In order to determine the prevalence and risk factors for Chlamydia trachomatis infection in adolescent females and young women in central Brazil, 296 subjects attending two public health services were evaluated. The overall prevalence of C. trachomatis infection, as determined using polymerase chain reaction, was 19.6% (95% confidence interval [CI], 15.3-24.7). In multivariate analysis, young age (odds ratio [OR]adjusted 2.32, 95%CI 1.1-4.8, p<0.05) and having 2-3 (ORadjusted 3.41, 95%CI 1.6-6.3, p<0.05) or >or=4 sexual partners in life (ORadjusted 3.10, 95%CI 1.1-6.3, p<0.05) were factors significantly associated with chlamydial infection. In conclusion, the prevalence of C. trachomatis infection was high in the studied population and risk factors were related to age and sexual behavior.
Objective. To evaluate serum chlamydia antibody titers (CATs) in tubal occlusion or previous ectopic pregnancy and the associated risk factors.Methods. The study population consisted of 55 women wih tubal damage and 55 parous women. CAT was measured using the whole-cell inclusion immunofluorescence test and cervical chlamydial DNA detected by PCR. Odds ratios were calculated to assess variables associated withC. trachomatis infection.Results. The prevalence of chlamydial antibodies and antibody titers in women with tubal occlusion or previous ectopic pregnancy was significantly higher (P < .01) than in parous women. Stepwise logistic regression analysis showed that chlamydia IgG antibodies were associated with tubal damage and with a larger number of lifetime sexual partners.Conclusions. Chlamydia antibody titers were associated with tubal occlusion, prior ectopic pregnancy, and with sexual behavior, suggesting that a chlamydia infection was the major contributor to the tubal damage in these women.
Despite a high prevalence of sexually transmitted Chlamydia trachomatis infections in Brazil and other countries in South America, very little is known about the distribution of C. trachomatis genovars. In this study, we genotyped C. trachomatis strains from urine or endocervical specimens collected from 163 C. trachomatis-positive female and male youths, and female adults, residing in two different regions of Brazil, the city of Goiâ nia located in the central part of Brazil, and the city of Vitó ria in the south-east region. C. trachomatis strains were genotyped by amplifying and sequencing the ompA gene encoding the chlamydial major outer-membrane protein, which is genovar specific. We found nine different C. trachomatis genovars: E (39.3 %), F (16.6 %), D (15.9 %), I (8.6 %), J (7.4 %), G (4.9 %), K (3.1 %), H (2.4 %) and B (1.8 %). The distribution of the C. trachomatis genovars in the two regions of Brazil was similar, and there was no statistically significant association of serovars with age, gender, number of sexual partners or clinical symptoms. The overall distribution of C. trachomatis genovars in Brazil appears similar to that found in other regions of the world, where E, D and F are the most common. This supports the notion that, during the last few decades, the overall distribution of C. trachomatis genovars throughout the world has been relatively stable. INTRODUCTIONChlamydia trachomatis urogenital infection is the primary cause of bacterial sexually transmitted diseases (STDs) in the world (WHO, 2001). In Brazil, several studies using highly sensitive diagnostic tests based on nucleic acid amplification technology have showed a prevalence of C. trachomatis infections ranging from 5.0 to 19.6 % among youths attending outpatient clinics and gynaecological clinics, and taking part in the Family Health programme (Guimarães et al., 2009;Araú jo et al., 2006;Fioravante et al., 2005;Miranda et al., 2004).Using polyvalent mouse antiserum, C. trachomatis isolates historically have been classified into 14 major serovars, A to K and L1, L2 and L3 (Wang et al., 1973). Urogenital tract infections are usually caused by serovars D to K. After it was discovered that serovar specificity resides in the major outer-membrane protein (MOMP) (Caldwell et al., 1981), immunotyping approaches were replaced by genotyping methods that identify genovar-specific DNA sequence variation markers within the MOMP-encoding gene, ompA (referred to in some publications as omp1) (Stothard et al., 1998;Yuan et al., 1989; Stephens et al., 1987). New genotyping approaches have recently been developed, such as multilocus variable number tandem repeat and multilocus sequence typing analyses, that increase the epidemiological resolution among the various C. trachomatis strains (Pedersen et al., 2008;Klint et al., 2007). However, these approaches have been used within the framework of the current ompA-based C. trachomatis classification system as there is not yet a standardized nomenclature or classification system based on these novel t...
Background: Sexually transmitted infections constitute the main health risk among adolescents. In developing countries the diagnosis and treatment of cervical infections is based on the syndromic approach. In this study we estimated the prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae among female adolescents from a Health Sector of the city of Goiânia, Brazil, and validated cervicitis diagnosis using World Health Organization/ Ministry of Health risk score and gynecological examination.
Background: Lassa fever (LF) is associated with a wide spectrum of clinical manifestations and its clinical diagnosis is often complicated by the fact that the initial symptoms of the disease are indistinguishable from a number of other infections seen in endemic areas. Over the years, many outbreaks and deaths from LF have been reported in Nigeria mostly associated with no or inadequate laboratory testing. Consequently, the accuracy of clinical diagnosis is therefore of interest.Methods: Data including blood specimens and background information were collected from 267 consented in-and out-patients clinically diagnosed to have LF at the Irrua Specialist Teaching Hospital, Nigeria. Blood specimens were tested for Lassa virus RNA using Reverse transcriptase polymerase chain reaction (RT-PCR). Data derived were analyzed using EpiInfo 6.04a version.Results: Comparison of clinical diagnoses with laboratory test results showed a low specificity of clinical judgement. Of the 267 clinically diagnosed cases, LF was laboratoryconfirmed in 62 (23.2%), of which 35 (56%) were rightly treated with Ribavirin. On the other hand, 57 (28%) of the 205 LF negative patients were erroneously treated with Ribavirin. However 35 (56%) of these patients recovered, 18 (29%) died and 1(2%) was referred to another hospital for further attention. Patients that tested positive to LF were more likely to report vomiting, bleeding and have fever, sore throat, headache, abdominal pain and malaise than those that did not (p < 0.05).Conclusion: Until now, the diagnosis of LF is mainly clinical, and was considered sufficient for treatment decision. Unfortunately, clinical diagnosis of LF by health workers is hardly achievable especially in the absence of haemorrhage. Ribavirin can only help if it is administered early in the course of illness. In the above elucidated challenge, prompt diagnosis is clearly needed for early commencement of treatment. The place of appropriate laboratory support in the effective and prompt diagnosis cannot be over-emphasized in the management of LF in all endemic countries of West Africa.
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