Feasibility ofChlamydia trachomatisscreening and treatment in pregnant women in Lima, Peru: a prospective study in two large urban hospitals: Table 1

Abstract

Objectives Chlamydia trachomatis, which is asymptomatic in most women, causes significant adverse effects for pregnant women and neonates. No programmes conduct antenatal screening in Latin America. We determined chlamydia prevalence, the feasibility and acceptability of chlamydia screening, and adherence to treatment in pregnant women in two urban public hospitals in Lima, Peru. Methods We offered chlamydia screening using self-collected vaginal swabs to pregnant women ≥ 16 years during their first antenatal visit. Chlamydia-infected women were contacted within 14 days and asked to bring partners for counselling and directly observed therapy with oral azithromycin. Unaccompanied women received counselling, directly observed therapy, and azithromycin to take to partners. Test of cure was performed ≥ 3 weeks after treatment. Results We approached 640 women for the study and enrolled 600 (93.7%). Median age was 27.3 years (range 16–47), median lifetime partners 2.3 (range 1–50), and median gestational age 26.1 weeks (range 4–41). Chlamydia prevalence was 10% (95% CI: 7.7% – 12.7%). Of 60 infected patients, 59 (98%) were treated with one dose of azithromycin. Fifty-two of 59 (88%) returned for test of cure, all of whom were treated successfully, with 46 (86%) achieving negative test of cure with one dose of azithromycin and 6 (12%) after retreatment with a second dose. Conclusions C. trachomatis screening and treatment in pregnancy was feasible and highly acceptable in two urban hospitals in Peru. Chlamydia prevalence was high. Clinical trials to evaluate efficacy and cost-effectiveness of chlamydia screening and treatment of pregnant women to prevent adverse pregnancy outcomes in low-resource settings are warranted.

A recommendation for timing of repeat Chlamydia trachomatis test following infection and treatment in pregnant and nonpregnant women

“…8 A more recent study, reported that 88% of pregnant women had a negative chlamydia NAAT 21 days following single-dose therapy, which is consistent with our data. 10 Our recommended timing for test-of-cure may decrease unnecessary retreatment of noninfectious organisms detected by NAAT before 30 days.…”

“…This study did not address why six women continued to have a positive NAAT despite effective therapy. 10 …”

Prevalencia de Chlamydia trachomatis en embarazadas durante el primer trimestre en una institución privada de la ciudad de Córdoba

“…Los valores de prevalencia comunicados en la población adolescente general fue del 8,7 % en Córdoba Capital (14) y del 3,5% en los ingresantes universitarios en la ciudad de Bahía Blanca, Buenos Aires (15) . En América Latina, se han reportado prevalencias en embarazadas del 5,9% en Chile (16) , 10% en Lima, Perú (17) y 12,3% en el sur de Brasil (18) . En Buenos Aires, se reportó en el año 2001 una prevalencia del 2,5% en mujeres asistidas en un hospital de esa provincia; este grupo de estudio incluyó sólo pacientes sintomáticas (19) .…”

High Rate of Partner Treatment Among Chlamydia trachomatis–Infected Pregnant Women in Lima, Peru

“…As part of a larger study to determine the acceptability and feasibility of Chlamydia trachomatis screening among pregnant women in Lima, Peru, we found a prevalence of Chlamydia trachomatis of 10% 12 . The primary objectives of the substudy were to report partner treatment uptake and to examine the associations between partner treatment uptake and whether the women were living with their partners.…”