1.  Peer Reviewed Title: Delivery of chlamydia screening to young women requesting emergency hormonal contraception at pharmacies in Manchester, UK : a prospective study. Author: Brabin L; Thomas G; Hopkins M; O'Brien K; Roberts SA Source: BMC Women's Health. 2009 Mar 26;9(1):7. Abstract: ABSTRACT: BACKGROUND: More women are requesting Emergency Hormonal Contraception (EHC) at pharmacies where screening for Chlamydia trachomatis is not routinely offered. The objective of this study was to assess the uptake of free postal chlamydia screening by women under 25 years who requested EHC at pharmacies in Manchester, UK. METHODS: Six Primary Care Trusts (PCTs) that had contracted with pharmacies to provide free EHC, requested the largest EHC providers ([greater than or equal to] 40 doses annually) to also offer these clients a coded chlamydia home testing kit. Pharmacies kept records of the ages and numbers of women who accepted or refused chlamydia kits. Women sent urine samples directly to the laboratory for testing and positive cases were notified. Audit data on EHC coverage was obtained from PCTs to assess the proportion of clients eligible for screening and to verify the uptake rate. RESULTS: 33 pharmacies participated. Audit data for 131 pharmacy months indicated that only 24.8% (675/2718) of women provided EHC were also offered chlamydia screening. Based on tracking forms provided by pharmacies for the whole of the study, 1348 /2904 EHC clients (46.4%) who had been offered screening accepted a screening kit. 264 (17.6%) of those who accepted a kit returned a sample, of whom 24 (9.1%) were chlamydia-positive. There was an increase in chlamydia positivity with age (OR: 1.2 per year; 1.04 to 1.44; p = 0.015). CONCLUSIONS: Chlamydia screening for EHC pharmacy clients is warranted but failure of pharmacists to target all EHC clients represented a missed opportunity for treating a well defined high-risk group. Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | PROSPECTIVE STUDIES | WOMEN | YOUTH | SCREENING | EMERGENCY CONTRACEPTION | CHLAMYDIA | PHARMACY DISTRIBUTION | Developed Countries | Europe, Western | Europe | Studies | Research Methodology | Demographic Factors | Population | Age Factors | Population Characteristics | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraception | Family Planning | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration Document Number: 330849 |
| 2. Title: Prevalence of Chlamydia trachomatis among women attending gynecology and infertility clinics in Gaza, Palestine. Author: El Qouqa IA; Shubair ME; Al Jarousha AM; Sharif FA Source: International Journal of Infectious Diseases. 2009 May;13(3):334-41. Abstract: BACKGROUND: Chlamydia trachomatis is an obligate intracellular bacterium characterized by a biphasic developmental cycle of replication. The organism is recognized as one of the major causes of sexually transmissible human bacterial infection throughout the world. Since there have been no previous studies dealing with chlamydial diagnosis in Palestine, this study was conducted to determine the prevalence of C. trachomatis infection among women attending gynecology and infertility clinics. METHODS: Endocervical swabs were collected from 109 women, aged 18-52 years (median 29 years), attending gynecology and infertility clinics in Gaza. These specimens were processed using molecular (polymerase chain reaction, PCR) and enzyme immunoassay (EIA; IDEIA PCE Chlamydia) techniques. RESULTS: The results obtained show that the overall prevalence rate of C. trachomatis was 20.2%. The sensitivity was 73% for the EIA, 86% for the MOMP (major outer membrane protein gene)-based PCR, and 100% for the plasmid-based PCR. Meanwhile the specificity was 94% for the EIA, 98% for the plasmid-based PCR, and 100% for the MOMP-based PCR. In multivariate analysis, only cervical discharge was significantly associated with positivity for C. trachomatis (adjusted odds ratio 5.6, 95% confidence interval 2.0-15.5; p=0.001). CONCLUSIONS: The study revealed that a significant proportion of Palestinian women expressed evidence of exposure to C. trachomatis. Women with cervicitis are more likely to have been previously infected or exposed to Chlamydia infection. Furthermore, PCR proved to be superior and more efficient in the diagnosis of C. trachomatis than EIA. Language: English Keywords: GAZA | RESEARCH REPORT | CLINICAL RESEARCH | SAMPLING STUDIES | CLIENTS | WOMEN | CHLAMYDIA | PREVALENCE | INFERTILITY | CERVICAL EFFECTS | LABORATORY PROCEDURES | SIGNS AND SYMPTOMS | Middle East | Developing Countries | Research Methodology | Studies | Program Activities | Programs | Organization and Administration | Demographic Factors | Population | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Measurement | Reproduction | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342115 |
| 3. Title: [Chlamydia trachomatis and Neisseria gonorrhoeae among women in a family planning clinic] Infeccao por Chlamydia trachomatis e Neisseria gonorrhoeae em mulheres atendidas Author: Fernandes AM; Daher G; Nuzzi RX; Petta CA Source: Revista Brasileira De Ginecologia E Obstetricia. 2009 May;31(5):235-40. Abstract: PURPOSE: to study infection prevalence by Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG), among adolescent and young women in a family planning outpatient clinic. METHODS: a total of 230 women up to 24 years old and history of up to four sexual partners have been followed-up for 48 months, with urine collection to search CT and NG, by the polymerase chain reaction method at the 1st, 12nd, 24th, 36th and 48th months. The variables studied were age group, schooling, marital status, number of gestations, abortions and children alive, age at the onset of sexual life, previous and present use of condom, previous use of intrauterine device, number of sexual partners in the previous six months and follow-up time. Bivariate analysis of variables according to positive tests for CT and NG, and multiple analyses by logistic regression were done. RESULTS: the ratio of infections by CT was 13.5% and by NG, 3%. Two women presented both tests as positive. The previous intrauterine device use was associated with positive tests for NG. CONCLUSIONS: the prevalence of infections by CT and NG was higher among the age group studied and the screening of young women must be taken into consideration in our services, to control the dissemination of sexually transmitted diseases and prevention of sequels. Language: Portuguese Keywords: DEVELOPING COUNTRIES | RESEARCH REPORT | PREVALENCE | WOMEN | ADOLESCENTS, FEMALE | CHLAMYDIA | LABORATORY PROCEDURES | SEXUALLY TRANSMITTED DISEASES | Measurement | Research Methodology | Demographic Factors | Population | Adolescents | Youth | Age Factors | Population Characteristics | Reproductive Tract Infections | Infections | Diseases | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342470 |
