Chlamydia silent epidemic disease: From research evidence to prevention

• Type: Chapter or Part of a Book
• Date: 2014

Authors

Silva, J (Author) Other; Cerqueira, F (Author) Other; Rui Medeiros (Author) ICBAS

Book

Title: Chlamydia: Prevalence, Pathogenesis and Prevention

Pages: 31-58

ISBN: 9781634630375; 9781634630092

Indexing

Scopus - 0 Citations

Other information

Authenticus ID: P-00K-4B5

Abstract (EN): As the most common reported bacterial sexually transmitted infection (STI) in developed countries, Chlamydia trachomatis is the focus of concerted public health control efforts based on screening and treatment. Annually, it is estimated 106 million new cases of C. trachomatis in adults (15-49 years) with a probable 100 million people infected at any one time. Chlamydia is still more important in developing countries, where control programs are virtually absent. C. trachomatis is an obligate intracellular bacterium, which normally infects the endocervical columnar epithelium of women and urethra of men. At the mucosal site intense inflammation response results in mucopurulent endocervical discharge, hypertrophic cervical ectopy and friability in women. The largest burden of C. trachomatis disease in women is the spread along the epithelial surface through the endometrium to the fallopian tubes to cause pelvic inflammatory disease (PID), infertility, ectopic pregnancy (EP) and chronic pelvic pain (CPP). In men, C. trachomatis is the most commonly reported STI and the leading cause of non-gonococcal urethritis and post-gonococcal urethritis. Following the upper genital tract ascension C. trachomatis may cause epididymitis and proctitis. Risk factors include co-infection with other(s) STIs, and sexual risk behaviours, such as young age of sexual intercourse, multiple sexual partners and failure in condom use. Because a high proportion of infected individuals have few or no symptoms, the prevalence and incidence of reported chlamydial infections is likely a gross global under-estimate and that screening of asymptomatic individuals would detect even more infections. Several public health strategies can be proposed: (i) Educational-based behaviour change promotion (e.g., increasing condom use, reducing partner numbers, sexual health discussion and awareness about C. trachomatis infection); (ii) increased screening and/or routine testing, treatment (azithromycin single dose) and contact tracing/partner notification; (iii) the development of new biomedical prevention or therapeutic technologies (e.g., vaccines). Advances in diagnostic techniques and methods of specimen collection make easier the detection, treatment and prevention of these infections. Here we present a state-of-the-art review concerning C. trachomatis epidemiology, pathogenesis, interaction with other STIs and prevention strategies.

Language: English

Type (Professor's evaluation): Scientific