Sexually Transmitted Diseases

Skip Navigation LinksHome > May 2008 - Volume 35 - Issue 5 > Epidemiology of Genital Chlamydia trachomatis Infection Amon...
Sexually Transmitted Diseases:
doi: 10.1097/OLQ.0b013e3181644b4c

Epidemiology of Genital Chlamydia trachomatis Infection Among Young Women in Costa Rica

Porras, Carolina MS*; Safaeian, Mahboohbeh PhD, MPH†; González, Paula MD*; Hildesheim, Allan PhD†; Silva, Sandra MS‡; Schiffman, Mark MD, PhD†; Rodríguez, Ana Cecilia MD†; Wacholder, Sholom PhD†; Freer, Enrique MD, PhD‡; Quint, Koen BSc§; Bratti, Concepción MD, MPH*; Espinoza, Albert MBA*; Cortes, Bernal PharmD*; Herrero, Rolando MD, PhD*; for the Costa Rica HPV Vaccine Trial (CVT) Group

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Objective: To investigate Chlamydia trachomatis (Ct) epidemiology among 5829 women 18 to 25 years old, in Costa Rica.

Methods: Data are from a community-based human papillomavirus 16/18 vaccine trial. Before randomization, eligible women who reported previous sexual activity were interviewed and tested for Ct DNA by Hybrid Capture 2 and polymerase chain reaction-based genotyping. Multivariate models were developed.

Results: Overall prevalence was 14.2% (95% confidence interval, 13.3–15.1). Among Ct genotypes, serovar E was the most common (4.3%), followed by serovar F (3.0%), serovar D/Da (2.9%), and serovar I/Ia (2.1%).

Ct increased with lifetime sexual partners of the women, and among women with 1 lifetime partner, with sexual partners of the partner. Current intrauterine device users had an increase in Ct detection [odds ratio (OR) 1.6, 1.1–2.5] but hormonal contraceptives or condom users did not. Miscarriages were associated with a reduction in Ct detection (OR 0.7, 0.5–1.0) while current regular smoking increased it (OR 1.7, 1.2–2.5).

Vaginal discharge, reactive changes, ASCUS or LSIL and moderate to severe inflammation in the cytology were significantly more common among Ct positive women (P <0.001). Gonorrhea prevalence was 0.8%, and it was, as other STIs, highly correlated with Ct detection.

Conclusions: This is a high-prevalence population where we confirmed the strong link between Ct and sexual behavior of women and their partners. The establishment of a screening program in the age group included in this study should be considered. More studies are needed in developing countries to further investigate the role of intrauterine devices and the lack of protection by condoms, in addition to the interplay between Ct and other STIs, ectopy, inflammation, and epithelial abnormalities.

© Copyright 2008 American Sexually Transmitted Diseases Association


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