| 4. Title: Comparison of Sexual Partnership Characteristics and Associations with Inconsistent Condom Use among a Sample of Adolescents and Adult Women Diagnosed with Chlamydia trachomatis. Author: Foulkes HB; Pettigrew MM; Livingston KA; Niccolai LM Source: Journal of Women's Health. 2009;18(3):393-399. Abstract: Abstract Background: This analysis compared characteristics of female adolescent and adult sexual partnerships and related these characteristics to inconsistent condom use. Methods: Data are from a study of 126 women with prevalent chlamydia infections who reported information about 172 sexual partnerships in the previous 3 months. Characteristics of sexual partnerships included type of partner (main vs. other), duration of sexual relationship (<3 months vs. >/=3 months), partner age difference (<2 years older vs. >/=2 years older), and two scale measures: overlap of social networks (a measure based on how well the participant knew her partner's friends, for example) and intimacy. Results: Compared with adult partnerships, adolescent partnerships were of shorter duration and had less social overlap but were more likely to be classified by the participants as main partnerships. Among adolescents, longer partnership duration was not associated with higher intimacy, yet higher intimacy was significantly correlated with inconsistent condom use. Conclusions: These differences suggest that adolescent females perceive and characterize their sexual relationships differently from adults. This, in turn, may have implications for risk of sexually transmitted infections (STIs). Prevention efforts for adolescents, including interventions and counseling, should consider the nature of their sexual partnerships. Language: English Keywords: CONNECTICUT | RESEARCH REPORT | KAP SURVEYS | COMPARATIVE STUDIES | CONTRACEPTIVE PREVALENCE SURVEYS | SEXUAL PARTNERS | ADOLESCENTS, FEMALE | WOMEN | SOCIAL NETWORKS | CONDOM USE | CHLAMYDIA | AGE FACTORS | TIME FACTORS | PERCEPTION | SEX BEHAVIOR | Developed Countries | United States of America | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Family Planning Surveys | Family Planning | Behavior | Adolescents | Youth | Population Characteristics | Demographic Factors | Population | Friends and Relatives | Family and Household | Sociocultural Factors | Risk Reduction Behavior | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Population Dynamics | Psychological Factors Document Number: 330416 |
| 5. Peer Reviewed Title: A 15-Minute Interactive, Computerized Condom Use Intervention With Biological Endpoints. Author: Grimley DM; Hook EW 3rd Source: Sexually Transmitted Diseases. 2009 Feb;36(2):73-78. Abstract: BACKGROUND:: Brief face-to-face-behavioral interventions have been shown to be efficacious, but are costly to sustain and to widely disseminate. This study evaluated the efficacy of a 15-minute theory-based behavioral intervention designed to increase condom use and reduce new cases of Neisseria gonorrhoeae and Chlamydia trachomatis. METHODS:: Participants were randomly assigned via the computer to the intervention or the comparison group stratified by gender and their baseline stage of change (motivational readiness) for using condoms consistently (100%) with their main partners. Behavioral data and biologic specimens for testing of Neisseria gonorrhoeae and Chlamydia trachomatis were obtained at baseline and at 6 months post intervention. The intervention was delivered via an audio, multimedia, computerized application that provided individualized interventions to patients based on their responses to assessment items; comparison patients interacted with a 15-minute, computerized, multiple health risk assessment with no intervention. RESULTS:: The majority of the sample (N = 430) was black (88%); 54.5% women; with a mean age = 24.5. Assuming all participants who did not return to the clinic at 6 months were not using condoms consistently, 32% of the treatment group versus 23% in the comparison group reported consistent condom use (P = 0.03). The combined Neisseria gonorrhoeae and Chlamydia trachomatis incidence declined to 6% in the intervention group versus 13% in the comparison group (P = 0.04). Results from a regression analysis revealed that the only statically significant predictor of sexually transmitted diseases infection at the follow-up was group assignment (OR = 1.91, 95% confidence index = 1.09-3.34; P = 0.043). CONCLUSIONS:: These findings suggest that brief, interactive, computer-delivered interventions provided at the evaluation visit increase condom use and reduce sexually transmitted diseases without putting additional burden on clinicians or staff. Language: English Keywords: ALABAMA | RESEARCH REPORT | KAP SURVEYS | CASE CONTROL STUDIES | STATISTICAL REGRESSION | THEORETICAL MODELS | BLACKS | COMPUTER PROGRAMS AND PROGRAMMING | GONORRHEA | CHLAMYDIA | CONDOM USE | AUDIOVISUAL AIDS | TIME FACTORS | RISK ASSESSMENT | CONTRACEPTIVE PREVALENCE | Developed Countries | United States of America | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Data Analysis | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Information Processing | Information | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Risk Reduction Behavior | Behavior | Educational Methods | Educational Activities | Education | Population Dynamics | Evaluation | Contraceptive Usage | Contraception | Family Planning Document Number: 329674 |
| 6. Title: Cytokine levels in HIV infected and uninfected Indian women: correlation with other STAs. Author: Guha D; Chatterjee R Source: Experimental and Molecular Pathology. 2009 Feb;86(1):65-8. Abstract: Host immune status is an important determinant of disease progression. Infections in the genital tract may alter the immunity in the particular site and hence affect the production of local cytokines. We performed this study to determine whether HIV in association with cervical HPV and CT/GC infections influences the production of local cytokines. Cervical secretions from 100 women with or without HIV infection were collected for measuring IL-1 beta, -6, -10 and -12 concentrations by ELISA. Cervical HPV and CT/GC DNA were detected by HCII test. Significant elevations of IL-6 and IL-10 were observed in patients having HIV infection. Although cervical HPV infection increased the concentrations of both IL-6 and IL-1 beta but HPV induced abnormal cervical smear was associated only with increased IL-6 concentrations significantly. Double infection had marked relation with IL-6 and IL-10. CT/GC had no direct effect on any of these cytokines but in association with HIV and HPV, these bacterial pathogens elevated the concentrations of IL-6 significantly. Thus, our results suggest that the presence of HIV and other STAs in the genital tract can cause imbalance of local cytokine levels which in turn may facilitate other opportunistic infections. Language: English Keywords: INDIA | RESEARCH REPORT | CLINICAL RESEARCH | GENETIC TECHNIQUES | WOMEN IN DEVELOPMENT | IMMUNOLOGICAL EFFECTS | HPV | HIV INFECTIONS | COMPLICATIONS | IMMUNITY, CELLULAR | PAP SMEAR | CHLAMYDIA | GONORRHEA | Developing Countries | Asia, Southern | Asia | Research Methodology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Economic Development | Economic Factors | Immunity | Immune System | Physiology | Biology | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections Document Number: 330392 |
