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Campaner AB, de Castro MA, Lucarelli AP. Chlamydia trachomatis prevalence in females in São Paulo, Brazil: 11 years' surveillance of the infection. Braz J Microbiol 2023; 54:151-158. [PMID: 36574206 PMCID: PMC9944148 DOI: 10.1007/s42770-022-00865-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 10/29/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Chlamydia trachomatis (CT) infection is the most prevalent sexually transmitted bacterial disease worldwide whose greatest impact is on the female reproductive system. The objective was to assess the prevalence of Chlamydia infection in a large population of female patients from a private health service in São Paulo (Brazil), identifying the main age groups affected by the agent and the evolution of the prevalence. METHODS A cross-sectional study was conducted based on the results of all molecular biology tests. The tests were carried out between January 2005 and December 2015. The positivity of test results was determined by year and age group. RESULTS A total of 85,292 patients who performed 103,576 tests for Chlamydia were considered eligible for the statistical data. The overall prevalence of C. trachomatis infection in the study population was 2.2% (95% CI: 2.07-2.25). A higher prevalence of infection was observed in the ≤ 25 years and ≤ 30 years age groups, with rates of 6.0% (95% CI: 5.59-6.35) and 4.4% (95% CI: 4.08-4.50), respectively. There was a significant increase in the positivity of the exams over time, especially in the ≤ 35 years age group. The prevalence at 26-30 years was 3.1% (95% CI: 2.82-3.30); 31-35 years 1.7% (95% CI: 1.50-1.82); 36-40 years 1.0% (95% CI: 0.86-1.16); 41-60 years 0.6% (95% CI: 0.50-0.70) and the prevalence at ≥ 61 years was 0.4% (95% CI: 0.11-0.75). CONCLUSION The screening of asymptomatic young women would have the potential to reduce infection, transmission, and sequelae of infection by this agent.
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Affiliation(s)
- Adriana Bittencourt Campaner
- Department of Gynecology and Obstetrics, Santa Casa de São Paulo Medical School, Rua Dr Cesário Mota Jr, 112 - Vila Buarque, São Paulo, 01221- 020 Brazil
| | - Marco Antonio de Castro
- Department of Gynecology and Obstetrics, Santa Casa de São Paulo Medical School, Rua Dr Cesário Mota Jr, 112 - Vila Buarque, São Paulo, 01221- 020 Brazil
| | - Adrienne Pratti Lucarelli
- Department of Gynecology and Obstetrics, Santa Casa de São Paulo Medical School, Rua Dr Cesário Mota Jr, 112 - Vila Buarque, São Paulo, 01221- 020 Brazil
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Evers YJ, van Liere GAFS, Dukers-Muijrers NHTM, van Bergen J, Kuizenga-Wessel S, Hoebe CJPA. Routine universal testing versus selective or incidental testing for oropharyngeal Chlamydia trachomatis in women in the Netherlands: a retrospective cohort study. THE LANCET. INFECTIOUS DISEASES 2022; 22:552-561. [PMID: 34919829 DOI: 10.1016/s1473-3099(21)00465-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 06/29/2021] [Accepted: 07/27/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Pharyngeal Chlamydia trachomatis in women might contribute to autoinoculation and transmission to sexual partners. Data for effectiveness of different testing practices for pharyngeal C trachomatis are scarce. We therefore aimed to assess the prevalence of pharyngeal C trachomatis, determinants, and effectiveness of different testing practices in women. METHODS We did a retrospective cohort study, in which surveillance data for all women visiting sexually transmitted infection clinics in all regions in the Netherlands between Jan 1, 2008, and Dec 31, 2017, were used. We collected consultation-level data and individual-level data from 2016 onwards for sociodemographic characteristics, sexual behaviour in the past 6 months, self-reported symptoms, and STI diagnoses. The primary outcome was the positivity rate of pharyngeal C trachomatis infection compared between routine universal testing (>85% tested pharyngeally per clinic year), selective testing (5-85% tested pharyngeally per clinic year), and incidental testing (<5% pharyngeally tested per clinic year). We calculated the number of missed infections by extrapolating the positivity rate assessed by routine universal testing to all selectively tested women. We used multivariable generalised estimating equations logistic regression analyses to assess independent risk factors for pharyngeal C trachomatis and used the assessed risk factors as testing indicators for comparing alternative testing scenarios. FINDINGS Between