Prevalence of Chlamydia trachomatis infection in Samoan women aged 18 to 29 and assessment of possible risk factors: a community-based study

Walsh, Mark; Hope, E.W.; Isaia, Lupeoletalalelei; Righarts, Antoinette; Niupulusu, Tavita; Temese, Seiuli V A; Iosefa-Siitia, Liai; Auvaa, Leveti; Tapelu, Siuomatautu A.; Motu, Maauga F.; Edwards, Ciaran; Wernick, Maya; Huston, Wilhelmina M.; Suaalii‐Sauni, Tamasailau; Hill, Philip C.

doi:10.1093/trstmh/trv014

Cited by 19 publications

(24 citation statements)

References 25 publications

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“…This outcome might reflect, at least in part, poor access to and utilisation of STI servicesthere is very limited capacity in the Middle East and north Africa for STI prevention and treatment, not to mention C trachomatis screening and broader sexual health programmes. As observed elsewhere, such as in Alaskan Eskimo populations 194 and populations in South Pacific Islands, 195 poor C trachomatis diagnosis and specific treatment can result in unusually high prevalence, 194,196 probably because C trachomatis is largely asymptomatic, 4 and if untreated, shedding can persist even for years, 197 thereby increasing the potential for reinfection within couples 198 and for transmission in the population.…”

Section: Discussionmentioning

confidence: 89%

Epidemiology of Chlamydia trachomatis in the Middle East and north Africa: a systematic review, meta-analysis, and meta-regression

Smolak

Chemaitelly

Hermez

et al. 2019

The Lancet Global Health

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Background The epidemiology of Chlamydia trachomatis in the Middle East and north Africa is poorly understood. We aimed to provide a comprehensive epidemiological assessment of C trachomatis infection in the Middle East and north Africa. Methods We did a systematic review of C trachomatis infection as well as a meta-analysis and meta-regression of C trachomatis prevalence. We searched PubMed and Embase, as well as regional and national databases up to March 13, 2019, using broad search terms with no language or year restrictions. Any document or report including biological measures for C trachomatis prevalence or incidence was eligible for inclusion. We extracted all measures of current (genital or rectal), recent, and ever infection with C trachomatis. We estimated pooled average prevalence in different populations using random-effects meta-analysis. Factors associated with prevalence and sources of betweenstudy heterogeneity were determined using meta-regression. Findings We identified a total of 1531 citations, of which 255 reports contributed to 552 C trachomatis prevalence measures from 20 countries. No incidence measures were identified. Pooled prevalence of current genital infection was 3•0% (95% CI 2•3-3•8) in general populations, 2•8% (1•0-5•2) in intermediate-risk populations, 13•2% (7•2-20•7) in female sex workers, 11•3% (9•0-13•7) in infertility clinic attendees, 12•4% (7•9-17•7) in women with miscarriage, 12•4% (9•4-15•7) in symptomatic women, and 17•4% (12•5-22•8) in symptomatic men. Pooled prevalence of current rectal infection was 7•7% (4•2-12•0) in men who have sex with men. Substantial between-study heterogeneity was found. Multivariable meta-regression explained 29•0% of variation. Population type was most strongly associated with prevalence. Additional associations were found with assay type, sample size, country, and sex, but not with sampling methodology or response rate (about 90% of studies used convenience sampling and >75% had unclear response rate). There was no evidence for temporal variation in prevalence between 1982 and 2018. Interpretation C trachomatis prevalence in the Middle East and north Africa is similar to other regions, but higher than expected given its sexually conservative norms. High prevalence in infertility clinic attendees and in women with miscarriage suggests a potential role for C trachomatis in poor reproductive health outcomes in this region.

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Section: Discussionmentioning

confidence: 89%

Epidemiology of Chlamydia trachomatis in the Middle East and north Africa: a systematic review, meta-analysis, and meta-regression

Smolak

Chemaitelly

Hermez

et al. 2019

The Lancet Global Health

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“…Previous research has shown that urine testing will miss up to 30% of endocervical C. trachomatis infections [19,29]. Interestingly, in the only published study from the PICT of non-pregnant females, urine testing showed a prevalence of 36% among women 18 to 29 years of age in Samoa [30], suggesting that genital prevalence may be even higher.…”