| 7. Peer Reviewed Title: Lack of utility of risk score and gynecological examination for screening for sexually transmitted infections in sexually active adolescents. Author: Guimaraes EM; Guimaraes MD; Vieira MA; Bontempo NM; Seixas MS; Garcia MS; Daud LE; Cortes RL; Alves Mde F Source: BMC Medicine. 2009;7:8. Abstract: BACKGROUND: Sexually transmitted infections constitute the main health risk among adolescents. In developing countries the diagnosis and treatment of cervical infections is based on the syndromic approach. In this study we estimated the prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae among female adolescents from a Health Sector of the city of Goiania, Brazil, and validated cervicitis diagnosis using World Health Organization/Ministry of Health risk score and gynecological examination. METHODS: A cross-sectional community-based sample of 914 15- to 19-year-old female teenagers was randomly selected and referred to the local Family Health Program. Of these, 472 (51.6%) were sexually active and gynecological examinations were carried out for 427. Endocervical samples were collected to perform the polymerase chain reaction for C. trachomatis and N. gonorrhoeae. Performance of risk score, the presence of mucopurulent discharge, friability, ectopia and pain during cervical maneuver were compared with the presence of C. trachomatis or N. gonorrhoeae or both. RESULTS: The prevalence of C. trachomatis and N. gonorrhoeae was 14.5% and 2.1%, respectively. The risk score had a specificity of 31.9% (95% confidence interval, 21.2 to 44.2) and a positive predictive value of 20.8% (95% confidence interval, 13.5 to 29.7). Friability was the component of the gynecological examination that presented the best performance with a sensitivity of 43.5%, specificity of 81.0%, and 30.6% of positive predictive value. CONCLUSION: The prevalence of infection by C. trachomatis and N. gonorrhoeae was high among these sexually active adolescents. The syndromic approach is clearly inadequate for screening and treating these infections in this population. Therefore, the implantation of other strategies to control these infections among adolescents is urgently required. Language: English Keywords: BRAZIL | RESEARCH REPORT | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | CROSS SECTIONAL ANALYSIS | ADOLESCENTS, FEMALE | URBAN POPULATION | RISK ASSESSMENT | SEX BEHAVIOR | GYNECOLOGY | CERVICAL EFFECTS | PREVALENCE | CHLAMYDIA | GONORRHEA | SIGNS AND SYMPTOMS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Evaluation | Behavior | Medicine | Health Services | Delivery of Health Care | Health | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Measurement | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases Document Number: 331079 |
| 8. Peer Reviewed Title: Prevalence and risk factors for Chlamydia trachomatis infection among cross-border truck drivers in Hong Kong. Author: Leung PH; Boost MV; Lau JT; Wong AT; Pang M; Ng TK; Tong ET Source: Sexually Transmitted Infections. 2009 Feb;85(1):27-29. Abstract: Objectives: To determine the prevalence and risk factors for chlamydial infection in cross-border truck drivers. Methods: 225 Hong Kong-based cross-border truck drivers were screened for chlamydial infection. Associations between infection and potential risk factors were determined by questionnaire. Results: 8.5% of drivers were positive for chlamydial infection. Of 62% of drivers reporting recent sex with commercial sex workers (CSW), 39% had not used condoms. 75% of drivers with extramarital sex partners (ESP) also frequented CSW and 47% of this group had not used condoms with CSW. 43.3% PCR-positive cases reported symptoms. No risk factor was associated with chlamydial infection after adjustment, although "had sex with ESP" approached significance. Conclusions: The prevalence of chlamydial infection among cross-border truck drivers was not strikingly high, although drivers engaged in sex with both ESP and CSW, with many admitting unprotected intercourse. The findings highlight the importance of promoting safe sex to truck drivers. Language: English Keywords: HONG KONG | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | TRUCK DRIVERS | SEX WORKERS | MULTIPLE PARTNERS | BORDER CROSSING | CHLAMYDIA | PREVALENCE | RISK FACTORS | SCREENING | EXTRAMARITAL SEX BEHAVIOR | CONDOM USE | Developed Countries | Asia, Eastern | Asia | Research Methodology | Labor Force | Human Resources | Economic Factors | Sex Behavior | Behavior | Sexual Partners | International Migration | Migration | Population Dynamics | Demographic Factors | Population | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Measurement | Health | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Risk Reduction Behavior Document Number: 340111 |
| 9. Peer Reviewed Title: Chlamydia trachomatis infection in women with secondary infertility. Author: Malik A; Jain S; Rizvi M; Shukla I; Hakim S Source: Fertility and Sterility. 2009 Jan;91(1):91-5. Abstract: OBJECTIVE: To assess the role of Chlamydia in secondary infertility in a prospective study. DESIGN: Forty women with secondary infertility and 30 healthy term pregnant women of similar age composition were studied for past and present Chlamydia trachomatis infection. SETTING: Women attending the outpatient Department of Obstetrics and Gynaecology with complaint of secondary infertility were enrolled as patients in the study. PATIENT(S): Forty women with secondary infertility formed the study group, and 30 healthy women served as the controls. INTERVENTION(S): Chlamydia IgG was detected by ELISA; titers of 1:320 or more were considered positive. Endocervical swabs were collected for culture on cycloheximide-treated McCoy cell lines, and ELISA was used to detect Chlamydia antigen. Hysterosalpingography was performed to assess tubal patency. MAIN OUTCOME MEASURE(S): A difference was expected between the prevalence of C. trachomatis infection in the infertile study subjects and fertile control group. RESULT(S): Immunoglobulin G antibodies were present in 22 (55%) women with secondary infertility, whereas positivity was seen among 2 (5.5%) controls. Tubal occlusion occurred in 16 (63.6%) cases positive for chlamydial antibody. Sensitivity of chlamydial IgG antibody as a diagnostic marker for infertility was 72.7%, and specificity was 44.4%. The majority of Chlamydia IgG antibody-positive cases, 17 (77.2%), were symptomatic. Unfavorable obstetric history was found in 16 (72.7%) cases. Active infection was found in 12 (30%) cases with one (3.3%) case of current infection occurring in the controls. CONCLUSION(S): Prevalence of past chlamydial infection is strongly statistically significant in women with secondary infertility. Current infection was also found statistically significantly in these women. Immunoglobulin G antibody detection is an effective and noninvasive tool for detection of Chlamydia and a more viable option than HSG in a developing country such as India. Screening of women with secondary infertility for C. trachomatis is strongly recommended to allow early therapeutic interventions. Language: English Keywords: INDIA | RESEARCH REPORT | PREVALENCE | WOMEN | PREGNANT WOMEN | INFERTILITY | CHLAMYDIA | CULTURE | ANTIBODIES | ANTIGENS | Developing Countries | Asia, Southern | Asia | Measurement | Research Methodology | Demographic Factors | Population | Population Characteristics | Reproduction | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Sociocultural Factors | Immunologic Factors | Immunity | Immune System | Physiology | Biology Document Number: 330025 |