Jan 1, 2008, and Dec 31, 2017, a total of 550 615 consultations with at least one C trachomatis test was recorded, of which 541 945 (98·4%) consultations (including repeat visits) were included in this analysis. Pharyngeal C trachomatis positivity was lower in the routine universal testing group than in the selective testing group (1081 [2·4%; 95% CI 2·2-2·5] of 45 774 vs 3473 [2·9%; 2·8-3·0] of 121 262; p<0·0001). The positivity rate was also higher among consultations done in the incidental testing group (44 [4·1%; 95% CI 3·1-5·5] of 1073; p<0·0001) than in the routine universal testing group. Based on extrapolation, selective testing would have hypothetically missed 64·4% (95% CI 63·5-65·3; 6363 of 9879) of the estimated total of C trachomatis infections. The proportion of pharyngeal-only C trachomatis was comparable between routinely universally tested women (22·9%) and selectively tested women (20·4%), resulting in a difference of 2·5% (95% CI -0·3 to 5·3; p=0·07). When using risk factors for pharyngeal C trachomatis as testing indicators, 15 484 (79·6%) of 19 459 women would be tested to detect 398 (80·6%) of 494 infections. INTERPRETATION No optimal testing scenario was available for pharyngeal C trachomatis, in which only a selection of high-risk women needs to be tested to find most pharyngeal C trachomatis infections. The relative low prevalence of pharyngeal-only C trachomatis (0·5%) and probably limited clinical and public health effect do not provide support for routine universal testing. FUNDING Public Health Service South Limburg.
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Affiliation(s)
- Ymke J Evers
- Department of Sexual Health, Infectious Diseases and Environmental Health, South Limburg Public Health Service, Heerlen, Netherlands; Department of Social Medicine and Medical Microbiology, School of Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, Netherlands.
| | - Geneviève A F S van Liere
- Department of Sexual Health, Infectious Diseases and Environmental Health, South Limburg Public Health Service, Heerlen, Netherlands; Department of Social Medicine and Medical Microbiology, School of Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Nicole H T M Dukers-Muijrers
- Department of Sexual Health, Infectious Diseases and Environmental Health, South Limburg Public Health Service, Heerlen, Netherlands; Department of Health Promotion, School of Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Jan van Bergen
- Faculty of Medicine, University of Amsterdam, Amsterdam, Netherlands
| | | | - Christian J P A Hoebe
- Department of Sexual Health, Infectious Diseases and Environmental Health, South Limburg Public Health Service, Heerlen, Netherlands; Department of Social Medicine and Medical Microbiology, School of Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, Netherlands
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Bancalari P, Nicholas C, Halpern M, Stonbraker S, Taylor B, Soriano L, Ljubicic D, Amesty S. High prevalence of rectal chlamydia among pregnant adolescents in La Romana, Dominican Republic warrants extragenital STI testing. Int J STD AIDS 2021; 33:31-37. [PMID: 34565231 DOI: 10.1177/09564624211043082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
To our knowledge, there are no studies estimating the prevalence of extragenital sexually transmitted infections (STIs) among pregnant adolescents in the Caribbean. This study sought to fill this gap by assessing the prevalence and correlates of oral, genital, and rectal chlamydia (CT) among a sample of pregnant adolescents in La Romana, Dominican Republic. Two hundred pregnant youths, aged 15-24 years, were recruited by systematic sampling during their first prenatal visit to a maternal care unit. A sociodemographic and behavioral questionnaire was administered and urine and oral/anal swabs were collected and tested for CT. Descriptive analyses and Fisher's exact tests were performed. The prevalence of oral, genital, and rectal CT was 6%, 15%, and 23%, respectively, although less than 5% of participants reported ever engaging in receptive anal intercourse. This discrepancy could be explained by autoinoculation, concurrent transmission during sex, undertreatment of rectal CT, or underreporting of anal sex. Almost half of CT infections would have been missed if only genital samples were collected, as current protocol dictates. More research is needed to understand sexual behaviors and rectal STI risk factors among heterosexual adolescent women. STI screening procedures for pregnant and sexually active adolescents should include routine testing of extragenital sites.
