<i>Chlamydia trachomatis</i> genital infection in apparently healthy adult population of Tamil Nadu, India: a population-based study

Joyee, Antony George; Thyagarajan, S P; Rajendran, P.; Hari, Rajeswary; Balakrishnan, Pachamuthu; Jeyaseelan, L.; Kurien, Thomas

doi:10.1258/095646204322637272

Cited by 30 publications

(34 citation statements)

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“…Current Indian treatment guidelines recommend VDRL and HIV testing of patients engaging in high-risk activities as part of routine STI care to be delivered through general health services. 25 Prior studies from India have shown that a large number of individuals with STIs may be harboring asymptomatic STIs, 13,26 which could contribute to the silent transmission to the community. Another study from western India found that reported symptoms had little correlation with the presence of actual infection.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Incidence of Sexually Transmitted Infections among South Indians at Increased Risk of HIV Infection

Kumarasamy¹,

Balakrishnan²,

Venkatesh³

et al. 2008

AIDS Patient Care and STDs

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Sexually transmitted infections (STIs) have been identified as cofactors of HIV transmission. Greater understanding of local STI burdens can assist in the development of more effective STI and HIV prevention strategies. The aim of this study is to determine the prevalence and incidence of STIs among South Indian men and women identified to be at increased risk for HIV infection. Individuals at increased risk for HIV infection were enrolled in a prospective longitudinal study in Chennai, India (n ϭ 480) between August 2002 and December 2003. Participants were enrolled from patients seeking services at an sexually transmitted disease (STD) clinic and a confidential HIV testing and counseling program. The most common prevalent STIs were herpes simplex virus (HSV)-2 (50% of women, 29% of men), syphilis (11% of women, 8% of men), and Trichomonas vaginalis (6% of women). At enrollment, women, participants with no schooling, participants with greater than four sex partners, and single participants were found to be at increased risk for HSV-2 infection (p Ͻ 0.05). The two most common incident STIs at 12 months were HSV-2 with 12% of men and 8% of women testing positive and hepatitis B with 2% of men and 5% of women testing hepatitis B surface antigen (HBsAg) positive. In this cohort of South Indian men and women with a high background prevalence of HSV-2, suppressive therapy against herpes replication may have a substantial impact in reducing both HSV-2 transmission and HIV acquisition. With the high incidence of STIs, targeted prevention and clinical management strategies among individuals practicing high risk behaviors may help to slow the continued spread of HIV in India.

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Section: Discussionmentioning

confidence: 99%

Prevalence and Incidence of Sexually Transmitted Infections among South Indians at Increased Risk of HIV Infection

Kumarasamy¹,

Balakrishnan²,

Venkatesh³

et al. 2008

AIDS Patient Care and STDs

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“…For example, an abnormal urethral discharge and burning or painful micturition (dysuria) in men are considered suggestive of gonorrhoea and chlamydia (Adler 1998), and syndromic guidelines are used to manage symptomatic men in India (Hawkes & Santhya 2002). However, recent studies of Indian men have reported low prevalences of gonorrhoea and chlamydia (Joyee et al 2004;Lindan et al 2005), in conjunction with a high burden of reported symptoms (International Institute for Population Sciences 2001). This suggests that the syndromic guidelines for the treatment of STIs may have low specificity and costeffectiveness among symptomatic Indian men in comparison with other developing countries where the prevalence of STIs is higher (Gilson et al 1997).…”

Section: Introductionmentioning

confidence: 99%

Socio‐cultural, psychosexual and biomedical factors associated with genital symptoms experienced by men in rural India

