men. Expert Rev Mol Diagn 2021; 21:861-868. [PMID: 34225553 DOI: 10.1080/14737159.2021.1952074] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Introduction: Point-of-care (POC) tests for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are urgently needed to control the STI epidemic in order to offer patients an immediate diagnoses and accurate treatment before they leave a clinical encounter and thus reduce transmission and sequelae. Nucleic acid amplification tests (NAATs) have increased sensitivity and specificity, but very few POC assays can provide results of such tests within the usual time of the patient visit.Areas covered: This review describes the technology and performance characteristics of the binx health io® [Boston, MA] (binx io) CT/NG assay, a new rapid molecular POC assay. The assay is compared to other available molecular POC tests. We also describe the importance of time to results and assay performance for this POC assay.Expert opinion: The binx io CT/NG assay offers the ability to incorporate the use of POC tests to identify and immediately treat chlamydia and gonococcal infections into the clinical visit, which will provide improved outcomes for patients. Additional implementation studies are needed to optimize the adoption of this new test.
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Affiliation(s)
- Barbara Van Der Pol
- University of Alabama at Birmingham School of Medicine, Department of Medicine, Birmingham, USA
| | - Charlotte A Gaydos
- Johns Hopkins University School of Medicine, Department of Medicine, Baltimore, USA
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Jacob L, Duse DA, Kostev K. Prevalence and treatment of sexually transmitted infections in men followed by urologists in Germany - a cross sectional study with 347,090 men. GERMAN MEDICAL SCIENCE : GMS E-JOURNAL 2018; 16:Doc03. [PMID: 30250416 PMCID: PMC6124731 DOI: 10.3205/000265] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 03/15/2018] [Indexed: 11/30/2022]
Abstract
Aim: The goal of this retrospective analysis was to study the prevalence and treatment of the most common sexually transmitted infections (STI) in men followed by urologists in Germany. Methods: This study included a total of 347,090 men followed in 71 urology practices in Germany between 2013 and 2015. The first outcome was the prevalence of individuals diagnosed with STI between 2013 and 2015. The following eight types of STI infections were included in the analysis: chlamydial infection, gonococcal infection, anogenital warts, anogenital herpes infection, trichomoniasis, ulcus molle, phthiriasis, and syphilis. The second outcome was the prevalence of individuals with STI who received an appropriate therapy within 90 days of their initial STI diagnosis. Results: The most frequent STI was anogenital warts (0.64%), whereas the least frequent STI was syphilis (0.03%). The median age at diagnosis ranged from 30.3 years for chlamydia infection to 47.5 years for trichomoniasis. The proportion of individuals receiving treatment was the highest for trichomoniasis (90.6%) and the lowest for anogenital warts (49.9%). Conclusions: Overall, approximately 1.25% of men followed in urology practices in Germany between 2013 and 2015 were diagnosed with at least one STI. Further research is needed to gain a better understanding of the factors potentially associated with the risk of being diagnosed with STI in this setting in Germany. Moreover, there is a need for enabling higher rates of diagnosis and thus treatment of infected persons.
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Affiliation(s)
- Louis Jacob
- Faculty of Medicine, University of Paris 5, Paris, France
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Silva GARD, Motta HLDSN, Souza EFAD, Cardoso PANM, Pilotto JH, Eyer-Silva WA, Ribeiro LCP, Santos MSD, Azevedo MCVMD, Pinto JFDC, Motta RN, Ferry FRDA. Prevalence of asymptomatic urethritis by Chlamydia trachomatis and Neisseria gonorrhoeae and associated risk factors among males living with HIV-1. Rev Inst Med Trop Sao Paulo 2018. [PMID: 29538508 PMCID: PMC5962100 DOI: 10.1590/s1678-9946201860011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objectives The increase in HIV transmissibility in non-ulcerative sexually transmitted infection is already well-established. It is estimated that symptomatic carriers of N. gonorrhoeae and C. trachomatis have a relative risk of 4.8-fold and 3.6-fold, respectively, for the sexual acquisition of HIV. This type of evaluation for asymptomatic urethritis is necessary to reinforce strategies to combat HIV transmission. This study aims to assess the prevalence of patients with asymptomatic urethritis among men diagnosed with HIV-1 and determine the risk factors associated with this infection. Methods We enrolled a total of 115 male patients aged 18 years or older who have been diagnosed with HIV infection and have no symptoms of urethritis or other sexually transmitted infections and who have been evaluated between May and August 2015 in a follow-up visit at the Immunology Outpatient Clinic of a Brazilian University Hospital. Results Four asymptomatic patients were positive for C. trachomatis and were considered asymptomatic carriers of urethritis. Prevalence was 3.47%. Patients who were positive for C. trachomatis urethritis had a lower mean age (p = 0.015). Conclusion The presence of asymptomatic sexually transmitted infection is a challenge in clinical practice. We recommend that, in outpatient practice, the habit of inquiring on previous sexual behavior to obtain more information about risks and associations with asymptomatic sexually transmitted infection, a routine physical examination and complementary tests to detect STI pathogens should be performed to discard these conditions. The development of rapid tests for this purpose should also be encouraged.