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Affiliation(s)
- Pilar Bancalari
- 33638Columbia University Mailman School of Public Health, New York, NY, USA
| | - Catherine Nicholas
- 12294Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Mina Halpern
- Clínica de Familia La Romana, La Romana, Dominican Republic
| | - Samantha Stonbraker
- 129263University of Colorado College of Nursing, Anschutz Medical Campus, Aurora, CO, USA
| | - Barbara Taylor
- University of Texas Health Science Center San Antonio, San Antonio, TX, USA
| | - Leidy Soriano
- Clínica de Familia La Romana, La Romana, Dominican Republic
| | - Dana Ljubicic
- 236434Columbia University School of General Studies, New York, NY, USA
| | - Silvia Amesty
- 33638Columbia University Mailman School of Public Health, New York, NY, USA
- 12294Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- 5798Columbia University Irving Medical Center, New York, NY, USA
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Ureaplasma urealyticum and U. parvum in sexually active women attending public health clinics in Brazil. Epidemiol Infect 2017. [PMID: 28637523 DOI: 10.1017/s0950268817001145] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Ureaplasma urealyticum and U. parvum have been associated with genital infections. The purpose of this study was to detect the presence of ureaplasmas and other sexually transmitted infections in sexually active women from Brazil and relate these data to demographic and sexual health, and cytokines IL-6 and IL-1β. Samples of cervical swab of 302 women were examined at the Family Health Units in Vitória da Conquista. The frequency of detection by conventional PCR was 76·2% for Mollicutes. In qPCR, the frequency found was 16·6% for U. urealyticum and 60·6% U. parvum and the bacterial load of these microorganisms was not significantly associated with signs and symptoms of genital infection. The frequency found for Trichomonas vaginalis, Neisseria gonorrhoeae, Gardnerella vaginalis and Chlamydia trachomatis was 3·0%, 21·5%, 42·4% and 1·7%, respectively. Higher levels of IL-1β were associated with control women colonized by U. urealyticum and U. parvum. Increased levels of IL-6 were associated with women who exhibited U. parvum. Sexually active women, with more than one sexual partner in the last 3 months, living in a rural area were associated with increased odds of certain U. parvum serovar infection.
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Lee G. Chronic Prostatitis: A Possible Cause of Hematospermia. World J Mens Health 2015; 33:103-8. [PMID: 26331127 PMCID: PMC4550592 DOI: 10.5534/wjmh.2015.33.2.103] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 05/06/2015] [Accepted: 05/08/2015] [Indexed: 11/15/2022] Open
Abstract
Purpose While hematospermia is mainly caused by genitourinary inflammatory disorders, very few studies have been published on prostatitis-associated hematospermia (PAH) diagnosed using robust prostatitis evaluation methods. Therefore, we have evaluated the incidence of PAH by using systematic methods for evaluating prostatitis. Materials and Methods We evaluated 37 hematospermia patients from a single hospital over the last five years. We classified the patients into PAH versus hematospermia without any evidence of prostatitis (HWP) by using a NIH-Chronic Prostatitis Symptom Index questionnaire and expressed prostatic secretion studies. Results The mean age was 55.89±14.87 years, and the patients were grouped into two groups: one group had 12 HWP patients and the other 25 PAH patients. PAH patients were further sub-classified: chronic bacterial prostatitis (3 patients), chronic nonbacterial prostatitis (10 patients), prostadynia (7 patients), and asymptomatic prostatitis (5 patients). We found Enterococcus faecalis in the three chronic bacterial prostatitis patients. We could not find any statistically significant difference between the PAH and the HWP groups in terms of the age interval, serum prostate-specific antigen level, and prostate volume. Even though there was no statistically significant difference in the items about urination between the two groups, we found a statistically significant difference in the quality of life (QoL) impact for the patients in this study. Conclusions Two-thirds of the hematospermia patients were associated with some evidence of prostatitis. Further, the patients with PAH revealed poor QoL compared with the patients with HWP. Therefore, we must evaluate the presence of prostatitis in hematospermia patients and alleviate the prostatitis-associated symptoms to improve their QoL.