Gautham

Singh

Weiss

et al. 2008

Tropical Med Int Health

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SummaryBiomedical, anthropological and psychiatric frameworks have been used to research different elements of men's sexual health -sexually transmitted infections, psychosexual concerns and psychological distress -but rarely within the same study. We combined these in a study in rural north India. In Tehri Garhwal and Agra districts, we explored male perceptions of genital and sexual symptoms through focus group discussions and then conducted a clinic-based survey of 366 symptomatic men who presented at rural private provider clinics. Men's urine specimens were tested for gonorrhoea and chlamydia infection using polymerase chain reaction techniques. Researchers screened them for probable psychological distress by administering the General Health Questionnaire (12-items). Results revealed that local and traditional notions of health influenced men's symptom perceptions, with semen loss their predominant concern. Dhat, commonly perceived as an involuntary semen loss, corresponded most closely with the symptom of urethral discharge, but was attributed mainly to non-infectious causes. It could also manifest as a syndrome with physical weakness and mental lethargy. FGD participants lacked correct and complete information on reproductive health. Around 75% of the symptomatic men presented with dhat, but only 5.5% tested positive for gonorrhoea or chlamydia. Application of syndromic sexually transmitted infection (STI) guidelines in these settings could result in over diagnosis and over treatment with antibiotics. In contrast, there was a significant association between dhat and probable psychological distress as detected by the GHQ (Adjusted OR, GHQ case positive: 2.66, 95% CI: 1.51-4.68). Our study confirms the existence of a dhat syndrome in rural India, which is culturally influenced and reflects heightened psychosexual concerns as well as mental distress states. Comprehensive health services for men should include assessments of their psychosexual needs and be supported by reproductive ⁄ sexual health education. STI treatment guidelines for urethral symptoms should be revised and be based on epidemiological data.

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“…In India C. trachomatis -infected female patients are large in number, i.e. 30-40% [15][16][17] . Despite this high number of infected patients, there is a lacking scenario for understanding recurrent infections and their relation to clinical treatment failures.…”

Section: Discussionmentioning

confidence: 99%

“…In India, a high prevalence of genital C. trachomatis infection in women was reported earlier [15][16][17] , but studies regarding recurrent chlamydial infections and treatment failures among symptomatic women are lacking, which has an impact on reproductive health. Therefore, understanding the recurrent infections and antichlamydial drug susceptibility profile of clinical isolates from these patients is important for the development of prevention and control strategies.…”

Section: Introductionmentioning

confidence: 99%

Decreased Susceptibility to Azithromycin and Doxycycline in Clinical Isolates of<i> Chlamydia trachomatis</i> Obtained from Recurrently Infected Female Patients in India

et al. 2010

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Background: Recurrent genital Chlamydia trachomatis infection often results in serious sequelae and has a major impact on reproductive health. Materials and Methods: Recurrent infections were determined in symptomatic female patients. In vitro susceptibility assay was performed for azithromycin and doxycycline using the cell culture technique against 21 clinical isolates obtained from C. trachomatis-positive patients including those who were recurrently infected. Results: Thirteen isolates (61.9%) were found to be susceptible to azithromycin and doxycycline with minimum inhibitory concentration (MIC) values ≤0.125 and ≤0.25 µg/ml, respectively. Eight isolates (38%) were found to be less susceptible to the drugs. Two of them had MICs of 8 µg/ml for both the drugs and could not be completely eradicated as observed by minimum bactericidal concentration assay. Conclusions: Decreased antibiotic susceptibility to the current first-line drugs (azithromycin and doxycycline) for chlamydial infection treatment was observed in isolates obtained from recurrently infected patients.

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Chlamydia trachomatis genital infection in apparently healthy adult population of Tamil Nadu, India: a population-based study

Cited by 30 publications

References 0 publications

Prevalence and Incidence of Sexually Transmitted Infections among South Indians at Increased Risk of HIV Infection

Prevalence and Incidence of Sexually Transmitted Infections among South Indians at Increased Risk of HIV Infection

Socio‐cultural, psychosexual and biomedical factors associated with genital symptoms experienced by men in rural India

Decreased Susceptibility to Azithromycin and Doxycycline in Clinical Isolates of<i> Chlamydia trachomatis</i> Obtained from Recurrently Infected Female Patients in India

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