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Affiliation(s)
- Guilherme Almeida Rosa da Silva
- Universidade Federal do Estado do Rio de Janeiro, Serviço de Clínica Médica 10ª Enfermaria, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Erik Friedrich Alex de Souza
- Universidade Federal do Estado do Rio de Janeiro, Serviço de Clínica Médica 10ª Enfermaria, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - José Henrique Pilotto
- Fundação Oswaldo Cruz, Laboratório de AIDS e Imunologia, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Walter Araujo Eyer-Silva
- Universidade Federal do Estado do Rio de Janeiro, Centro de Ciências Biológicas e da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Mônica Soares Dos Santos
- Hospital Universitário Gaffrée e Guinle, Laboratório de Imunologia, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Jorge Francisco da Cunha Pinto
- Universidade Federal do Estado do Rio de Janeiro, Serviço de Clínica Médica 10ª Enfermaria, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rogerio Neves Motta
- Universidade Federal do Estado do Rio de Janeiro, Serviço de Clínica Médica 10ª Enfermaria, Rio de Janeiro, Rio de Janeiro, Brazil
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Jalkh AP, Miranda AE, Hurtado-Guerreiro JC, Ramos LAC, Figliuolo G, Maia J, Costa CM, Ramasawmy R, de Lima Ferreira LC. Chlamydia trachomatis in human immunodeficiency virus-infected men treated at a referral hospital for sexually transmitted diseases in the Amazonas, Brazil. Braz J Infect Dis 2013; 18:158-63. [PMID: 24216156 PMCID: PMC9427454 DOI: 10.1016/j.bjid.2013.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Revised: 06/12/2013] [Accepted: 06/19/2013] [Indexed: 11/02/2022] Open
Abstract
OBJECTIVES The aim of the present study was to determine the Chlamydia trachomatis prevalence and to identify the demographic, behavioural and clinical factors associated with C. trachomatis in human immunodeficiency virus infected men. STUDY This was a cross-sectional study of C. trachomatis prevalence among human immunodeficiency virus-infected men enrolled at the Outpatient clinic of acquired immunodeficiency syndrome of the Fundação de Medicina Tropical Dr. Heitor Vieira Dourado in Manaus, Amazonas, Brazil. C. trachomatis deoxyribonucleic acid from urethral samples was purified and submitted to real time polymerase chain reaction to identify the presence of C. trachomatis. RESULTS A total of 276 human immunodeficiency virus-infected men were included in the study. The prevalence of C. trachomatis infection was 12% (95% confidence interval 8.1%-15.7%). The mean age of the participants was 34.63 (standard deviation 10.80) years. Of the 276 human immunodeficiency virus-infected men, 93 (56.2%) had more than one sexual partner in the past year and 105 (38.0%) reported having their first sexual intercourse under the age of 15 years. Men having sex with men and bisexuals amounted to 61.2% of the studied population. A total of 71.7% had received human immunodeficiency virus diagnosis in the last three years and 55.1% were using antiretroviral therapy. Factors associated with C. trachomatis infection in the logistic model were being single (p<0.034), men having sex with men (p<0.021), and having previous sexually transmitted diseases (p<0.001). CONCLUSION The high prevalence of C. trachomatis infection among human immunodeficiency virus-infected men highlights that screening human immunodeficiency virus-infected men for C. trachomatis, especially among men having sex with men, is paramount to control the spread of C. trachomatis infection.
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Affiliation(s)
- Alex Panizza Jalkh
- Fundação Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, AM, Brazil.
| | - Angelica Espinosa Miranda
- Fundação Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, AM, Brazil; Infectious Diseases Unit, Federal University of Espírito Santo, Vitória, ES, Brazil
| | | | | | - Guiseppe Figliuolo
- Fundação Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, AM, Brazil
| | - Jussimara Maia
- Fundação Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, AM, Brazil
| | - Cintia Mara Costa
- Fundação Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, AM, Brazil
| | - Rajendranath Ramasawmy
- Fundação Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, AM, Brazil; Universidade Nilton Lins, Manaus, AM, Brazil
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Barbosa MJ, Moherdaui F, Pinto VM, Ribeiro D, Cleuton M, Miranda AE. Prevalence of Neisseria gonorrhoeae and Chlamydia trachomatis infection in men attending STD clinics in Brazil. Rev Soc Bras Med Trop 2011; 43:500-3. [PMID: 21085857 DOI: 10.1590/s0037-86822010000500005] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2010] [Accepted: 07/13/2010] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The study aimed to assess the prevalence of Neisseria gonorrhoeae and Chlamydia trachomatis infections and identify demographic, behavioral and clinical factors correlated with such infections in men attending six sexually transmitted disease clinics in Brazil. METHODS Multicentric, cross-sectional study performed among men attending STD clinics in Brazil. The study included STD clinics in six cities distributed throughout the five geographic regions of Brazil in 2005. Patients provided 20 ml of first catch urine for testing for NG and CT by DNA-PCR. RESULTS A total of 767 (92.9%) men were included in the study. The mean age was 26.5 (SD 8.3) years-old. Prevalence of Chlamydia infection was 13.1% (95%CI 10.7%-15.5%) and gonorrhea was 18.4% (95%CI 15.7%-21.1%). Coinfection prevalence was 4.4% (95%CI 2.95%-5.85%) in men who sought attendance in STI clinics. Factors identified as associated with C. trachomatis were younger age (15-24) [OR=1.4 (95%CI 1.01-1.91)], present urethral discharge [OR=4.8 (95%CI 1.52-15.05)], genital warts [OR=3.0 (95%CI 1.49-5.92)] and previous history of urethral discharge [OR=2.4 (95%CI 1.11-5.18)]. Variables associated with gonorrhea were younger age (15 to 24) [OR=1.5 (95%CI 1.09-2.05)], presence of urethral discharge [OR=9.9 (95%CI 5.53-17.79)], genital warts [OR=18.3 (95%CI 8.03-41.60)] and ulcer present upon clinical examination [OR=4.9 (95%CI 1.06-22.73)]. CONCLUSIONS These findings have important implications for education and prevention actions directed toward men at risk of HIV/STD. A venue-based approach to offer routine screening for young men in STD clinics should be stimulated.