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Affiliation(s)
- Gilho Lee
- Department of Urology, Dankook University Medical College, Cheonan, Korea
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Peuchant O, Le Roy C, Desveaux C, Paris A, Asselineau J, Maldonado C, Chêne G, Horovitz J, Dallay D, de Barbeyrac B, Bébéar C. Screening for Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycoplasma genitalium should it be integrated into routine pregnancy care in French young pregnant women? Diagn Microbiol Infect Dis 2015; 82:14-9. [PMID: 25753079 DOI: 10.1016/j.diagmicrobio.2015.01.014] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 01/23/2015] [Accepted: 01/27/2015] [Indexed: 12/17/2022]
Abstract
Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycoplasma genitalium screening during pregnancy is not performed routinely in France. We conducted the first prospective study in 1004 women attending for routine antenatal care to determine the prevalence and risk factors for these bacterial infections. The overall prevalence of C. trachomatis, N. gonorrhoeae, and M. genitalium infections was 2.5%, 0%, and 0.8%, respectively. In patients aged 18-24 years, the prevalence increased to 7.9% for C. trachomatis and to 2.4% for M. genitalium. C. trachomatis infection was associated with age ≤24 years or being single or having more than 5 sexual partners in a lifetime. M. genitalium infection was more frequent in patients aged ≤24 years or who had a history of abortion or their first sexual intercourse after 20 years of age. The high prevalence of C. trachomatis in pregnant women aged ≤24 years, mostly asymptomatic, suggests that systematic screening could be beneficial.
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Affiliation(s)
- O Peuchant
- Univ. Bordeaux, USC EA 3671 Mycoplasmal and Chlamydial Infections in Humans, 33076 Bordeaux, France; INRA, USC EA 3671 Mycoplasmal and Chlamydial Infections in Humans, 33076 Bordeaux, France; Centre Hospitalier Universitaire de Bordeaux, Laboratoire de Bactériologie, 33076 Bordeaux, France.
| | - C Le Roy
- Univ. Bordeaux, USC EA 3671 Mycoplasmal and Chlamydial Infections in Humans, 33076 Bordeaux, France; INRA, USC EA 3671 Mycoplasmal and Chlamydial Infections in Humans, 33076 Bordeaux, France
| | - C Desveaux
- Centre Hospitalier Universitaire de Bordeaux, Service de Gynécologie Obstétrique, 33076 Bordeaux, France
| | - A Paris
- Centre Hospitalier Universitaire de Bordeaux, Service de Gynécologie Obstétrique, 33076 Bordeaux, France
| | - J Asselineau
- Centre Hospitalier Universitaire de Bordeaux, Unité de Soutien Méthodologique à la Recherche Clinique et Epidémiologique, 33076 Bordeaux, France
| | - C Maldonado
- Centre Hospitalier Universitaire de Bordeaux, Unité de Soutien Méthodologique à la Recherche Clinique et Epidémiologique, 33076 Bordeaux, France
| | - G Chêne
- Centre Hospitalier Universitaire de Bordeaux, Unité de Soutien Méthodologique à la Recherche Clinique et Epidémiologique, 33076 Bordeaux, France
| | - J Horovitz
- Centre Hospitalier Universitaire de Bordeaux, Service de Gynécologie Obstétrique, 33076 Bordeaux, France
| | - D Dallay
- Centre Hospitalier Universitaire de Bordeaux, Service de Gynécologie Obstétrique, 33076 Bordeaux, France
| | - B de Barbeyrac
- Univ. Bordeaux, USC EA 3671 Mycoplasmal and Chlamydial Infections in Humans, 33076 Bordeaux, France; INRA, USC EA 3671 Mycoplasmal and Chlamydial Infections in Humans, 33076 Bordeaux, France; Centre Hospitalier Universitaire de Bordeaux, Laboratoire de Bactériologie, 33076 Bordeaux, France
| | - C Bébéar
- Univ. Bordeaux, USC EA 3671 Mycoplasmal and Chlamydial Infections in Humans, 33076 Bordeaux, France; INRA, USC EA 3671 Mycoplasmal and Chlamydial Infections in Humans, 33076 Bordeaux, France; Centre Hospitalier Universitaire de Bordeaux, Laboratoire de Bactériologie, 33076 Bordeaux, France
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Lavorato HL, Moço NP, Martin LF, Santos AGP, Pontes A, Duarte MTC, Silva MGD. Screenning of <i>Chlamydia trachomatis</i> Infection among Women Attending Outpatient Clinic of Infertility. ACTA ACUST UNITED AC 2015. [DOI: 10.4236/ojog.2015.511085] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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de Lima YAR, Turchi MD, Fonseca ZC, Garcia FLB, de Brito e Cardoso FA, da Guarda Reis MN, de Britto Guimarães EM, Alves RRF, Carvalho NR, de Fátima Costa Alves M. Sexually transmitted bacterial infections among young women in Central Western Brazil. Int J Infect Dis 2014; 25:16-21. [PMID: 24818991 DOI: 10.1016/j.ijid.2014.03.1389] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Revised: 03/23/2014] [Accepted: 03/27/2014] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Studies