The Role of Surinamese Migrants in the Transmission of Chlamydia trachomatis between Paramaribo, Suriname and Amsterdam, The Netherlands

Abstract

The large Surinamese migrant population in the Netherlands is a major risk group for urogenital Chlamydia trachomatis infection. Suriname, a former Dutch colony, also has a high prevalence of C. trachomatis. Surinamese migrants travel extensively between the Netherlands and Suriname. Our objective was to assess whether the Surinamese migrants in the Netherlands form a bridge population facilitating transmission of C. trachomatis between Suriname and the Netherlands. If so, joint prevention campaigns involving both countries might be required. Between March 2008 and July 2010, participants were recruited at clinics in Paramaribo, Suriname and in Amsterdam, the Netherlands. Participants were grouped as native Surinamese, native Dutch, Surinamese migrant, Dutch migrant, or Other, based on country of residence and country of birth of the participant and of their parents. Risk behavior, such as sexual mixing between ethnic groups, was recorded and C. trachomatis positive samples were typed through multilocus sequence typing (MLST). A minimum spanning tree of samples from 426 participants showed four MLST clusters. The MLST strain distribution of Surinamese migrants differed significantly from both the native Surinamese and Dutch populations, but was not an intermediate state between these two populations. Sexual mixing between the Surinamese migrants and the Dutch and Surinamese natives occurred frequently. Yet, the MLST cluster distribution did not differ significantly between participants who mixed and those who did not.Sexual mixing occurred between Surinamese migrants in Amsterdam and the native populations of Suriname and the Netherlands. These migrants, however, did not seem to form an effective bridge population for C. trachomatis transmission between the native populations. Although our data do not seem to justify the need for joint campaigns to reduce the transmission of C. trachomatis strains between both countries, intensified preventive campaigns to decrease the C. trachomatis burden are required, both in Suriname and in the Netherlands.

UrogenitalChlamydia trachomatisstrain types, defined by high-resolution multilocus sequence typing, in relation to ethnicity and urogenital symptoms among a young screening population in Amsterdam, The Netherlands

“…The inner PCR was performed with M13-tagged primers as described previously 17 20. The M13-tagged amplified DNA was processed at a central sequence facility using primers that specifically target the M13-amplified region.…”

“…In a previous study, we investigated the association between C. trachomatis infections and ethnic groups, with a focus on sexual mixing between Surinamese migrants and native Dutch and Surinamese residents to identify transmission networks between Surinam and the Netherlands 20. However, as yet, no studies have been performed including individuals from a general urban population to investigate associations between C. trachomatis infections and specific ethnic groups.…”

Global Multilocus Sequence Type Analysis of Chlamydia trachomatis Strains from 16 Countries

“…The third scheme was developed by Klint et al (10); it is intended for short-term clinical epidemiology and outbreak investigations and is based on five highly variable genomic loci (hctB [CT046], CT058, CT144, CT172, and pbpB [CT682]). The MLST scheme has been slightly modified to facilitate rational processing with only 1% loss of discriminatory capacity (13), and the current setup can be found at the Uppsala University C. trachomatis MLST database (http: //mlstdb.bmc.uu.se).Since its development in 2007, the scheme has been applied to a variety of clinical specimens, including samples from cases of urogenital chlamydia (7,(13)(14)(15)(16)(17)(18)(19)(20)(21), LGV (22,23), and trachoma (24). It has been useful for different purposes: (i) identification of clonal spread of LGV (22) …”

“…Since its development in 2007, the scheme has been applied to a variety of clinical specimens, including samples from cases of urogenital chlamydia (7,(13)(14)(15)(16)(17)(18)(19)(20)(21), LGV (22,23), and trachoma (24). It has been useful for different purposes: (i) identification of clonal spread of LGV (22) …”

“…Since its development in 2007, the scheme has been applied to a variety of clinical specimens, including samples from cases of urogenital chlamydia (7,(13)(14)(15)(16)(17)(18)(19)(20)(21), LGV (22,23), and trachoma (24). It has been useful for different purposes: (i) identification of clonal spread of LGV (22) and the new variant of C. trachomatis (16,17); (ii) differentiation of strains within the predominating serotype, E (7,17); (iii) differentiation of strains infecting men who have sex with men (MSM) and heterosexuals (15,19); (iv) investigation of the role of tissue tropism (21); and (v) molecular epidemiology and antibiotic treatment of trachoma (24).…”