BackgroundChlamydia trachomatis is the most prevalent bacterial sexually transmitted infection (STI) in the world. Approximately 80% of infected women are asymptomatic, although this infection can lead to serious complications in the female reproductive tract. Few data on Chlamydia infection are available in rural Amazonian communities.ObjectivesTo evaluate the prevalence of sexual C. trachomatis infection in women from Marajó Archipelago communities in the Amazon region of Brazil and to identify associated factors and genotypes.MethodsWe utilized amplification of the ompA gene by nested PCR. Positive samples were genotyped by sequencing. Study participants completed a questionnaire on social, epidemiological, and reproductive health variables. A Poisson regression was used to evaluate the degree of association of these variables with the infection.ResultsThe sexual infection by C. trachomatis was observed in 4% (16/393) of the subjects, and was more often found in women aged ≤25 (14.3%; 95% CI = 2.83–35.47; p <0.001), and in women with a household income of less than one Brazilian monthly minimum wage (5.2%; 95% CI = 1.33–11.37; p = 0.014). The ompA gene was sequenced in 13 samples, revealing F genotypes (38.4%, n = 5), D (23%, n = 3), E (15.3%, n = 2), Ia (7.6%, N = 1), J (7.6%, n = 1) and B (7.6%, n = 1).ConclusionsWe recorded a high prevalence of sexual infection by C. trachomatis in young and poor women from the interior of the Brazilian Amazon. This high prevalence and the frequencies of the main genotypes were similar to those found in major Brazilian urban centers. Our results reinforce the importance of the screening of this neglected infection, and the prevention of later sequelae in young women from rural and urban areas of Brazil.
RESUMOOBJETIVOS: Descrever a prevalência e os fatores associados à infecção endocervical por Chlamydia trachomatis em estudantes de uma universidade da capital e de três de seus campi do interior do estado do Pará, Amazônia, Brasil. MATERIAIS E MÉTODOS: Estudo transversal, com mulheres de idade igual ou superior a 18 anos, que realizaram o preventivo do câncer do colo uterino, de setembro de 2010 a outubro de 2014. O DNA da secreção cérvico-vaginal foi extraído pelo método fenol-clorofórmio e submetido à amplificação dos genes da β-globina humana e ompA de C. trachomatis por reação em cadeia da polimerase. Foram utilizados os testes de Mann-Whitney, estimação da proporção e odds ratio para análises estatísticas. O p ≤ 0,05 foi considerado estatisticamente significativo para um intervalo de confiança (IC) de 95%. RESULTADOS: A prevalência de C. trachomatis foi de 11,9% [54/454 (IC 95% 8,9-14,9)]. A infecção foi identificada em 10,4% [36/345 (IC 95% 7,2-13,7)] das estudantes da Capital e em 16,5% [18/109 (IC 95% 10,3-24,6)] das estudantes dos campi do interior (p = 0,12), sendo de 7,1% (2/28) no Interior 1, 22,2% (6/27) no Interior 2 e 18,5% (10/54) no Interior 3. Não foi observada associação entre as variáveis investigadas e a infecção endocervical por C. trachomatis. CONCLUSÃO: A prevalência da infecção por C. trachomatis entre as universitárias se assemelhou à média encontrada no Brasil e não se mostrou associada às condições sociodemográficas e comportamentais das universitárias investigadas. ARTIGO ORIGINAL | ORIGINAL ARTICLEABSTRACT OBJECTIVES: To describe the prevalence and factors associated with endocervical infection by Chlamydia trachomatis in students from a university in the capital and three campuses in inland towns of Pará State, Amazon, Brazil. MATERIALS AND METHODS: A cross-sectional study with women aged 18 years or older who underwent cervical cancer prevention from September 2010 to October 2014. DNA from cervicovaginal secretion was extracted using the phenol-chloroform method and subjected to the amplification of the human β-globin and ompA genes of C. trachomatis by polymerase chain reaction. Mann-Whitney tests, proportion estimation, and odds ratio were used for statistical analysis. The p ≤ 0.05 was considered statistically significant for a confidence interval (CI) of 95%. RESULTS: The prevalence of C. trachomatis was 11.9% ]. Infection was identified in 10.4% [36/345 (95% CI 7.2-13.7)] of the students in the Capital and in 16.5% ) of students from the campuses in the inland towns (p = 0.12), with 7.1% (2/28) in the Town 1, 22.2% (6/27) in the Town 2, and 18.5% (10/54) in the Town 3. No association between the investigated variables and the endocervical infection by C. trachomatis was observed. CONCLUSION: The prevalence of C. trachomatis infection among those university students was similar to the average found in Brazil and was not associated with the sociodemographic and behavioral conditions of the university students investigated.
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