on sexually transmitted infections in Brazil are done mainly in large metropolises and screening is available for pregnant women only. We aimed to estimate the prevalence and risk factors for Chlamydia trachomatis, Neisseria gonorrhoeae, and Treponema pallidum infection among young non-pregnant women in non-clinical settings in middle-sized cities of Central Brazil. METHODS A cross-sectional community-based sample of 1072 participants was included. Sexually active women (64.9%) provided first-catch urine samples for PCR investigation of chlamydial and gonococcal infection. Syphilis was tested in serum. Univariate analysis investigated risk factors for chlamydial infection. Multivariate logistic regression included associations with a p-value <0.20. RESULTS The mean age of participants was 18 years; 73.2% reported unprotected intercourse, 37.6% were married/cohabiting, and 5% reported a previous STI. Prevalence rates of C. trachomatis, N. gonorrhoeae, and T. pallidum were 9.6% (95% confidence interval (CI) 7.4-12.4%), 0.7% (95% CI 0.2-1.9%), and 0.15% (95% CI 0.0-0.7%), respectively. After adjustments, being <20 years old (adjusted odds ratio (aOR) 1.90, 95% CI 1.07-3.37) and having three or more lifetime sexual partners (aOR 2.57, 95% CI 1.46-4.53) were associated with the risk for chlamydial infection. CONCLUSIONS We observed a high prevalence of chlamydial infection and sexual risk behaviors in this population. These findings are important to guide screening strategies in Brazil.
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Affiliation(s)
- Yanna Andressa Ramos de Lima
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Rua 235, s/n, Setor Universitário, CEP 74605050, Goiânia, Goiás, Brazil.
| | - Marília Dalva Turchi
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Rua 235, s/n, Setor Universitário, CEP 74605050, Goiânia, Goiás, Brazil
| | - Zulmirene Cardoso Fonseca
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Rua 235, s/n, Setor Universitário, CEP 74605050, Goiânia, Goiás, Brazil
| | - Fernanda Lopes Brito Garcia
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Rua 235, s/n, Setor Universitário, CEP 74605050, Goiânia, Goiás, Brazil
| | - Fernanda Alves de Brito e Cardoso
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Rua 235, s/n, Setor Universitário, CEP 74605050, Goiânia, Goiás, Brazil
| | - Mônica Nogueira da Guarda Reis
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Rua 235, s/n, Setor Universitário, CEP 74605050, Goiânia, Goiás, Brazil
| | | | | | - Nígela Rodrigues Carvalho
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Rua 235, s/n, Setor Universitário, CEP 74605050, Goiânia, Goiás, Brazil
| | - Maria de Fátima Costa Alves
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Rua 235, s/n, Setor Universitário, CEP 74605050, Goiânia, Goiás, Brazil
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Tavares MCM, de Macêdo JL, de Lima Júnior SF, de Andrade Heráclio S, Amorim MMR, de Mascena Diniz Maia M, de Souza PRE. Chlamydia trachomatis infection and human papillomavirus in women with cervical neoplasia in Pernambuco-Brazil. Mol Biol Rep 2014; 41:865-74. [PMID: 24395291 DOI: 10.1007/s11033-013-2927-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Accepted: 12/18/2013] [Indexed: 10/25/2022]
Abstract
Chlamydia trachomatis (CT) is the most common bacterial cause of sexually transmitted disease. High-risk human papillomavirus (HR-HPV) is considered the main etiological agent for cervical neoplasia. Evidences showed that the presence of co-infection of CT and HR-HPV plays a central role in the etiology of cervical intraepithelial neoplasia (CIN) and cervical cancer. The goals of this study were: evaluate the human papillomavirus (HPV) and CT prevalence among Brazilian women with abnormal cytology and provide the effect of this association on the severity of cervical neoplasia. The population of this study was composed by 142 women with incident histological incidence of CIN grades I, II, III or cervical cancer from Recife, Northeast of Brazil. The polymerase chain reaction method on a cervical brush specimen was used to detect both agents and the automatic sequencing method was used for HPV genotyping assay. The prevalence of HPV and CT was 100 and 24.65 %, respectively. Thirteen types of HPV were detected; HPV 16, 18, 31 and 33 were the most common. The most prevalent HPV types were HPV 16 and 18. A significant association between CT positive and HPV 16 infection was found (p < 0.0106; OR = 5.31; 95 % IC 1.59-17.67). In the study population, there was diversity of HPV infections, with high-risk types being the most common. Also, the data collected suggest that CT infection may play an important role in the natural history of HPV infection.
