Bacterial-aetiology of neonatal conjunctivitis in Trinidad - abstract

This prospective, consecutive survey of 3,645 babies delivered at the Mount Hope Women's Hospital from March 1 to November 8, 1990 was to determine the aetiology of neonatal conjunctivitis and to compare 3 methods for detection of Chlamydial infection in material from affected eyes. One hundred and twenty babies presented with purulent conjunctivitis within the first four weeks of life and were investigated for bacterial infection including chlamydia trachomatis. Material from infected eyes was examined for the presence of aerobic bacteria by standard bacteriological methods and for chlamydial infection by fluorescein antibody (FA) test, ELISA method and tissue culture. Staphylococcus aureus (40 percent) and Chlamydia trachomatis (11 percent) were the commonest organisms isolated. The prevalence rate of chlamydia trachomatis was 3.84 percent per 1,000 live births. Tissue culture and ELISA methods were more sensitive than the immuno-fluorescence technique. The cost per test for chlamydia trachomatis by the 3 methods varied from a minimum of TT$37.44 to a maximum of TT$63.11. In spite of the cost, it is recommended that testing for Chlamydial as well as bacterial infections should be a routine part of investigating neonatal conjunctivitis (AU)

Chlamydia trachomatis in antenatal women at Mount Hope Women's Hospital in Trinidad and Tobago: prevalence and perinatal transmission

Chlamydia trachomatis infection is being increasingly recognized as an important public health problem worldwide. The prevalence and rate of perinatal transmission of chlamydia was examined in 200 women attending antenatal clinic at the Mt. Hope Women's Hospital using tissue culture (TC), ELISA and fluorescent antibody (FA) methods. 27 (13.6 percent) women were found to be chlamydia positive by TC. 13 of the babies born to these mothers were also found to be positive, giving a vertical transmission rate of 48 percent. Compared to TC, the ELISA test was 96 percent sensitive and 100 percent specific while FA was 67 percent sensitive and 99 percent specific. Chlamydial infection was significantly associated (p<0.001) with being of Afro-Trinidadian descent, age <25 years, being unmarried and having two or more sexual partners in the past five years. The association with ethnicity could be explained on the basis of numbers of sexual partners and marital status. Chlamydia is often asymptomatic and no association was found with a history of previous STD, vaginitis or lower abdominal pain. It is recommended that women attending antenatal, family planning and STD clinics be screened for chlamydia infection and treated, together with their sexual partners, as an effective way of prevention. Enhanced chlamydia surveillance and strengthened laboratory capabilities are also recommended. (AU)