| 10. Peer Reviewed Title: Molecular identification of endocervical Chlamydia trachomatis infection among gestations at risk for preterm birth in Ecuador. Author: Medina M; Moya W; Hidalgo L; Calle A; Teran E; Chedraui P Source: Archives of Gynecology and Obstetrics. 2009 Jan;279(1):9-10. Abstract: AIM AND METHOD: To identify Chlamydia trachomatis (CT) endocervical infection among gestations at risk for preterm birth by means of DNA amplification. RESULTS: One hundred fifty eight (n = 158) gestations of Guayaquil (63.3%) and Quito (36.7%) Ecuador, at risk for preterm birth: threatened preterm labor (TPL, 60.8%) and preterm premature rupture of membranes (PPROM, 39.2%) were recruited. CT infection was presented in 8.2% of cases (TPL: 10.4% and PPROM: 4.8%). No significant difference was observed in this frequency in regard to city or diagnosis. CONCLUSION: Although the causative role of CT infection for these antenatal complications cannot be completely ruled out, its presence may justify an antenatal routine screening program in order to provide appropriate therapy. Language: English Keywords: ECUADOR | RESEARCH REPORT | PREGNANT WOMEN | CHLAMYDIA | PREMATURE BIRTH | RISK FACTORS | ANTENATAL CARE | PREGNANCY OUTCOMES | Developing Countries | South America, Western | South America | Latin America | Americas | Population Characteristics | Demographic Factors | Population | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Pregnancy | Reproduction | Health | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care Document Number: 341009 |
| 11. Peer Reviewed Title: Sex work, Syphilis, and Seeking Treatment: An Opportunity for Intervention in HIV Prevention Programming in Karnataka, South India. Author: Mishra S; Moses S; Hanumaiah PK; Washington R; Alary M; Ramesh BM; Isac S; Blanchard JF Source: Sexually Transmitted Diseases. 2009 Feb 9; Abstract: OBJECTIVES:: To measure the determinants of syphilis among female sex workers (FSWs) in the state of Karnataka, South India. METHODS:: During 2004-2006, cross-sectional surveys were administered to 2312 FSWs across 5 districts in the state, in the context of a large-scale HIV preventive intervention program. Demographic and behavioral information, and serum (for syphilis, HSV-2 and HIV) and urine specimens (for Neisseria gonorrhoeae and Chlamydia trachomatis) were obtained. RESULTS:: The prevalences of lifetime (TPHA positive) and active (RPR and TPHA positive) syphilis were 25.3% and 9.6%, respectively. There was considerable variation in the prevalence between districts, ranging from 10.9% to 37.4% lifetime, and 3.4% to 24.9% active infection. Factors associated with lifetime syphilis were older age, longer duration of sex work, illiteracy, client volume, practising sex work in >1 city, and sex work typology (public solicitation followed by brothel or lodge-based sex). The same typology, client volume, illiteracy, and having been widowed, divorced or deserted, were predictive of active infection. Of the 976 women who had symptoms of an STI, 78.8% had sought medical treatment, behavior that was protective for both outcomes. HIV infection was strongly associated with lifetime (OR 2.0; 95% CI: 1.6-2.6) and active syphilis (OR 2.1; 95% CI: 1.5-2.9). CONCLUSIONS:: Despite reasonable treatment-seeking behavior, the high prevalence of syphilis has necessitated enhanced outreach efforts for FSWs and acceleration of the implementation of syphilis screening. Mobilizing resources to enhance syphilis control will not only reduce the burden of syphilis morbidity, but should impact in reducing HIV transmission. Language: English Keywords: INDIA | RESEARCH REPORT | KAP SURVEYS | CROSS SECTIONAL ANALYSIS | EPIDEMIOLOGIC METHODS | WOMEN IN DEVELOPMENT | SEX WORKERS | SYPHILIS | UTILIZATION OF HEALTH CARE | HIV PREVENTION | HERPES GENITALIS | GONORRHEA | CHLAMYDIA | AGE FACTORS | PREVALENCE | ILLITERACY | Asia, Southern | Asia | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Sex Behavior | Behavior | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Health Services | Delivery of Health Care | Health | HIV Infections | Viral Diseases | Population Characteristics | Demographic Factors | Population | Measurement | Educational Status | Socioeconomic Status | Socioeconomic Factors Document Number: 341500 |
| 12. Peer Reviewed Title: Highly effective contraception and acquisition of HIV and other sexually transmitted infections. Author: Morrison CS; Turner AN; Jones LB Source: Best Practice and Research: Clinical Obstetrics and Gynaecology. 2009 Apr;23(2):263-284. Abstract: A key question for clinicians is whether an aetiological association exists between highly effective contraceptive methods and women's risk of acquiring sexually transmitted infections (STIs), including human immunodeficiency virus (HIV). The authors searched the peer-reviewed literature for prospective studies published from January 1966 to August 2008 that assessed contraception and STI/HIV risk. The focus was on combined oral contraceptives (OCs), depot-medroxyprogesterone acetate (DMPA), the T380a copper intra-uterine device (IUD) and the risk of infection with HIV, Chlamydia trachomatis and Neisseria gonorrhoeae. Current data suggest that neither OCs nor DMPA increase HIV risk among women in the general population. Data are equivocal for women in high-risk groups (e.g. sex workers). Current data suggest an increased risk of chlamydial infection associated with OC use, with weaker evidence supporting a harmful effect of DMPA. Reports of OCs and gonococcal infection are inconsistent, and DMPA does not appear to be associated with gonorrhoea acquisition. Data suggest no increased STI/HIV risk among copper IUD users. Prospective data on highly effective contraceptive methods and women's STI/HIV risk are limited, and many studies have important methodological weaknesses. Additional information about the STI/HIV risks associated with these highly effective contraceptive methods is needed. Language: English Keywords: UNITED STATES OF AMERICA | LITERATURE REVIEW | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | WOMEN | CONTRACEPTIVE EFFECTIVENESS | HIV TRANSMISSION | SEXUALLY TRANSMITTED DISEASES | DEPO-PROVERA | IUD | CHLAMYDIA | GONORRHEA | ORAL CONTRACEPTIVES | CONTRACEPTIVE SAFETY | Developed Countries | North America | Americas | Research Methodology | Demographic Factors | Population | Contraception | Family Planning | HIV Infections | Viral Diseases | Diseases | Reproductive Tract Infections | Infections | Medroxyprogesterone Acetate | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraceptive Methods | Safety | Public Health | Health Document Number: 341508 |