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Chlamydia trachomatis prevalence and risk behaviors in parturient women aged 15 to 24 in Brazil. Sex Transm Dis 2013; 38:957-61. [PMID: 21934572 DOI: 10.1097/olq.0b013e31822037fc] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Chlamydia trachomatis (CT) is a sexually transmitted infection having repercussions on reproductive health and impact on the foetus. Our goal was to estimate the prevalence of and risk factors for CT in young parturient women in Brazil. METHODS A national cross-sectional study of parturient women, aged 15 to 24 years, attending Brazilian public hospitals was performed in 2009. Participants answered a questionnaire including demographic, behavioral, and clinical data. A sample of urine was collected and screened for CT and Neisseria gonorrhoeae (NG), using polymerase chain reaction COBAS Amplicor CT/NG (Roche Molecular Systems, Branchburg, NJ). RESULTS A total of 2400 women were selected and 2071 (86.3%) participated in the study. Mean age was 20.2 years (standard deviation = 2.7). Prevalence rates of CT and NG were 9.8% (95% confidence interval [CI]: 8.5-11.1) and 1.0% (95% CI: 0.6%-1.4%), respectively. Four percent of women infected with CT also had NG infection. CT associated factors were: being younger (15-19 years old) (odds ratio [OR] = 1.6 [95% CI: 1.15-2.17]); first sexual intercourse before 15 years of age (OR = 1.4 [95% CI: 1.04-6.24]); having more than 1 sexual partner in lifetime (OR = 1.6 [95% CI: 1.13-2.26]); Pap smear screening more than 1 year (OR = 1.5 [95% CI: 1.08-2.05]); and NG infection (OR = 7.6 [95% CI: 3.05-19.08]). CONCLUSIONS This study shows a high prevalence of CT infection among young pregnant women in Brazil. We suggest that CT screening should be included as part of antenatal care routine in this group in Brazil.
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Cunha Machado MS, da Costa e Silva BFB, Caetité Gomes IL, Santana IU, Rios Grassi MF. Prevalence of cervical Chlamydia trachomatis infection in sexually active adolescents from Salvador, Brazil. Braz J Infect Dis 2012. [DOI: 10.1016/s1413-8670(12)70304-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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12
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Chlamydial infection in a high risk population: association with vaginal flora patterns. Arch Gynecol Obstet 2011; 285:1013-8. [DOI: 10.1007/s00404-011-2085-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2010] [Accepted: 09/06/2011] [Indexed: 11/25/2022]
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Jin X, Chan S, Ding G, Wang H, Xu J, Wang G, Chang D, Reilly KH, Wang N. Prevalence and risk behaviours for Chlamydia trachomatis and Neisseria gonorrhoeae infection among female sex workers in an HIV/AIDS high-risk area. Int J STD AIDS 2011; 22:80-4. [DOI: 10.1258/ijsa.2010.010289] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- X Jin
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control & Prevention, Beijing
| | - S Chan
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control & Prevention, Beijing
| | - G Ding
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control & Prevention, Beijing
| | - H Wang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control & Prevention, Beijing
| | - J Xu
- Key Laboratory of Immunology of AIDS, Ministry of Health, First Hospital of China Medical University
| | - G Wang
- Kaiyuan City Center for Disease Control & Prevention, Yunnan Province, PRChina
| | - D Chang
- Kaiyuan City Center for Disease Control & Prevention, Yunnan Province, PRChina
| | - K H Reilly
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
- Institute for Global Health, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - N Wang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control & Prevention, Beijing
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Prevalence and Risk Factors of Chlamydia trachomatis Cervicitis in Pregnant Women at the Genital Tract Infection in Obstetrics Unit Care at Botucatu Medical School, São Paulo State University - UNESP, Brazil. J Low Genit Tract Dis 2011; 15:20-4. [DOI: 10.1097/lgt.0b013e3181ed3d58] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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15