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Affiliation(s)
- Marcelo Joaquim Barbosa
- STD Unit, National Department of STD/AIDS and Viral Hepatitis, Ministry of Health, Brasília, DF, Brazil
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Reynolds R, Oakman T. Genital chlamydia in southern New South Wales: An ecological analysis of testing and notification patterns 2004-2008. Aust J Rural Health 2010; 18:159-65. [DOI: 10.1111/j.1440-1584.2010.01134.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Cai S, He F, Samra HS, de la Maza LM, Bottazzi ME, Joshi SB, Middaugh CR. Biophysical and stabilization studies of the Chlamydia trachomatis mouse pneumonitis major outer membrane protein. Mol Pharm 2009; 6:1553-61. [PMID: 19650664 DOI: 10.1021/mp900110q] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Native Chlamydia trachomatis mouse pneumonitis major outer membrane protein (nMOMP) induces effective protection against genital infection in a mouse challenge model. The conformation of nMOMP is crucial to confer this protective immunity. To achieve a better understanding of the conformational behavior and stability of nMOMP, a number of spectroscopic techniques are employed to characterize the secondary structure (circular dichroism), tertiary structure (intrinsic fluorescence) and aggregation properties (static light scattering and optical density) as a function of pH (3-8) and temperature (10-87.5 degrees C). The data are summarized in an empirical phase diagram (EPD) which demonstrates that the thermal stability of nMOMP is strongly pH-dependent. Three distinctive regions are seen in the EPD. Below the major thermal transition regions, nMOMP remains in its native conformation over the pH range of 3-8. Above the thermal transitions, nMOMP appears in two different structurally altered states; one at pH 3-5 and the other at pH 6-8. The EPD shows that the highest thermal transition point ( approximately 65 degrees C) of nMOMP is near pH 6. Several potential excipients such as arginine, sodium citrate, Brij 35, sucrose and guanidine are also selected to evaluate their effects on the stability of nMOMP. These particular compounds increase the aggregation onset temperature of nMOMP by more than 10(omicron)C, without affecting its secondary and tertiary structure. These results should help formulate a vaccine using a recombinant MOMP.
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Affiliation(s)
- Sumin Cai
- Laboratory for Macromolecular and Vaccine Stabilization, Department of Pharmaceutical Chemistry, University of Kansas, Lawrence, Kansas 66047, USA
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C3H male mice with severe combined immunodeficiency cannot clear a urethral infection with a human serovar of Chlamydia trachomatis. Infect Immun 2009; 77:5602-7. [PMID: 19805533 DOI: 10.1128/iai.00766-09] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The pathogenesis of an infection of the male genitourinary tract of mice with a human serovar of Chlamydia trachomatis has not been characterized. To establish a new model, we inoculated C3H/HeN (H-2(k)) mice in the meatus urethra with C. trachomatis serovar D. To determine the 50% infectious dose (ID(50)), male mice were inoculated with doses ranging from 10(2) to 10(6) inclusion-forming units (IFU). The mice were euthanized 10 days post infection (p.i.), and the urethra, bladder, epididimydes, and testes were cultured for Chlamydia. Positive cultures were obtained from the urethra, urinary bladder, and epididimydes, and the ID(50) was determined to be 5 x 10(4) IFU/mouse. Subsequently, to characterize the course of the infection, wild-type (WT) and C3H animals with severe combined immunodeficiency (SCID animals) were inoculated with 10(6) IFU/mouse (20 times the ID(50)). In the WT mice, the infection peaked in the second week, and by 42 days p.i., it was cleared. In contrast, most of the SCID mice continued to have positive cultures at 60 days p.i. C. trachomatis-specific antibodies were first detected in WT animals' sera at 21 days p.i. and increased until 42 days p.i. The immunoglobulin G2a (IgG2a) titers were 32-fold higher than those of IgG1, indicative of a Th1-biased immune response. A lymphoproliferative assay using splenocytes showed a significant cell-mediated immune response in the WT mice. As expected, no humoral or cell-mediated immune responses were observed in the SCID animals. In conclusion, inoculation of WT male mice in the meatus urethra with a human serovar of C. trachomatis resulted in a limited infection mainly localized to the lower genitourinary tract. On the other hand, SCID animals could not clear the infection, suggesting that in male mice, the adaptive immune response is necessary to control an infection with a C. trachomatis human serovar.
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Incidence and risk factors for genital Chlamydia trachomatis infection: a 4-year prospective cohort study. Sex Transm Dis 2009; 36:273-9. [PMID: 19265733 DOI: 10.1097/olq.0b013e3181924386] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Few long-term studies reporting incidence and behavioral data for Chlamydia trachomatis (CT) infection in the general population have been published. Such studies are important to understand risk factors associated with infection and to develop screening recommendations. METHODS A fixed prospective 4-year cohort study of 898 sexually active Norwegian women, aged 16 to 23 years at study start, was conducted to assess incidence, repeat infection, and risk factors associated with genital CT infection. Participants were interviewed at study start and at 6-month intervals thereafter for behavioral characteristics. The women were tested for CT infection at 12-month intervals beginning at study start. Risk factors were assessed using Fisher exact test and conditional logistic regression. Person-time was estimated in survival analyses and incidence of CT infection was reported as events per 100 woman-years. RESULTS Median duration of observation was 48.0 months (range 10-74) whereas 4.4 specimens were collected per woman (range 2-5). Of the 836 women eligible for the analysis, 19 (2.2%) had a prevalent infection at baseline. The 4-year cumulative incidence of CT infection was 7.7 (95% CI: 6.7-8.7) with annual incidences ranging from 1.2 to 2.9 per 100 woman-years. The 2-year cumulative incidence of repeat CT infection was 11.2 (95% CI: 9.3-13.1) per 100 woman-years. In multivariate analyses, factors associated with incident CT infection were young age (< or =24 years) and number of new partners over the last 12 months prior being tested. CONCLUSION The annual incidences observed for women 24 years or younger with 1 or more new partners over the last 12 months support recommendations for annual testing for CT in this age group in Norway.
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Acceptability of urine-based screening for Chlamydia trachomatis in asymptomatic young men: a systematic review. Sex Transm Dis 2008; 35:S28-33. [PMID: 18418291 DOI: 10.1097/olq.0b013e31816938ca] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
We performed a structured literature review of published studies from 2000-2007 that measured the acceptability and acceptance (uptake) of urine testing for C. trachomatis among asymptomatic men. Studies were categorized as three types: (a) non-STD clinic venues where men were approached in person and offered testing on site (urgent care clinics, freestanding clinics or health screening settings, corrections, community centers); (b) delivery of testing kits to men at their homes; and (c) qualitative measurement related to men's experience of screening. When offered in established nonhome-based settings (clinics, schools, corrections), acceptability and consequent uptake of testing by men is generally good (mid-60% range). However, acceptance rates even in these settings vary widely and are influenced by venue, provider, and a diversity of other factors. Acceptance of home-based testing invitations, including direct mailing of test kits, is considerably lower. Attitudinal characteristics of men who decline testing primarily include low self-perception of risk for asymptomatic infection and perceived inconvenience of providing test specimens. Given these findings, testing strategies targeting asymptomatic men in established community and clinic settings are most likely to yield relatively high acceptance rates. However, barriers to both implementation and uptake remain, even when such testing is free. Interventions to enhance uptake of testing in asymptomatic men should be developed and selected with underlying C. trachomatis population prevalence in mind.