| 13. Peer Reviewed Title: Screening for Chlamydia trachomatis in secondary schools, family planning and occupational health centres in Luxembourg. Author: Mossong J; Muller M; Majery N; Mardaga C; Decruyenaere F; Schneider F Source: Sexually Transmitted Infections. 2009 Jul 1; Abstract: BACKGROUND: We conducted a prospective pilot screening study in three settings in Luxembourg where routine urine testing is carried out independently for other purposes with a short sexual behaviour questionnaire to estimate prevalence and determine risk factors of urogenital Chlamydia trachomatis (CT) infection. METHODS: Screening was offered to sexually active volunteer participants aged less than 25 years in three settings: i) women in 3 family planning centres (FPC), ii) young women and men in 29 secondary schools and iii) women and men in an occupational health centre (OHC) for newly recruited employees and workers. First catch urine samples were tested using the COBAS Amplicor and an in-house assay. Multiple logistic regression was performed to analyse risk factors. RESULTS: Overall prevalence among 4141 participants was 7.7% (95% confidence interval (CI) 6.3-9.2) in FPCs, 1.9% (95% CI 1.2-2.8) in secondary schools and 4.5% (95% CI 3.5-5.6) in the OHC. Depending on the setting, identified risk factors included being 18-22 years old, female sex, having three or more sexual partners in the past year, and inconsistent condom use. CONCLUSION: Screening is feasible in the three settings, but the prevalence of CT infection among men and women is highest in age groups that have left secondary school. Family planning centres were the setting with the highest CT prevalence and the only setting in our study able to provide case management, follow-up and repeat testing. Language: English Keywords: LUXEMBOURG | RESEARCH REPORT | PROSPECTIVE STUDIES | PILOT PROJECTS | CHLAMYDIA | SCREENING | SECONDARY SCHOOLS | FAMILY PLANNING CENTERS | OCCUPATIONAL HEALTH | PREVALENCE | RISK FACTORS | Developed Countries | Europe, Western | Europe | Studies | Research Methodology | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Schools | Education | Health Facilities | Measurement Document Number: 341862 |
| 14. Title: Prevalence of human papillomavirus and Chlamydia trachomatis infection among women attending cervical cancer screening in the Republic of Korea. Author: Oh JK; Franceschi S; Kim BK; Kim JY; Ju YH; Hong EK; Chang YC; Rha SH; Kim HH; Kim JH; Kim CY; Shin HR Source: European Journal of Cancer Prevention. 2009 Feb;18(1):56-61. Abstract: Cervical cancer screening with the conventional Papanicolaou test is recommended for the women aged 30 years and more in Korea. Cervical infection with human papillomavirus (HPV) is the most important cause of cervical cancer and Chlamydia trachomatis (CT) is the most common bacterial sexually transmitted infection and may also be associated with risk of cervical cancer. A cross-sectional study of women attending the National Cervical Cancer Screening Program in Busan and Suwon was carried out. Exfoliated cervical cells were collected, and questionnaires were administered to 4595 women. High-risk HPV types and CT were tested by Hybrid Capture 2 (HC2). HPV genotyping of 355 high-risk HPV-positive women at HC2 was performed using linear array. Age-standardized prevalence of high-risk HPV types and CT was 10.4% (95% confidence interval: 9.5-11.3) and 4.3% (95% confidence interval: 3.7-4.8). That 68.5% of women were high-risk HPV-positive at HC2 was confirmed by Linear Array whereas 17.5% seemed to be infected with only low-risk HPV types, not normally detected by HC2. Korean women showed a relatively high prevalence of high-risk HPV and a rather low prevalence of CT. As in cancer-free women in other Asian populations, HPV 52, 58, and 39 were detected more frequently than HPV 16. Cross-reaction of HC2 with low-risk HPV types is of some concern, were the test to be used in primary screening. Language: English Keywords: REPUBLIC OF KOREA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | CROSS SECTIONAL ANALYSIS | WOMEN IN DEVELOPMENT | PREVALENCE | HPV | CERVICAL CANCER | SCREENING | CHLAMYDIA | Asia, Eastern | Asia | Developed Countries | Research Methodology | Economic Development | Economic Factors | Measurement | Viral Diseases | Diseases | Cancer | Neoplasms | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections Document Number: 330253 |
| 15. Peer Reviewed Title: Promotion of adolescent sexual health in primary care: survey in Finnish health centres. Author: Sannisto T; Kosunen E Source: European Journal of Contraception and Reproductive Health Care. 2009 Feb;14(1):27-38. Abstract: OBJECTIVES: To describe adolescent sexual health services in primary care in Finland, focusing on services for contraceptive counselling, sexually transmitted infections and abortion. METHODS: Service provision, accessibility and practices were surveyed in all 63 health centre organizations (HCOs) in a hospital district in Western Finland via separate e-mailed questionnaires to chief physicians (n = 49, response rate 78%), directors of nursing (58, 92%), doctors (49, 78%) and nurses (62, 98%). RESULTS: Dedicated youth clinics existed in only three HCOs. In others, services were provided in family planning, maternity or outpatient clinics. The average wait for contraceptive consultation was 4.8 days to a nurse and 12.5 days to a doctor. In 15 HCOs doctors stipulated a minimum age for combined hormonal contraception. Free supply of contraceptives was often limited to initiation. On-site instructions for chlamydia screening existed in 11 HCOs. Nurses could test for chlamydia without doctor's involvement in 46 HCOs. School nurses participated actively in sexuality education in secondary schools. CONCLUSIONS: Adolescent sexual health services were generally adequately available in the HCOs studied. However, services tailored for adolescents were rare. Some medical barriers to access to contraception were found. To improve the system, further involvement of nurses in service provision is recommended. Language: English Keywords: FINLAND | RESEARCH REPORT | ADOLESCENTS, FEMALE | CONTRACEPTION | SEXUALLY TRANSMITTED DISEASES | PRIMARY HEALTH CARE | CHLAMYDIA | ABORTION | COUNSELING | HEALTH SERVICES | Developed Countries | Europe, Northern | Europe | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Family Planning | Reproductive Tract Infections | Infections | Diseases | Delivery of Health Care | Health | Fertility Control, Postconception | Clinic Activities | Program Activities | Programs | Organization and Administration Document Number: 341235 Notification |
