Conventional tissue culture compared with rapid immunofluorescence for identifying Chlamydia trachomatis in specimens from patients attending a genitourinary clinic

Urogenital Chlamydia trachomatis in Gabon: an unrecognised epidemic

Samples from 218 men with urethritis, 517 women with pelvic pain or pelvic pain and vaginal discharge, 218 women consulting for infertility, and 598 postpartal women were screened for Chlamydia trachomatis by culture and direct immunofluorescence. Chlamydiae were detected in 18% (39/218) of the men, 18% (45/252) of women with vaginal discharge, 14% (38/265) of those with pelvic pain, 10% (21/218) of infertile, and 10% (59/598) of postpartal women. A chlamydial prevalence of 18% (41) was observed in 229 postpartal women aged under 21, whereas only 5% (10) of 360 postpartal women over 21 had C trachomatis. In the other clinical groups, an age related decrease in prevalence was noted in women over 25. The direct immunofluorescence test correlated well with culture. The small difference in isolation between symptomatic and postpartal women indicates that women in this population do not seek medical attention for chlamydial infections and expose themselves to chlamydial salpingitis and infertility.

Transmission of chlamydial infections to sexual partners

The incidence of chlamydial infections was studied in 33 male and 48 female regular sexual partners of 81 patients attending a sexually transmitted disease clinic who had chlamydial infections. Chlamydia trachomatis was isolated from 42% of the male partners and 62% of the female partners (p greater than 0.05). The number of infected partners was independent of the incidence of sexual intercourse and of the presenting symptoms. The use of condoms was the only contraceptive method that seemed to lower the risk of transmission of chlamydial infection. If diagnostic facilities for C trachomatis are not available, and sexual partners of patients with chlamydial infection are treated epidemiologically, a high proportion of both men and women may be treated unnecessarily.

Chlamydia trachomatis as a cause of neonatal conjunctivitis

Chlamydia trachomatis was identified in 37 of 73 consecutive neonates with purulent conjunctivitis, including four delivered by caesarean section with intact membranes. Most (28/37) presented in the first week. Infection was significantly associated with referral from the community. Genital C. trachomatis infection was present in 13 of 35 parents of affected infants.