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Trei JS, Canas LC, Gould PL. Reproductive tract complications associated with Chlamydia trachomatis infection in US Air Force males within 4 years of testing. Sex Transm Dis 2008; 35:827-33. [PMID: 18562984 DOI: 10.1097/olq.0b013e3181761980] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Chlamydia trachomatis (CT) is a common sexually transmitted infection for which young, sexually active persons are at highest risk. Health consequences such as orchitis/epididymitis, prostatitis, infertility, and urethral stricture have been described among CT-infected males, although not all of these are indisputably linked to CT. Current literature lacks population-based studies needed to examine these associations on a larger scale, to evaluate the true risk of developing complications after a CT infection. The US Air Force contains a large population of young, sexually active males, making it suitable for conducting such a study. METHODS We conducted a retrospective cohort study between 2001 and 2005 comparing the incidence of orchitis/epididymitis, prostatitis, infertility, and urethral stricture among male Air Force members with and without prior CT infections. Cumulative incidence rates were calculated and Cox proportional hazard models were generated to evaluate the risk of developing complications and to adjust for potential confounders. RESULTS Among 17,764 men enrolled in the study, 913 (5.14%) experienced a reproductive tract outcome. Among CT-positive men, cumulative incidences of orchitis/epididymitis, prostatitis, infertility, and urethral stricture were 4.28%, 1.41%, 1.27%, and 0.13%, respectively. Orchitis/epididymitis [Hazard ratio (HR) = 1.38 (1.13-1.70)] and "any" outcome [HR = 1.37 (1.16-1.61)] were positively associated with CT; infertility was marginally associated [HR = 1.36 (0.93-2.00)]. CONCLUSIONS Overall, the burden of reproductive health outcomes among Air Force males is small. Significant associations were observed between CT and both orchitis/epididymitis and any outcome; a larger cohort or longer follow-up may have detected a significant association between CT and infertility.
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Affiliation(s)
- Jill S Trei
- Air Force Institute for Operational Health, Brooks City-Base, Texas 78235, USA.
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Serovar-specific immune responses to peptides of variable regions of Chlamydia trachomatis major outer membrane protein in serovar D-infected women. Clin Exp Med 2008; 8:207-15. [DOI: 10.1007/s10238-008-0004-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2008] [Accepted: 06/10/2008] [Indexed: 10/21/2022]
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Cunningham KA, Carey AJ, Finnie JM, Bao S, Coon C, Jones R, Wijburg O, Strugnell RA, Timms P, Beagley KW. ORIGINAL ARTICLE: Poly-Immunoglobulin Receptor-Mediated Transport of IgA into the Male Genital Tract is Important for Clearance of Chlamydia muridarum Infection. Am J Reprod Immunol 2008; 60:405-14. [DOI: 10.1111/j.1600-0897.2008.00637.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Albay DT, Mathisen GE. Head and Neck Manifestations of Lymphogranuloma Venereum. EAR, NOSE & THROAT JOURNAL 2008. [DOI: 10.1177/014556130808700817] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Lymphogranuloma venereum (LGV)—caused by Chlamydia trachomatis serovars L1, L2, or L3—rarely occurs in the United States. The disease clinically manifests in three stages: primary, secondary, and tertiary. The primary manifestation, a self-limited genital ulcer at the site of inoculation, often is absent by the time the patient seeks medical attention. The most common clinical manifestation of LGV is evident in its secondary stage: unilateral tender inguinal and/or femoral lymphadenopathy. However, proctocolitis or inflammatory involvement of perirectal or perianal lymphatic tissues resulting in fistulas and strictures may also occur. The diagnosis of LGV is usually made serologically and by exclusion of other causes of inguinal lymphadenopathy or genital ulcers. Doxycycline is the preferred treatment; it cures the infection and prevents ongoing tissue damage. This case highlights an unusual manifestation of LGV infection—cervical lymphadenopathy following suspected oropharyngeal infection with C trachomatis. Head and neck manifestations of LGV may become an increasing problem in the future if sexual practices such as orogenital contact become more widespread.
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Affiliation(s)
- Diana T. Albay
- From the Department of Infectious Diseases, UCLA Medical Center, Los Angeles
| | - Glenn E. Mathisen
- Department of Infectious Diseases, Olive View Medical Center, Sylmar, Calif
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Williamson LM, Scott G, Carrick-Anderson K, Kernaghan K, Hart GJ. Chlamydia trachomatis testing among 13-25-year-olds in non-genitourinary medicine settings. ACTA ACUST UNITED AC 2008; 33:177-82. [PMID: 17609076 DOI: 10.1783/147118907781005083] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES In this paper we examine Chlamydia trachomatis testing in settings other than genitourinary medicine (GUM) clinics, focusing on the factors associated with chlamydial infection and with postal testing. METHODS Analysis of tests collected from young people aged 13-25 years (n = 4475) between May 2001 and June 2004 via postal testing kits, at a local sexual health clinic, and at further education colleges in Lothian, Scotland. RESULTS 84.8% of the testers were female and 15.2% were male. 84 men (12.3%, 95% CI 10.1-15.0) and 403 women (10.6%, 95% CI 9.7-11.6) tested positive. The odds of a positive result was nearly doubled for postal and clinic testers, relative to college testers; and increased by 70% for 16-19-year-olds, compared with 13-15-year-olds. Postal testing was the main source for men (80.2%) while 46.1% of women used postal and 48.1% used clinic testing. Postal testing was significantly associated with age, sex and National Health Service (NHS) board area, with odds increasing with age, and lower odds among females than males, and among Lothian residents than those outwith this NHS board area. CONCLUSIONS Substantial chlamydial infection was apparent among the young people in this study and positivity rates were highest among postal and clinic testers and those in the 16-19-year age group. While postal kits were the main source for men, and should be used to target them, the combination of this approach with continuing screening programmes in clinic settings would be most effective at targeting those most at risk.