| 16. Peer Reviewed Title: Male circumcision and Neisseria gonorrhoeae, Chlamydia trachomatis and Trichomonas vaginalis: observations after a randomised controlled trial for HIV prevention. Author: Sobngwi-Tambekou J; Taljaard D; Nieuwoudt M; Lissouba P; Puren A; Auvert B Source: Sexually Transmitted Infections. 2009 Apr;85(2):116-20. Abstract: OBJECTIVE: To assess the association between male circumcision and Neisseria gonorrhoeae, Chlamydia trachomatis and Trichomonas vaginalis using data from a male circumcision randomised controlled trial. METHODS: We used data collected during the male circumcision trial conducted in Orange Farm (South Africa) among men aged 18-24 years. Altogether, 1767 urine samples collected during the final follow-up visit were analysed using PCR. Prevalence of N gonorrhoeae, C trachomatis and T vaginalis was assessed as a function of male circumcision using odds ratios (OR) given by univariate and multivariate logistic regression. RESULTS: In an intention-to-treat analysis, prevalence of N gonorrhoeae, C trachomatis and T vaginalis among intervention and control groups were 10.0% versus 10.3% (OR 0.97; p = 0.84), 2.1% versus 3.6% (OR 0.58; p = 0.065) and 1.7% versus 3.1% (OR 0.54; p = 0.062), respectively. The association between T vaginalis and male circumcision remained borderline when controlling for age, ethnic group, number of lifetime partners, marital status, condom use and HIV status (AOR 0.48; p = 0.069). In the as-treated analysis, this association became significant (OR 0.49, p = 0.030; AOR 0.41, p = 0.030). CONCLUSIONS: This study demonstrates for the first time that male circumcision reduces T vaginalis infection among men. This finding explains why women with circumcised partners are less at risk for T vaginalis infection than other women. The protective effect on T vaginalis is an additional argument to recommend male circumcision in Africa where it is acceptable. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | CONTROL GROUPS | MEN | MALE CIRCUMCISION | GONORRHEA | CHLAMYDIA | TRICHOMONIASIS | PREVALENCE | LABORATORY PROCEDURES | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Demographic Factors | Population | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Measurement | Laboratory Examinations and Diagnoses | Examinations and Diagnoses Document Number: 341848 |
| 17. Peer Reviewed Title: Commentary on "Prevalence and risk factors for Chlamydia trachomatis infection among cross-border truck drivers in Hong Kong". Author: Sorensen W Source: Sexually Transmitted Infections. 2009 Feb;85(1):29-30. Abstract: The report by Leung et al1 highlights many dimensions of concern from the global perspective of sexually transmitted infection (STI) control, while investigating only Chlamydia trachomatis infection among Hong Kong truckers. This is the only truck driver study, to my knowledge, focused solely on chlamydia infection and its determinants. Because of their screening procedure, one third of the truckers accessed their results-unprecedented for men in this occupation. Of course, the problematical characteristic of chlamydia infection is its asymptomatic status, thereby reducing the impetus to seek testing. This probably contributes to the moderate to high rates of infection (estimated at 89 million new cases annually)2 experienced globally. .... The report by Leung et al1 failed to uncover any significant behavioural or demographic information associated with chlamydia infection among truckers. Yet this null finding informs us, for China is the latest and largest theatre under the spotlight of global STI concern. Chlamydia infection in China "is both a danger in itself and a marker of possible paths of the HIV/AIDS epidemic as it moves into heterosexual transmission networks".5 The chlamydia epidemic in China may already be generalised to the point that risk categories can be misinterpreted if they do surface from analysis. A more fundamental question is whether the traditional categories of FSW or MSM are oversimplified. The challenge to health experts is to continue to tease apart this complexity in order to address prevention efforts. (excerpt) Language: English Keywords: HONG KONG | RESEARCH REPORT | CRITIQUE | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | TRUCK DRIVERS | SEX WORKERS | MULTIPLE PARTNERS | BORDER CROSSING | CHLAMYDIA | PREVALENCE | RISK FACTORS | SCREENING | EXTRAMARITAL SEX BEHAVIOR | CONDOM USE | Developed Countries | Asia, Eastern | Asia | Research Methodology | Labor Force | Human Resources | Economic Factors | Sex Behavior | Behavior | Sexual Partners | International Migration | Migration | Population Dynamics | Demographic Factors | Population | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Measurement | Health | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Risk Reduction Behavior Document Number: 340112 |
| 18. Title: A qualitative study of pharmacists' views on offering chlamydia screening to women requesting emergency hormonal contraception. Author: Thomas G; Humphris G; Ozakinci G; O'Brien K; Roberts SA; Hopkins M; Brabin L Source: BJOG. 2009 Sep 23; Abstract: Please cite this paper as: Thomas G, Humphris G, Ozakinci G, O'Brien K, Roberts SA, Hopkins M, Brabin L. A qualitative study of pharmacists' views on offering chlamydia screening to women requesting emergency hormonal contraception. BJOG 2009; DOI: 10.1111/j.1471-0528.2009.02362.x.This was a qualitative study to understand why pharmacists, asked to offer free chlamydia postal screening to Emergency Hormonal Contraception clients, had not offered screening to all eligible women. Twenty-six pharmacists completed exit interviews and 12 agreed to semi-structured in-depth interviews. Although pharmacists were keen to expand their services, they were reluctant to offer chlamydia screening to women who were married or in a long term relationship. To avoid offence they selected women based on age, education and ethnicity. The rationale for chlamydia screening in pharmacy-based EHC schemes is compromised if pharmacists do not offer screening comprehensively. Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | QUALITATIVE RESEARCH | PHARMACISTS | WOMEN | CURRENTLY MARRIED | EMERGENCY CONTRACEPTION | SCREENING | CHLAMYDIA | ATTITUDES | Developed Countries | Europe, Western | Europe | Research Methodology | Health Personnel | Delivery of Health Care | Health | Demographic Factors | Population | Marital Status | Nuptiality | Contraception | Family Planning | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Psychological Factors | Behavior Document Number: 342925 |
