Low Prevalence of Chlamydia trachomatis Infection in Non-Urban Pregnant Women in Vellore, S. India

Abstract

ObjectiveTo determine the prevalence and risk factors for Chlamydia trachomatis (CT) infection in pregnant women and the rate of transmission of CT to infants.MethodsPregnant women (≥28 weeks gestation) in Vellore, South India were approached for enrollment from April 2009 to January 2010. After informed consent was obtained, women completed a socio-demographic, prenatal, and sexual history questionnaire. Endocervical samples collected at delivery were examined for CT by a rapid enzyme test and nucleic acid amplification test (NAAT). Neonatal nasopharyngeal and conjunctival swabs were collected for NAAT testing.ResultsOverall, 1198 women were enrolled and 799 (67%) endocervical samples were collected at birth. Analyses were completed on 784 participants with available rapid and NAAT results. The mean age of women was 25.8 years (range 18–39 yrs) and 22% (95% CI: 19.7–24.4%) were primigravida. All women enrolled were married; one reported >one sexual partner; and six reported prior STI. We found 71 positive rapid CT tests and 1/784 (0.1%; 95% CI: 0–0.38%) true positive CT infection using NAAT.ConclusionsTo our knowledge, this is the largest study on CT prevalence amongst healthy pregnant mothers in southern India, and it documents a very low prevalence with NAAT. Many false positive results were noted using the rapid test. These data suggest that universal CT screening is not indicated in this population.

Prevalence ofChlamydia trachomatisamong Childbearing Age Women in India: A Systematic Review

“…Of the 38 deemed to be relevant to the key question, 21 were on HIV positive women or sex workers and 10 included only male subjects. The six remaining studies were included in this analysis ( Table 1 ) [ 15 – 20 ].…”

“…Three studies were conducted in North India [ 16 , 18 , 19 ], with two studies done in Delhi [ 16 , 19 ] and one in Bhubaneswar, Orissa [ 18 ]. The remaining three studies were conducted in South India [ 15 , 17 , 20 ]. Two were conducted in the state of Tamil Nadu, one in the city of Vellore [ 15 ], and one in the districts of Tanjore, Ramnad, and Dindigul [ 20 ] and used the “probability proportion to size” cluster survey method in these districts.…”

“…The remaining three studies were conducted in South India [ 15 , 17 , 20 ]. Two were conducted in the state of Tamil Nadu, one in the city of Vellore [ 15 ], and one in the districts of Tanjore, Ramnad, and Dindigul [ 20 ] and used the “probability proportion to size” cluster survey method in these districts. The final study was conducted in northern Karnataka [ 17 ].…”

“…The final study was conducted in northern Karnataka [ 17 ]. One study recruited women <18 years of age [ 20 ] and all the remaining recruited adult women [ 15 – 18 ]. Mean or median age was reported in four of the studies and varied from 25.8 to 31.5 years [ 15 – 18 ].…”

Evaluation of Cortez Onestep Chlamydia RapicardTM Insta Test for the Detection of Chlamydia Trachomatis in Pregnant Women at Mbare Polyclinic in Harare, Zimbabwe

“…The manufacturer’s sensitivity claims was higher than the values reported by other studies (3.3-18.8%). [ 26 ]…”