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Seroprevalence of Chlamydia trachomatis in Inner-City Children and Adolescents—Implications for Vaccine Development

Banniettis, Natalie MD*; Thumu, Sirisha MD; Weedon, Jeremy PhD; Chotikanatis, Kobkul MD*; Szigeti, Aviva MD*; Hammerschlag, Margaret R. MD*; Kohlhoff, Stephan A. MD*

doi: 10.1097/OLQ.0000000000000683
Original Study

Background: Prevention of Chlamydia trachomatis infection is an ideal application for a vaccine program, which should optimally be administered before sexual debut. However, there are limited epidemiologic studies of C. trachomatis infection in an unselected pediatric population since routine screening and treatment of pregnant women was implemented in the United States in 1993.

Methods: Anonymized serum samples were obtained from children younger than 21 years in 2 medical centers in Brooklyn, New York, from 2013 to 2015. Anti–C. trachomatis IgG antibody was determined by a validated enzyme immunoassay. Infants younger than 1 year were excluded from the final analysis due to interference of maternal antibody.

Results: One thousand two sera were included in the final analysis. Fifty-seven percent were females. No antibody was detected at younger than 11 years. Anti–C. trachomatis IgG antibody was detected in 11.4% and 5.6% of female and male subjects, respectively, older than 11 years (P = 0.0027), and seropositivity increased with age. There was no significant difference in the distribution of age at infection between the centers (P = 0.432), but a difference was detected between genders (P = 0.012) with a higher percentage of female subjects testing positive.

Conclusions: Antibody was first detected at 11 years of age, likely coinciding with sexual debut. The prevalence of antibody was higher and appeared earlier in females, mirroring national surveillance trends based on nucleic acid amplification testing. The delay in male antibody detection may be due to biological or behavioral differences between genders. These data are critical in informing potential C. trachomatis vaccine strategies.

A serosurvey of children and adolescents in Brooklyn, New York, found Chlamydia trachomatis lifetime prevalence increased with age, starting at age 11 years, was higher and appeared earlier in females.

From the *Department of Pediatrics, State University of New York Downstate Medical Center; †Department of Family Medicine, New York University, Lutheran Medical Center; and ‡Department of Epidemiology & Biostatistics, State University of New York, Downstate Medical Center, Brooklyn, NY

Acknowledgements: The authors thank the following individuals for assistance with serological testing: Shivani Sharma, Ghussai Abd El Gadir, MD, Marc Braunstein, MD. The authors thank their colleagues at Lutheran Medical Center for their collaboration. The authors thank the State University of New York, Downstate Medical Center’s Virology Department for usage of their photometer.

Conflicts of interest: none declared.

Source of funding: This work was supported by the New York State Empire Clinical Research Investigator Program (ECRIP)—2011.

Correspondence: Natalie Banniettis, MD, Department of Pediatrics, State University of New York Downstate Medical Center, Box 49. 450 Clarkson Avenue, Brooklyn, NY 11203. E-mail:

Received for publication December 25, 2016, and accepted June 3, 2017.

© Copyright 2017 American Sexually Transmitted Diseases Association