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Affiliation(s)
- Lisa M Williamson
- Medical Research Council Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK. lisa@
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Anglès d'Auriac M, Refseth UH, Espelund M, Moi H, Størvold G, Jeansson S. A new automated method for isolation of Chlamydia trachomatis from urine eliminates inhibition and increases robustness for NAAT systems. J Microbiol Methods 2007; 70:416-23. [PMID: 17610971 DOI: 10.1016/j.mimet.2007.05.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2007] [Revised: 05/09/2007] [Accepted: 05/22/2007] [Indexed: 10/23/2022]
Abstract
Chlamydia trachomatis is a leading cause of sexually transmitted infection. Diagnostic methods with easy non-invasive sample collection are important to increase testing and hence to reduce the spread of this infection. To enable more use of urine samples in C. trachomatis diagnostics, automation is an absolute requirement since obtaining high-quality DNA from urine specimens involves extensive processing. Here, we present a study in which a new automated sample preparation method, BUGS'n BEADS STI (BnB STI), was used up-front of the BDProbeTec ET end point analysis and compared with the full BDProbeTec ET method to analyze C. trachomatis in 1002 urine samples. The BnB STI system represents a new concept within magnetic sample preparation in which bacteria are first isolated from the sample material followed by purification of bacterial nucleic acid using the same magnetic particles. Similar sensitivity and specificity were obtained with both methods. None of the samples processed with BnB STI inhibited the BDProbeTec ET test whereas 1.8% showed inhibition when processed according to the manual BDProbeTect ET DNA preparation method. Moreover, the average MOTA scores obtained with the BnB STI system were 48% higher for all amplification controls and 57% higher for positive samples, compared to the manual sample preparation. Based on these results and the significant reduction in hands-on-time for urine sample processing, the automated BnB STI sample preparation method was implemented for routine analysis of C. trachomatis from urine samples.
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Yu MC, Li LH, Tang LH, Chen KT. Genital chlamydial infection among male attendees at a sexually transmitted disease clinic in urban Taiwan. Public Health 2007; 121:534-9. [PMID: 17286995 DOI: 10.1016/j.puhe.2006.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2006] [Revised: 10/30/2006] [Accepted: 11/17/2006] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The aim of this study was to examine the epidemiology of genital Chlamydia trachomatis infection among male patients attending a sexually transmitted disease (STD) clinic in urban Taiwan. METHODS From July 2003 to June 2004, all male attendees at an STD clinic were invited to participate in this study. Attendees provided a first-void urine sample for examination for C. trachomatis using polymerase chain reaction (PCR) assay. RESULTS A total of 390 patients provided first-void urine specimens for testing for C. trachomatis. The overall prevalence of C. trachomatis was 17.7% (95% CI 16.3-19.1%). The age-specific prevalence was higher among patients aged under 20 years and lowest among those aged over 30 years. Approximately 40% of the infections were asymptomatic or subclinical. Younger age (aged <or= 30 years; adjusted odds ratio (AOR)=2.37, 95% confidence interval (CI)=1.31-4.34), inconsistent use of condoms (AOR=2.10, 95% CI=1.21-3.54), and being symptomatic at the time of testing (dysuria, urethral discharge, painful urination, urethral irritation/itching; AOR=2.05, 95% CI=1.16-3.40) were shown to be risk factors for C. trachomatis infection. CONCLUSIONS The prevalence of untreated asymptomatic chlamydial infection is high in young adults in Taipei. Young Taiwanese men attending STD clinics should be screened routinely for chlamydial infection.
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Affiliation(s)
- M-C Yu
- Department of Chemical Engineering, Tatung University, Taiwan
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Chen KT, Chen SC, Chiang CC, Li LH, Tang LH. Chlamydial infection among patients attending STD and genitourinary clinics in Taiwan. BMC Public Health 2007; 7:120. [PMID: 17593300 PMCID: PMC1914048 DOI: 10.1186/1471-2458-7-120] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2006] [Accepted: 06/25/2007] [Indexed: 11/23/2022] Open
Abstract
Background The main objective of this study is to examine the epidemiology of Chlamydia trachomatis (CT) infection amongst patients (473 men, 180 women) seen two hospitals in Taiwan. Methods Between July 2004 and June 2005, a total of 653 patients provided first-void urine samples for examination of CT using PCR assay. Results The overall prevalence of CT infection was 18.4% (95% confidence interval [CI] 17.3–19.5). Prevalence for men and women were 16.7 % (95% CI 15.3–18.0%) and 22.8% (95% CI 17.5–28.1%), respectively. Age group-specific prevalence was 25.7% (95% CI 22.5–28.9%) in < 20 year olds, 23.5% (95% CI 20.3–26.7%) in 20–24 year olds, 22.3% (95% CI 18.9–25.7%) in 25–30 year olds, and 11.5% (95% CI 10.3–12.7%) in > 30 year olds. Independent risk factors for chlamydial infection included younger age (aged ≤ 30 years) (adjusted odds ratio [AOR] = 2.44; 95% CI 1.52–3.84; p < 0.001), inconsistent condom use (AOR = 2.01; 95% CI 1.32–3.06; p < 0.001), being symptomatic (dysuria, urethral discharge) at the time of testing (AOR = 1.84; 95% CI 1.21–2.80; p < 0.001), and having N. gonorrhoeae infection (AOR = 3.82; 95% CI 2.20–6.58; p < 0.001). Conclusion Genital chlamydial infection is an important sexually transmitted disease in Taiwan. Young Taiwanese persons attending a STD clinic should be screened for CT infection and counselled on condom use.