Section: Discussionmentioning

confidence: 98%

Hyperendemic Chlamydia trachomatis sexually transmitted infections among females represent a high burden of asymptomatic disease and health disparity among Pacific Islanders in Fiji

et al. 2020

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Background Chlamydia trachomatis is the most common bacterial sexually transmitted infection worldwide with some of the highest prevalence rates among Pacific Island Countries where syndromic management is practiced. However, little is known about the true prevalence and risk indicators for infection among neglected populations in these countries that suffer from health disparities. Methodology/Principal findings Consecutive sampling was used to enroll sexually active females, aged 18-40 years, attending 12 Fijian Ministry of Health and Medical Services Health Centers and outreach locations from February to December, 2018. A Behavioral Surveillance Survey was administered to assess risk indicators for infection. Signs and symptoms were recorded, and vaginal swabs were tested for C. trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Candida and bacterial vaginosis. Bivariate and multivariate logistic regression analyses were performed using R-Studio. Of 577 participants, 103 (17.85%) were infected with C. trachomatis of whom 80% were asymptomatic and only 11 met criteria for syndromic management; 38.8% of infected women were 18-24 years old with a prevalence of 30.5%. 91.7% of participants intermittently or did not use condoms. C. trachomatis infection was associated with iTaukei ethnicity (OR 21.41 [95% CI: 6.38-133.53]); two lifetime partners (OR 2.12

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“…Parity, 47,48 the number of sexual partners, 49 and early sexual debut 47,49 have been previously associated with STIs/RTIs among pregnant women. No association was found between malarial and STI/RTI coinfection and factors such as parity, age, the number of sexual partners, early sexual debut, bed-net ownership, bednet use, and wealth quintile in this study.…”

Section: Discussionmentioning

confidence: 99%

Malarial Infection and Curable Sexually Transmitted and Reproductive Tract Infections Among Pregnant Women in a Rural District of Zambia

Chaponda

Chico

Bruce

et al. 2016

The American Society of Tropical Medicine and Hygiene

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Abstract. Malarial infection and curable sexually transmitted and reproductive tract infections (STIs/RTIs) are important causes of adverse birth outcomes. Reducing the burden of these infections in pregnancy requires interventions that can be easily integrated into the antenatal care (ANC) package. However, efforts to integrate the control of malarial infection and curable STIs/RTIs in pregnancy have been hampered by a lack of evidence related to their coinfection. Thus, we investigated the prevalence of coinfection among pregnant women of rural Zambia. A prospective cohort study was conducted in Nchelenge District, Zambia, involving 1,086 first ANC attendees. We screened participants for peripheral malarial infection and curable STIs/RTIs (syphilis, Chlamydia, gonorrhea, trichomoniasis, and bacterial vaginosis), and collected relevant sociodemographic data at booking. Factors associated with malarial and STI/RTI coinfection were explored using univariate and multivariate regression models. Among participants with complete results (N = 1,071), 38.7% (95% confidence interval [CI] = 35.7-41.6) were coinfected with malaria parasites and at least one STI/RTI; 18.9% (95% CI = 16.5-21.2) were infected with malaria parasites only; 26.0% (95% CI = 23.5-28.8) were infected with at least one STI/RTI but no malaria parasites, and 16.4% (95% CI = 14.1-18.6) had no infection. Human immunodeficiency virus (HIV)-infected women had a higher risk of being coinfected than HIV-uninfected women (odds ratio [OR] = 3.59 [95% CI = 1.73-7.48], P < 0.001). The prevalence of malarial and STI/RTI coinfection was high in this population. An integrated approach to control malarial infection and STIs/RTIs is needed to reduce this dual burden in pregnancy.

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Prevalence of Chlamydia trachomatis infection in Samoan women aged 18 to 29 and assessment of possible risk factors: a community-based study

Abstract: The prevalence of CT infection in these Samoan women is very high. Further studies, including investigating the prevalence of CT infection in men, and strategies for sustainable control are needed.

Cited by 19 publications

References 25 publications

Epidemiology of Chlamydia trachomatis in the Middle East and north Africa: a systematic review, meta-analysis, and meta-regression

Epidemiology of Chlamydia trachomatis in the Middle East and north Africa: a systematic review, meta-analysis, and meta-regression

Hyperendemic Chlamydia trachomatis sexually transmitted infections among females represent a high burden of asymptomatic disease and health disparity among Pacific Islanders in Fiji

Malarial Infection and Curable Sexually Transmitted and Reproductive Tract Infections Among Pregnant Women in a Rural District of Zambia

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