| 19. Title: Vertical transmission of Chlamydia trachomatis in Chongqing China. Author: Yu J; Wu S; Li F; Hu L Source: Current Microbiology. 2009 Apr;58(4):315-20. Abstract: This is the first study to investigate vertical transmission of Chlamydia trachomatis in Chongqing China. For this study, 300 cervical swab samples from pregnant women and 305 nasopharygeal swab samples from their babies (605 specimens) were collected for nest polymerase chain reaction (nPCR) of the ompl gene, which encodes the major outer membrane protein (MOMP) and typed C. trachomatis using Cleavase fragment-length polymorphism (CFLP) labeled with digoxin. From these samples, 11% (33/300) of pregnant women samples were successfully amplified. The vertical transmission rate of C. trachomatis from mother to baby was 24% (8/33). The vertical transmission rates were 66.7% (6/9) for mothers with vaginal delivery and 8.3% (2/24) for those with cesarean section. The incidence of premature membrane rupture among C. trachomatis-positive pregnant women was 30.3% (10/33), which was greater than among those who were C. trachomatis-negative (13.5%, 36/267; chi(2) = 4.2; p < 0.05). Four genotypes including type E (3 pairs), type F (2 pairs), type H (2 pairs), and type D (1 pair) were observed by CFLP assay labeled with digoxin and confirmed by DNA sequencing in the 16 C. trachomatis-positive samples from eight pregnant women and their eight infants. Each pair of matched maternal-infantile samples showed identical CFLP. This study showed the incidence of C. trachomatis infection in pregnant women, the vertical transmission rate for C. trachomatis, and the genotypes of C. trachomatis in Chongqing, China. The CFLP assay labeled at the 5' end of the forward primer with digoxin was first used successfully to genotype of C. trachomatis. As a promising method for C. trachomatis genotyping, CFLP had good sensitivity, reproducibility, and simplicity and no radioactive contamination. Language: English Keywords: CHINA | RESEARCH REPORT | INCIDENCE | LABORATORY PROCEDURES | PREGNANT WOMEN | CHLAMYDIA | MOTHER-TO-CHILD TRANSMISSION | RISK FACTORS | Asia, Eastern | Asia | Developing Countries | Measurement | Research Methodology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Population Characteristics | Demographic Factors | Population | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Transmission Document Number: 341190 |
| 20. Peer Reviewed Title: Risk behaviour, healthcare access and prevalence of infection with Chlamydia trachomatis and Neisseria gonorrhoeae in a population-based sample of adults in Barbados. Author: Adams OP; Carter AO; Prussia P; McIntyre G; Branch SL Source: Sexually Transmitted Infections. 2008 Jun;84(3):192-194. Abstract: The objectives were to estimate the prevalence of urogenital infection with Chlamydia trachomatis and Neisseria gonorrhoeae in people 18 to 35 years of age in Barbados, and to examine factors associated with infection. Cross-sectional survey of randomly selected people from the voters' register of one electoral district and the collection of urine samples for testing by PCR. The response rate was 82%; 408 people (195 males and 213 females) completed a questionnaire and had their urine collected. 397 urine samples were satisfactorily tested. Prevalence of C trachomatis urogenital infection was 11.3% (95% CI plus or minus 2.9) and N gonorrhoeae 1.8% (95% CI plus or minus 1.2) with 12.6% (95% CI plus or minus 3.1) having either or both infections. The difference in prevalence by gender was not significant. Multivariate logistic regression showed that prevalence of C trachomatis and/or N gonorrhoeae decreased with increasing age (per year OR 0.89, 95% CI 0.84 to 0.96, p=0.001), and decreasing time (less than or equal to 6 months vs greater than 6 months) since last medical consultation (OR 0.44, 95% CI 0.22 to 0.88, p=0.02). Most (76%) infected people were asymptomatic. Condom use at last intercourse with a partner not being lived with was not protective (reported by 52%, p=0.617). The usual source of health care was evenly distributed between the public and private sectors and was not associated with infection. Only 30% of people had ever heard of chlamydia, whereas 92% were aware of gonorrhoea. Asymptomatic infection with C trachomatis is an important reservoir of infection, which will remain undetected unless physicians and young people are made aware of this and screening is introduced. (author's) Language: English Keywords: BARBADOS | RESEARCH REPORT | SURVEYS | CROSS SECTIONAL ANALYSIS | ADULTS | CHLAMYDIA | GONORRHEA | PREVALENCE | RISK BEHAVIOR | Caribbean | Americas | Developed Countries | Sampling Studies | Studies | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Measurement | Behavior Document Number: 327202 |
| 21. Title: Prevalence of Chlamydia trachomatis infection in infertile women at a university hospital in Jordan. Author: Al-Ramahi M; Mahafzah A; Saleh S; Fram K Source: Eastern Mediterranean Health Journal. 2008 Sep-Oct;14(5):1148-54. Abstract: In a prospective controlled study, we aimed to determine the prevalence of Chlamydia trachomatis infection in Jordanian women attending an infertility clinic and whether screening is useful as part of routine investigations for infertility. Two groups of patients (152 infertile patients and 146 control patients) had endocervical swab testing by polymerase chain reaction for the presence of C. trachomatis infection. A total of 6/152 patients in the infertility group tested positive for C. trachomatis (3.9%), compared with 1/146 patients in the control group (0.7%), a difference that was not statistically significant. In view of the tendency toward increased prevalence of C. trachomatis infection, screening women for chlamydial infection as part of routine investigations for infertility is recommended. Language: English Keywords: JORDAN | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | CASE CONTROL STUDIES | PROSPECTIVE STUDIES | WOMEN IN DEVELOPMENT | PREVALENCE | INFERTILITY | CHLAMYDIA | SCREENING | Developing Countries | Middle East | Research Methodology | Studies | Economic Development | Economic Factors | Measurement | Reproduction | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 330306 |
| 22. Title: [Chlamydia trachomatis infection in females consulting health centres in Maracaibo, Venezuela] Infeccion por Chlamydia trachomatis en mujeres consultantes en Maracaibo, Author: Arraiz N; Marcucci R; Colina S; Reyes F; Rondon N; Bermudez V; Reyna N Source: Revista De Salud Publica. 2008 Aug-Oct;10(4):615-24. Abstract: OBJECTIVE: Evaluating Chlamydia trachomatis infection prevalence in a group of symptomatic and asymptomatic females attending gynaecology services in health centres in Maracaibo in the state of Zulia in Venezuela. METHODOLOGY: 168 patients attending two health centres in Maracaibo were included in this study. Gynaecological evaluation was based on examining the pelvis, deep areas of the vagina and the cervix. Patients were classified into groups according to age and the presence of clinical manifestations. Two DNA amplification assays of endogenous plasmid and the omp1 gene taken from endocervical swabs were used for investigating C. trachomati. RESULTS: 168 patients were evaluated; 81 (48,2 %) were symptomatic and 87 (51,8 %) asymptomatic, A 7,7 % prevalence (p>0.05) was found in the total population (9,9 % prevalence for symptomatic patients and 5,8 % for asymptomatic ones). The 18- 28 year old patient group exhibited the highest prevalence (13,7 %) (p=0.0322). The predominant clinical manifestations were mucopurulent secretion (35,8 %) and cervicitis (21 %). C. trachomatis was detected in 7,1 % of patients having mucopurulent secretion and 23,5 % of cervicitis cases; however, no significant association between infection and individual clinical manifestations was shown (p>0.05). CONCLUSION: Medium C. trachomatis infection prevalence was found In the population being assessed here, the highest frequency being exhibited in young females. This microorganism should be investigated in sexually-active young women, regardless of their symptomatic or asymptomatic status. Language: Spanish Keywords: VENEZUELA | RESEARCH REPORT | PREVALENCE | WOMEN | CHLAMYDIA | EXAMINATIONS AND DIAGNOSES | South America, Northern | South America | Latin America | Americas | Developing Countries | Measurement | Research Methodology | Demographic Factors | Population | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 341061 |
