Chlamydial infection among patients attending STD and genitourinary clinics in Taiwan.(Research article)(Report)

Authors: Kow-Tong Chen (corresponding author) [1]; Shou-Chien Chen (equal contributor) [2,3]; Chien-Chou Chiang (equal contributor) [4]; Lan-Hui Li (equal contributor) [4]; Li-Hui Tang (equal contributor) [5]

Background

Young, sexually active people are at high risk for genital infection by

Chlamydia trachomatis (CT) [1, 2]. It is estimated that 340 million new cases of common bacterial and protozoal sexually transmitted infections occur annually worldwide [3]. An increase in sexually risky behaviour amongst young people and an associated subsequent increase in the prevalence of CT have been reported [4, 5]. Chlamydial infections can cause severe complications in untreated infected women such as pelvic inflammatory diseases (PID), ectopic pregnancy, tubal infertility and abdominal pain [6]. Serious sequelae among men with untreated infection include urethritis, prostatitis, epididymitis and Reiter syndrome [6]. Active CT infection is an important risk factor facilitating sexual transmission of HIV infection [7]. Most women (> 50%) infected with CT remain symptom-free, and for men, the rate of asymptomatic chlamydia infection is higher than for symptomatic gonorrhea infection [8, 9, 10]. Early diagnosis and early treatment of affected individuals are the types of strategies necessary to prevent the development of sequelae and to reduce transmission [6]. In Taiwan, although the incidence and prevalence of CT infection is rising [11], only limited information is available. The aim of this study was therefore to examine the epidemiology of genital chlamydia infection amongst patients attending STD and genitourinary clinics in Taiwan.

Methods

Patients

The pool of patients included all patients attending two outpatient clinics between July 2004 and June 2005; one group was investigated at the Taipei City STD Control Center clinic (northern Taiwan) and another group was studied at genitourinary outpatient clinic at a Kaohsiung primary care service (southern Taiwan).

Taipei and Kaohsiung are two large metropolitan areas in Taiwan. Only those patients who met the following criteria were included for study: aged> 17 years, sexually active (reported to have sexual intercourse in the last 60 days) provided a urine specimen and no antibiotic use in the preceding 15 days. Approval was obtained from the Ethics Committee of Taipei City STD Control Center. After signing an informed consent form, patients were given a self-administered questionnaire regarding limited demographic information, symptoms of urethritis (dysuria, urethral discharge) and condom use during the last intercourse.

A patient was classified as "symptomatic" if the patient reported having one of the symptoms (dysuria, urethral discharge) and as "non-symptomatic" if neither of these symptoms were reported.

Subsequently, a genital examination was performed by a doctor and blood samples were tested for

Treponema pallidum and HIV antibodies. Each participant provided a first void urine specimen that was tested for CT, …