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Affiliation(s)
- Kow-Tong Chen
- Department of Public Health, College of Medicine, National Cheng- Kung University, Tainan, Taiwan
| | - Shou-Chien Chen
- Department of Bioengineering, Tatung University, Tiapei, Taiwan
- Department of Family Medicine, Zhongxiao Branch, Taipei City Hospital, Taipei, Taiwan
| | | | - Lan-Hui Li
- Taipei City STD Control Center, Taipei, Taiwan
| | - Li-Hui Tang
- Center for Disease Control, Department of Health, Taipei, Taiwan
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Marrazzo JM, Ellen JM, Kent C, Gaydos C, Chapin J, Dunne EF, Rietmeijer CA. Acceptability of urine-based screening for Chlamydia trachomatis to asymptomatic young men and their providers. Sex Transm Dis 2007; 34:147-53. [PMID: 16924180 DOI: 10.1097/01.olq.0000230438.12636.eb] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE The objective of this study was to describe acceptability of urine chlamydia testing among asymptomatic men and providers' attitudes toward testing. STUDY DESIGN Asymptomatic men (no urethral discharge/dysuria) were offered free testing and characteristics of men who accepted were compared with those who declined. Acceptability logs tallied the proportion who accepted, and a standardized survey was administered to providers at study's end. RESULTS Median acceptance was 64% (range, 8-100%). Men accepting were younger and more likely to be in adolescent primary care or detention, to report higher numbers of recent partners, no prior sexually transmitted disease, time to last healthcare visit >1 year, and to have received an incentive. Provider-reported barriers to testing included difficulty in conveying importance of testing to asymptomatic men (65%) and time constraints (24%). CONCLUSIONS Asymptomatic men are likely to accept testing depending on venue and approach. However, barriers exist for men and providers, even when testing is free.
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Affiliation(s)
- Jeanne M Marrazzo
- Department of Medicine, Division of Infectious Diseases, Harborview Medical Center, University of Washington, 325 Ninth Avenue, Seattle, WA 98104, USA.
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Van der Pol B. Trichomonas vaginalis infection: the most prevalent nonviral sexually transmitted infection receives the least public health attention. Clin Infect Dis 2006; 44:23-5. [PMID: 17143810 DOI: 10.1086/509934] [Citation(s) in RCA: 105] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2006] [Accepted: 09/18/2006] [Indexed: 11/03/2022] Open
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Trick WE, Kee R, Murphy-Swallow D, Mansour M, Mennella C, Raba JM. Detection of Chlamydial and Gonococcal Urethral Infection During Jail Intake: Development of a Screening Algorithm. Sex Transm Dis 2006; 33:599-603. [PMID: 16540885 DOI: 10.1097/01.olq.0000204509.42307.f5] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To determine risk factors for chlamydial or gonococcal urethral infection among adult male detainees at Cook County Jail. To develop a screening algorithm with high sensitivity and specificity for detection of urethral infection. STUDY DESIGN We interviewed adult male detainees and tested them for chlamydial or gonococcal urethral infection during jail intake from June 24 through July 29, 2004. We supplemented the cross-sectional survey with a nested case-control study. RESULTS We screened 5,634 (93%) of 6,028 detainees; 348 (6.2%) had chlamydial or gonococcal urethral infection. Interviews were completed and collected for 35%. By multivariable analysis, infected detainees were more likely to be <31 years of age, have more than 6 sex partners in the previous 12 months, or have symptoms. Age less than 31 years or symptoms would have identified 73% of infected detainees while screening only 50%. CONCLUSIONS A simple algorithm that included age and symptoms best identified detainees at increased risk for chlamydial or gonococcal urethral infection.
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Affiliation(s)
- William E Trick
- Collaborative Research Unit, John H. Stroger Hospital of Cook County, Chicago, Illinois 60612, USA.
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Abstract
Health professionals are frequently reluctant to recognize or investigate the sexuality of their older patients. Thus, sexual health may never be addressed, even among older adults who come into frequent contact with health care professionals. As the dominant culture continues to shift toward a more realistic view of aging that supports the expression of sexuality among older adults, evaluation of sexual health will become a critical component of comprehensive assessment of the geriatric patient. This article reviews the clinical features and management of common sexually transmitted diseases in the older adult.
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Affiliation(s)
- Margaret-Mary G Wilson
- Division of Geriatric Medicine, St Louis University Health Sciences Center, 1402 South Grand Boulevard, Room M238, St. Louis, MO 63104, USA.
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Sternak SL, Kruzic V, Cavlek TV, Skerk V. Chlamydia trachomatis infection in Croatian symptomatic and asymptomatic men. ACTA ACUST UNITED AC 2006. [DOI: 10.1016/j.jmhg.2005.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Pal S, Peterson EM, de la Maza LM. Vaccination with the Chlamydia trachomatis major outer membrane protein can elicit an immune response as protective as that resulting from inoculation with live bacteria. Infect Immun 2006; 73:8153-60. [PMID: 16299310 PMCID: PMC1307068 DOI: 10.1128/iai.73.12.8153-8160.2005] [Citation(s) in RCA: 136] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BALB/c mice were vaccinated by the intramuscular (i.m.) and subcutaneous (s.c.) routes with a native preparation of the Chlamydia trachomatis mouse pneumonitis (MoPn) major outer membrane protein (MOMP), using Montanide ISA 720 and CpG-1826 as adjuvants. A negative control group was immunized with ovalbumin and the two adjuvants, and a positive control group was immunized intranasally (i.n.) with 10(4) inclusion-forming units (IFU) of C. trachomatis. Four weeks after the last i.m.-plus-s.c. immunization, mice were challenged in the ovarian bursa with 10(5) IFU of C. trachomatis MoPn. Six weeks after the genital challenge, animals were mated, and the pregnancies were monitored. After vaccination with MOMP, the mice developed strong Chlamydia-specific humoral and cellular immune responses. Following the genital challenge, of the mice vaccinated with the MOMP, only 15% (3/20) had positive vaginal cultures, while 85% (17/20) of the animals immunized with ovalbumin had positive cultures over the 6 weeks of observation (P < 0.05). Also, only 14% (3/21) of the animals inoculated i.n. with Chlamydia had positive vaginal cultures. After mating, 75% (15/20) of the mice vaccinated with MOMP carried embryos in both uterine horns. Of the animals vaccinated i.n. with the Chlamydia, 81% (17/21) had embryos in both uterine horns (P > 0.05). In contrast, only 10% (2/20) of the mice immunized with ovalbumin had embryos in both uterine horns (P < 0.05). In conclusion, immunization with a purified preparation of the MOMP is as effective as vaccination with viable C. trachomatis in eliciting a protective immune response against a genital challenge in mice.
