Genital Chalmydia trachomatis (serotypes D-K) infection in Jamaican commercial street sex workers

OBJECTIVE: To determine in the prevalence of genital Chlamydia trachomatis infections in commercial street sex workers (CSSW) in Jamaica. METHODS: The prevalence of C trachomatis infection was determined in 129 Jamaican CSSW using the direct fluorescent antibody (DFA) method and the isolation techniques which utilise fluorescent and iodine staining of endocervical cytobrush specimens cultured in McCoy cells. The seroprevalence of C trachomatis in the CSSW was also compared with that in blood donors (n = 435), using the microimmuofluorescence (MIF) test. RESULTS: The DFA detect C trachomatis in 16 percent (21/129) of the specimens. The prevalence as determined by the iodine and fluorescein stained cultures was 24 percent (31/129) and 25 percent (33/129) respectively. The overall prevalence of current chalmydial infection detected by the isolation techniques used was 25 percent (33/129). As determined by the MIF test, a statistically significantly higher seroprevalence rate of C trachomatis (95 percent, 61/64) was found in CSSW compared with blood donors (53 percent, 229/435; OR 22.6; chi 2 = 49.8; p < 0.001). The prevalence of current infection in CSSW as indicated by the isolation of C trachomatis was not influenced by history of previous pelvic inflammatory disease (PID), sexually transmitted disease, or condom use. N gonorrhoeae (9 percent) and Candida albicans (7 percent) were found in comparatively low frequencies, while Trichomonas vaginalis (0 percent) was not found in specimens from the CSSW. CONCLUSIONS: A high seroprevalence rate and a high rate of current infection with C trachomatis occur in Jamaican CSSW. In order to control the spread and prevent the severe clinical complications and sequeles of C trachomatis infection, the diagnosis and treatment in such high risk groups such as CSSW should be optimised.(AU)

Genital Chlamydia trachomatis (serotypes D-K) infection in Jamaican commercial street sex workers.

OBJECTIVES: To determine the prevalence of genital Chlamydia trachomatis infections in commercial street sex workers (CSSW) in Jamaica. METHODS: The prevalence of C trachomatis infection was determined in 129 Jamaican CSSW using the direct fluorescent antibody (DFA) method and the isolation techniques which utilise fluorescent and iodine staining of endocervical cytobrush specimens cultured in McCoy cells. The seroprevalence of C trachomatis in the CSSW was also compared with that in blood donors (n = 435), using the microimmunofluorescence (MIF) test. RESULTS: The DFA detected C trachomatis in 16% (21/129) of the specimens. The prevalence as determined by the iodine and fluorescein stained cultures was 24% (31/129) and 25% (33/129) respectively. The overall prevalence of current chlamydial infection detected by the isolation techniques used was 25% (33/129). As determined by the MIF test, a statistically significantly higher seroprevalence rate of C trachomatis (95%, 61/64) was found in CSSW compared with blood donors (53%, 229/435; OR 22.6; chi 2 = 49.8; p < 0.001). The prevalence of current infection in CSSW as indicated by the isolation of C trachomatis was not influenced by history of previous pelvic inflammatory disease (PID), sexually transmitted disease, or condom use. N gonorrhoeae (9%) and Candida albicans (7%) were found in comparatively low frequencies, while Trichomonas vaginalis (0%) was not found in specimens from the CSSW. CONCLUSIONS: A high seroprevalence rate and a high rate of current infection with C trachomatis occur in Jamaican CSSW. In order to control the spread and prevent the severe clinical complications and sequelae of C trachomatis infection, the diagnosis and treatment in such high risk groups such as CSSW should be optimised.

PIP: The prevalence of Chlamydia trachomatis infection was investigated in 129 commercial sex workers (CSWs) recruited on the streets in Kingston, Jamaica. The direct fluorescent antibody method detected C. trachomatis in endocervical cytobrush specimens from 21 women (16%). When the specimens were cultured, current chlamydial infection was detected by iodine staining in 31 (24%) and by monoclonal antibodies in 33 (25%). The microimmunofluorescence test for chlamydial antibodies was performed on clotted blood samples obtained from 64 CSWs and, as controls, 435 blood bank donors. A significantly higher seroprevalence rate was found among CSWs (95%) than blood donors (53%) (p 0.001). Among CSWs, the most common clinical manifestation of C. trachomatis infection was vaginal discharge. The presence of C. trachomatis infection was not related to previous history of pelvic inflammatory disease, sexually transmitted disease (STD), or condom use. Neisseria gonorrhoeae was isolated from 11 (9%) endocervical swabs. This study confirms the predominance of C. trachomatis among the bacterial causes of STDs in high-risk groups in Jamaica, and suggests a need for screening and treatment to control the spread and prevent the severe clinical sequelae of chlamydial infection.

Response of chlamydial non-gonococcal urethriti (NGU) to treatment with rosythromycin - abstract

The efficacy of roxythromycin 150 mg twice daily was evaluated for treatment of NGU caused by Chlamydia trachomatis in an adult outpatient setting with a high non-compliance level. Eligible patients were male adults (> 18 years) attending a sexually transmitted diseases (STD) clinic in Kingston with uncomplicated NGU. Chlamydial aetiology was identified by direct immunofluorescence and tissue culture techniques using monoclonal antibodies for final confirmation. In a 14-week study, 245 cases of NGU were identified of which 178 (72.7 per cent) were Chlamydia-positive. The results showed that C. trachomatis was eradicated from 87.2 per cent of the 125 patients finally evaluable. The prevalence of C. trachomatis is high in genital infections in Jamaica. These results indicated that roxythromycin was a suitable alternative for treatment in view of reports of resistance to tetracycline. A distinct advantage of roxythromycin was the twice daily dosage compared with four times daily for tetracycline, in treating a common sexually transmitted disease in a population group with a high non-compliance rate (AU)