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Machado ACS, Bandea CI, Alves MFC, Joseph K, Igietseme J, Miranda AE, Guimarães EMB, Turchi MD, Black CM. Distribution of Chlamydia trachomatis genovars among youths and adults in Brazil. J Med Microbiol 2010; 60:472-476. [PMID: 21183598 DOI: 10.1099/jmm.0.026476-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Despite a high prevalence of sexually transmitted Chlamydia trachomatis infections in Brazil and other countries in South America, very little is known about the distribution of C. trachomatis genovars. In this study, we genotyped C. trachomatis strains from urine or endocervical specimens collected from 163 C. trachomatis-positive female and male youths, and female adults, residing in two different regions of Brazil, the city of Goiânia located in the central part of Brazil, and the city of Vitória in the south-east region. C. trachomatis strains were genotyped by amplifying and sequencing the ompA gene encoding the chlamydial major outer-membrane protein, which is genovar specific. We found nine different C. trachomatis genovars: E (39.3%), F (16.6%), D (15.9%), I (8.6%), J (7.4%), G (4.9%), K (3.1%), H (2.4%) and B (1.8%). The distribution of the C. trachomatis genovars in the two regions of Brazil was similar, and there was no statistically significant association of serovars with age, gender, number of sexual partners or clinical symptoms. The overall distribution of C. trachomatis genovars in Brazil appears similar to that found in other regions of the world, where E, D and F are the most common. This supports the notion that, during the last few decades, the overall distribution of C. trachomatis genovars throughout the world has been relatively stable.
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Affiliation(s)
- Ana C S Machado
- Department of Microbiology, Immunology, Parasitology and Pathology, Institute of Tropical Pathology and Public Health, Federal University of Goiás, Brazil
| | - Claudiu I Bandea
- Division of Scientific Resources, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Maria F C Alves
- Department of Microbiology, Immunology, Parasitology and Pathology, Institute of Tropical Pathology and Public Health, Federal University of Goiás, Brazil
| | - Kahaliah Joseph
- Division of Scientific Resources, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Joseph Igietseme
- Division of Scientific Resources, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Angélica E Miranda
- Nucleus of Infectious Diseases, Federal University of Espírito Santo, Vitória, Brazil
| | - Eleuse M B Guimarães
- Division of Adolescent Medicine, Department of Pediatrics, Faculty of Medicine, Federal University of Goiás, Brazil
| | - Marília D Turchi
- Department of Community Health, Institute of Tropical Pathology and Public Health, Federal University of Goiás, Brazil
| | - Carolyn M Black
- Division of Scientific Resources, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Rugpao S, Rungruengthanakit K, Werawatanakul Y, Sinchai W, Ruengkris T, Lamlertkittikul S, Pinjareon S, Koonlertkit S, Limtrakul A, Sriplienchan S, Wongthanee A, Sirirojn B, Morrison CS, Celentano DD. Risk factors and algorithms for chlamydial and gonococcal cervical infections in women attending family planning clinics in Thailand. J Obstet Gynaecol Res 2010; 36:147-53. [PMID: 20178541 DOI: 10.1111/j.1447-0756.2009.01105.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To identify risk factors associated with and evaluate algorithms for predicting Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) cervical infections in women attending family planning clinics in Thailand. METHODS Eligible women were recruited from family planning clinics from all regions in Thailand. The women were followed at 3-month intervals for 15-24 months. At each visit, the women were interviewed for interval sexually transmitted infection (STI) history in the past 3 months, recent sexual behavior, and contraceptive use. Pelvic examinations were performed and endocervical specimens were collected to test for CT and NG using polymerase chain reaction. RESULTS Factors associated with incident CT/NG cervical infections in multivariate analyses included region of country other than the north, age <or=25 years, polygamous marriage, acquiring a new sex partner in the last 3 months, abnormal vaginal discharge, mucopurulent cervical discharge, and easily induced bleeding of the endocervix. Three models were developed to predict cervical infection. A model incorporating demographic factors and sexual behaviors had a sensitivity of 61% and a specificity of 71%. Incorporating additional factors did not materially improve test performance. Positive predictive values for all models evaluated were low. CONCLUSION In resource-limited settings, algorithmic approaches to identifying incident cervical infections among low-risk women may assist providers in the management of these infections.