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Affiliation(s)
- Sukumar Pal
- Department of Pathology and Laboratory Medicine, Medical Sciences I, Room D440, University of California, Irvine, Irvine, CA 92697-4800, USA
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Bakken IJ, Nordbø SA, Skjeldestad FE. 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. Sex Transm Dis 2006; 33:26-30. [PMID: 16385219 DOI: 10.1097/01.olq.0000187929.36118.d2] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE 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. GOAL The goal of this study was to obtain data for recommendations regarding CT screening. STUDY DESIGN Laboratory data on CT tests for persons 15 to 24 years old were retrieved and analyzed. RESULTS 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. CONCLUSIONS More men and more female teenagers need to be tested. Repeat testing is particularly important among people who have been diagnosed with CT.
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Daniels NA, Ewing SK, Zmuda JM, Wilt TJ, Bauer DC. Correlates and prevalence of prostatitis in a large community-based cohort of older men. Urology 2005; 66:964-70. [PMID: 16286104 DOI: 10.1016/j.urology.2005.05.034] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2005] [Revised: 04/26/2005] [Accepted: 05/13/2005] [Indexed: 01/02/2023]
Abstract
OBJECTIVES To describe the prevalence and correlates of self-reported history of prostatitis in terms of lower urinary tract symptoms and associated dissatisfaction in community-dwelling older men. METHODS We performed a cross-sectional analysis from a prospective cohort study of 5821 men aged 65 years and older recruited from six clinical centers. RESULTS Overall, 1439 men (25%) self-reported a history of prostatitis. Men with a history of prostatitis were more likely to self-report a history of prostate cancer (26% versus 7%; P < 0.0001) and a history of benign prostatic hyperplasia (83% versus 38%; P < 0.0001) within a lifetime compared with men without a history of prostatitis. Men with a history of prostatitis also had a greater mean American Urological Association symptom score (mean +/- SD, 10.1 +/- 7.1 versus 7.7 +/- 5.9; P < 0.0001) than men without a history of prostatitis. Also, a greater percentage of men with a history of prostatitis reported being dissatisfied with their present urinary condition than did men without a history of prostatitis (21% versus 11%; P < 0.0001). We found positive associations for a history of prostatitis with a history of benign prostatic hyperplasia (odds ratio 8.0, 95% confidence interval 6.8 to 9.5), a history of prostate cancer (odds ratio 5.4, 95% confidence interval 4.4 to 6.6), and dissatisfaction with current urinary condition (odds ratio 1.2, 95% confidence interval 1.01 to 1.5). CONCLUSIONS A self-reported history of prostatitis is common in older men and was associated with self-reported prostate cancer and benign prostatic hyperplasia and increased severity of lower urinary tract symptoms and associated dissatisfaction. Because of the potential detection bias, recall bias, and the cross-sectional nature of the study, limiting causal inference, the associations among these urologic conditions require additional study.
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Affiliation(s)
- Nicholas A Daniels
- Division of General Internal Medicine, Department of Medicine, University of California, School of Medicine, San Francisco, California 94115, USA.
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Affiliation(s)
- Catherine Stevens-Simon
- Department of Pediatrics, Division of Adolescent Medicine, University of Colorado Health Sciences Center, Denver, 80218, USA.
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Golden MR, Manhart LE. Innovative Approaches to the Prevention and Control of Bacterial Sexually Transmitted Infections. Infect Dis Clin North Am 2005; 19:513-40. [PMID: 15963886 DOI: 10.1016/j.idc.2005.03.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Bacterial STI continues to be a major problem in developed nations. Research and evolving standards of public health practice are cause for optimism and concern. Innovations in case-finding and treatment, particularly the application of NAATs to test for chlamydial infection in nonclinical settings, are successes that merit more widespread application. EPT, selective STI screening in men, and rescreening are all promising, but are not yet in widespread use and may face significant operational barriers. To date, public health efforts to alter sexual behavior, at least through specific interventions, are more discouraging. Although some behavioral interventions have been effective, none has been widely instituted. Moreover, the likelihood that existing behavioral interventions will be widely applied seems remote. Future research efforts in this area will need to focus less on proof-of-concept efficacy trials and more on developing and testing sustainable, cost-effective interventions that focus on those at greatest risk and that can be scaled-up within the existing public health infrastructure.
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Affiliation(s)
- Matthew R Golden
- Center for AIDS and STD, University of Washington, Harborview Medical Center, 325 9th Avenue, Box 359777, Seattle, WA 98104, USA.
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Levidiotou S, Vrioni G, Papadogeorgaki H, Avdeliodi K, Kada H, Kaparos G, Kouskouni E, Fragouli E, Legakis NJ. Chlamydia trachomatis infections in Greece: first prevalence study using nucleic acid amplification tests. Eur J Clin Microbiol Infect Dis 2005; 24:207-13. [PMID: 15776253 DOI: 10.1007/s10096-005-1296-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The present retrospective study was initiated to determine the prevalence of Chlamydia trachomatis and to assess the risk factors for infection in adult women and men presenting to general practitioners, gynecologists, dermatologists, and family-planning centers in Greece. The study was carried out in four different Greek hospital centers using highly sensitive nucleic acid amplification techniques. Altogether, 16,834 women and 1,035 men were enrolled from October 1998 to April 2004. Two types of specimens were collected from each patient: cervical swabs from women, urethral swabs from men, and first-catch urine from women and men. All specimens were examined with the Cobas Amplicor C. trachomatis polymerase chain reaction assay (Roche Molecular Systems, Branchburg, NJ, USA) or the LC x C. trachomatis ligase chain reaction assay (Abbott Laboratories, Abbott Park, IL, USA). Demographic and behavioral data were collected by clinicians using a standardized questionnaire. A total of 704 (3.9%) patients were infected with C. trachomatis. The prevalence among female patients was 3.5% and that among male patients 11.2%. Among infected patients, 88% were under 30 years of age, 71% reported more than one sexual partner, and 91% reported a new sexual partner within the last year. In conclusion, the prevalence of C. trachomatis infection in Greece is low. Young age and new and multiple sexual partners within the last year were factors consistently associated with an increased risk of chlamydial infection.