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Affiliation(s)
- Sungwal Rugpao
- Research Institute for Health Science, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Guimarães EMB, Guimarães MDC, Vieira MAS, Bontempo NM, Seixas MSS, Garcia MSD, Daud LES, Côrtes RLM, Alves MDFC. Lack of utility of risk score and gynecological examination for screening for sexually transmitted infections in sexually active adolescents. BMC Med 2009; 7:8. [PMID: 19284575 PMCID: PMC2664828 DOI: 10.1186/1741-7015-7-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2009] [Accepted: 03/11/2009] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Sexually transmitted infections constitute the main health risk among adolescents. In developing countries the diagnosis and treatment of cervical infections is based on the syndromic approach. In this study we estimated the prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae among female adolescents from a Health Sector of the city of Goiânia, Brazil, and validated cervicitis diagnosis using World Health Organization/Ministry of Health risk score and gynecological examination. METHODS A cross-sectional community-based sample of 914 15- to 19-year-old female teenagers was randomly selected and referred to the local Family Health Program. Of these, 472 (51.6%) were sexually active and gynecological examinations were carried out for 427. Endocervical samples were collected to perform the polymerase chain reaction for C. trachomatis and N. gonorrhoeae. Performance of risk score, the presence of mucopurulent discharge, friability, ectopia and pain during cervical maneuver were compared with the presence of C. trachomatis or N. gonorrhoeae or both. RESULTS The prevalence of C. trachomatis and N. gonorrhoeae was 14.5% and 2.1%, respectively. The risk score had a specificity of 31.9% (95% confidence interval, 21.2 to 44.2) and a positive predictive value of 20.8% (95% confidence interval, 13.5 to 29.7). Friability was the component of the gynecological examination that presented the best performance with a sensitivity of 43.5%, specificity of 81.0%, and 30.6% of positive predictive value. CONCLUSION The prevalence of infection by C. trachomatis and N. gonorrhoeae was high among these sexually active adolescents. The syndromic approach is clearly inadequate for screening and treating these infections in this population. Therefore, the implantation of other strategies to control these infections among adolescents is urgently required.
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Affiliation(s)
- Eleuse M B Guimarães
- 1Division of Adolescent Medicine, Department of Pediatrics, Faculty of Medicine, Federal University of Goiás, Goiânia, Goiás, Brazil.
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Lima HE, Oliveira MB, Valente BG, Afonso DAF, Darocha WD, Souza MCM, Alvim TC, Barbosa-Stancioli EF, Noronha FSM. Genotyping of Chlamydia trachomatis from endocervical specimens in Brazil. Sex Transm Dis 2007; 34:709-17. [PMID: 17414937 DOI: 10.1097/01.olq.0000258399.27873.d9] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND There is no data concerning genotyping of Chlamydia trachomatis from Brazilian samples. GOAL To characterize the genotype of C. trachomatis detected in women assisted at a STD public clinic and establish the prevalence of this infection in that population. STUDY DESIGN Endocervical samples of a group of 100 women were tested for chlamydial infection with PCR directed to C. trachomatis cryptic plasmid. Genotyping of positive samples were done after omp1 amplification and sequencing. RESULTS The overall prevalence of C. trachomatis infection was 19%, with the highest prevalence in women between 15 and 25 years old (68.4%). Four genotypes were found associated with endocervical infections: D, E, F, and K. Sequence analysis revealed a coinfection of genotypes D and E in 1 woman. CONCLUSIONS To our knowledge this is the first study to characterize Brazilian C. trachomatis endocervical samples and Brazilian C. trachomatis genotype coinfection. Our results also emphasize the importance of routine diagnosis of C. trachomatis for the control of this STD.
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Affiliation(s)
- Haleta E Lima
- Departamento de Microbiologia, Universidade Federal de Minas Gerais, Brasil
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