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Affiliation(s)
- S Levidiotou
- Department of Microbiology, Medical School, University of Ioannina, 45110, Ioannina, Greece.
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Fioravante FCR, Costa Alves MDF, Guimarães EMDB, Turchi MD, Freitas HAG, Domingos LT. Prevalence of Chlamydia trachomatis in Asymptomatic Brazilian Military Conscripts. Sex Transm Dis 2005; 32:165-9. [PMID: 15729153 DOI: 10.1097/01.olq.0000152897.44969.02] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Few data are available on the prevalence and risk factors for Chlamydia trachomatis infection among young men in Brazil. OBJECTIVES To assess prevalence and risk factors for C. trachomatis infection in male military conscripts. METHODS In 2000, 627 young men recruited for military service in Goiania, Goias, Brazil, were enrolled in this cross-sectional study. Participants completed a demographic and sexual risk behavior questionnaire, and urine samples were screened for C. trachomatis by polymerase chain reaction. RESULTS The prevalence of chlamydial infection among asymptomatic conscripts was 5.0% (95% confidence interval [CI], 3.3-7.3). In multivariate analysis, failure to use condoms (odds ratio [OR](adjusted) 5.3; 95% confidence interval [CI], 1.2-23.4; P = 0.028) and having more than 2 sexual partners in the last 2 months (OR(adjusted) 2.6; 95% CI, 1.1-6.9; P = 0.049) were significantly associated with positivity for C. trachomatis. CONCLUSIONS A substantial number of asymptomatic young male military recruits were infected with C. trachomatis, and risk factors for this infection were related to sexual behavior. Further research is required to determine if routine screening may be considered as a strategy to reduce prevalence among this population.
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Hocking J, Fairley CK. Do the characteristics of sexual health centre clients predict chlamydia infection sufficiently strongly to allow selective screening? Sex Health 2005; 2:185-92. [PMID: 16335546 DOI: 10.1071/sh05011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Objectives: This study aimed to estimate chlamydia prevalence and risk factors for infection and to assess the performance of chlamydia-selective screening criteria among clients attending a large sexually transmitted infection (STI) clinic. Methods: Computerised records for all attendances between 1 July 2002 and 30 June 2003 were analysed. Chlamydia prevalence and risk factors for infection were determined for all new clients. The sensitivity and specificity of risk factors for chlamydia were assessed. Results: 2642 male and 2084 female new clients were tested for chlamydia with a prevalence of 7.3% (95% CI: 6.3%, 8.4%) among men and 3.9% (95% CI: 3.1%, 4.9%) among women. Screening heterosexual men based on a positive contact or symptoms of non-specific urethritis or any two of age < 25 years, 4+ partners last 12 months, inconsistent condom use or not presenting for an asymptomatic screen detected 88% of infections by screening 62%. Screening women based on a positive contact or injecting drug use or any two of age < 25 years, 2+ partners last 12 months or inconsistent condom use would detect 86% of infections by screening 57%. Conclusions: Selective screening could be used to more efficiently identify heterosexual men and women at risk of chlamydia.
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Affiliation(s)
- Jane Hocking
- Macfarlane Burnet Institute for Medical Research and Public Health, Melbourne, Australia.
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Pal S, Peterson EM, de la Maza LM. New murine model for the study of Chlamydia trachomatis genitourinary tract infections in males. Infect Immun 2004; 72:4210-6. [PMID: 15213165 PMCID: PMC427456 DOI: 10.1128/iai.72.7.4210-4216.2004] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The lack of an experimental model has significantly limited the understanding of the pathogenesis of Chlamydia trachomatis infections in males. In an attempt to establish a model using the natural route of infection, we inoculated male mice in the meatus urethra. To establish the 50% infectious dose (ID(50)), C3H/HeN (H-2(k)) male mice were inoculated in the meatus urethra with doses ranging from 10(1) to 10(7) inclusion-forming units (IFU) of C. trachomatis mouse pneumonitis biovar (MoPn) and were euthanized at 10 days postinfection (p.i.). Approximately 50% of the animals inoculated with 5 x 10(4) IFU had positive cultures of the urethra, urinary bladder, epididymides, and/or testes. Subsequently, to characterize the course of the infection, a group of animals was inoculated with 10(6) IFU/mouse (20 times the ID(50)). Positive cultures from the urethra, urinary bladder, epididymides, and testes were obtained from the animals. The infection peaked in the first 2 weeks p.i. and subsequently declined over the 7 weeks of observation. C. trachomatis-specific antibodies were first detected in serum by 2 weeks p.i. and rose over the period of observation. The titers of immunoglobulin G2a (IgG2a) were 16-fold higher than those of IgG1. A lymphoproliferative assay using splenocytes and local lymph nodes showed a strong cell-mediated immune response. Levels of gamma interferon were significantly higher than those of interleukin-4 in the supernatants from stimulated lymphocytes. An acute inflammatory infiltrate consisting of polymorphonuclear leukocytes was detected in the urethra at 1 week p.i. At 3 weeks p.i., a mixed acute and chronic inflammatory infiltrate was observed in the urethra that by 5 to 6 weeks was mainly composed of mononuclear cells. Similar findings were also observed in the urinary bladder, although the inflammatory infiltrate was delayed by approximately a week relative to that in the urethra. Sections of the epididymides showed a focal acute inflammatory infiltrate at 2 weeks p.i. Immunohistochemical staining demonstrated multiple chlamydial inclusions in the epithelium of the urethra and urinary bladder. No chlamydial inclusions were observed in the epididymides or testes. In conclusion, inoculation of male mice in the meatus urethra with C. trachomatis MoPn results in an infection of the genitourinary tract that closely parallels that described in humans. This model should help to characterize the pathogenesis of chlamydial infections in males and to test therapeutic and preventive measures.
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Affiliation(s)
- Sukumar Pal
- Department of Pathology, Medical Sciences, Room D440, University of California-Irvine, Irvine, CA 92697-4800, USA
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Affiliation(s)
- Jeffrey F Peipert
- Division of Research, Department of Obstetrics and Gynecology and Community Health, Brown University Medical School and the Women and Infants Hospital, Providence, RI 02905, USA.
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