| 23. Title: Emergency contraception [letter] Author: Barker S Source: Australian Family Physician. 2008 Aug;37(8):599. Abstract: The Clockwork Young People's Health Service sees a large number of young women requiring emergency contraception (EC). Past experience suggests that these women constitute a particularly at risk group. A pilot study in 2002 demonstrated a chlamydia rate twice that of the rest of the population screened.1 In 2005, an ongoing quality assurance activity in the form of an anonymous survey of all emergency contraception users was commenced. Its purpose was to confirm our suspicions of this being a high risk group, to ensure women requesting EC receive appropriate care and follow up, and to help direct our service's increasing preventive efforts. Responses to the survey have been fairly consistent over the 3 years. Results in 2007 were: of 85 EC recipients aged 13-24 years, 34 (40%) had used EC at least once before, 41 (48.2%) had been on regular contraception in the past but had stopped using this, 32 (37.6%) had been using a condom at the time (but were either aware of an accident with it or were wanting extra protection), 56 (65.9%) were with a partner whom they classed as 'regular' (34.1% were with a casual partner), and 34 (40%) had been drinking or using drugs before the unprotected sex (47%). Our survey results raise a number of topical issues. First, the increased binge drinking trend is currently receiving attention, but the binge drinking by-product of unplanned, unsafe sex has not been highlighted. Clearly it should be. Young women need to be alerted to the possibility of poor decisions/coercion when they are drunk. Second, even though there are recognised benefits for young people being able to purchase EC over-the-counter (in particular, availability on the weekend means that it can be taken closer to the common time for unplanned, unprotected sex) the downside is that a timely opportunity to screen and educate is missed. Perhaps we should be at least ensuring that health access information is supplied at the time of purchase. Finally, with the release of The Sexual and Reproductive Health of Young Victorians report2 there has been some discussion about the provision of EC by nondoctors. Perhaps what the survey suggests is that the imparting of thorough, accurate information about sexual health, including access information, and scheduling a follow up appointment is important; who does this is less important. We need to remain mindful that young EC users are indeed at high risk -of future unplanned pregnancies, STIs, unhealthy relationships, inappropriate alcohol use (and all that is associated with this), and poor self esteem. Ideally all young women should have adequate time at initial presentation and all should be scheduled follow up appointments to look at these issues and the importance of taking control of their reproductive lives. (full text) Language: English Keywords: AUSTRALIA | RESEARCH REPORT | CONTRACEPTIVE PREVALENCE SURVEYS | WOMEN | EMERGENCY CONTRACEPTION | CHLAMYDIA | CONDOM USE | CONTRACEPTIVE USAGE | CONTRACEPTION TERMINATION | ALCOHOL USE AND ABUSE | DRUG USE AND ABUSE | CONTRACEPTIVE AVAILABILITY | Developed Countries | Oceania | Family Planning Surveys | Family Planning | Demographic Factors | Population | Contraception | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Risk Reduction Behavior | Behavior Document Number: 329108 |
| 24. Peer Reviewed Title: The detection of urethritis pathogens among patients with the male urethritis syndrome, genital ulcer syndrome and HIV voluntary counselling and testing clients: should South Africa's syndromic management approach be revised? Author: Black V; Magooa P; Radebe F; Myers M; Pillay C; Lewis DA Source: Sexually Transmitted Infections. 2008 Aug;84(4):254-8. Abstract: OBJECTIVES: To determine the prevalence of urethritis pathogens amongst male symptomatic urethritis (MUS) patients, genital ulcer (GUS) patients without urethritis symptoms and men requesting HIV testing at a voluntary counselling and testing (VCT) clinic. METHODS: A prospective study was conducted in Johannesburg, South Africa. Men from the three groups were screened for urethritis pathogens using molecular tests. Culture for Neisseria gonorrhoeae and, initially, trichomoniasis was performed. Antimicrobial susceptibility testing was undertaken for ciprofloxacin on all gonococcal isolates; ciprofloxacin resistant isolates were screened for ceftriaxone resistance. RESULTS: 664 participants were recruited (438 MUS, 76 GUS and 158 VCT) over 2 years. Gonorrhoea was detected in 62.3% MUS, 15.8% GUS and 3.2% VCT participants. Chlamydial infection was detected in 19.3% MUS, 13.2% GUS and 8.2% VCT participants. Trichomoniasis was detected in 4.9% MUS, 19.7% GUS and 3.8% VCT participants. Mycoplasma genitalium infection was detected in 14.4% MUS, 13.2% GUS and 7.0% VCT participants. Ciprofloxacin resistance increased from 13.0% in the first year to 26.3% in the second year; all resistant isolates were susceptible to ceftriaxone. CONCLUSIONS: Urethritis pathogens, including Trichomonas vaginalis, should be covered in syndromic management treatment of genital ulcers in the absence of clinical urethritis. Consideration should be given to adding metronidazole to existing MUS treatment. Ciprofloxacin can no longer be relied upon to treat presumptive gonococcal infections in South Africa. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | PROSPECTIVE STUDIES | MEN | CHLAMYDIA | TRICHOMONIASIS | PREVALENCE | VOLUNTARY COUNSELING AND TESTING | SEXUALLY TRANSMITTED DISEASES | DRUG RESISTANCE | GONORRHEA | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Studies | Demographic Factors | Population | Reproductive Tract Infections | Infections | Diseases | Measurement | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Treatment Document Number: 328657 |
| 25. Peer Reviewed Title: Chlamydia in the Pacific region, the silent epidemic. Author: Cliffe SJ; Tabrizi S; Sullivan EA Source: Sexually Transmitted Diseases. 2008 Sep;35(9):801-6. Abstract: BACKGROUND: Second generation surveillance of HIV infection and sexually transmitted infections (STIs) among pregnant women in 6 Pacific Island Countries and Territories were undertaken to improve knowledge and to make recommendations on future prevention and management of STIs. METHODS: Cross-sectional studies, using standardized questionnaire, laboratory tests, and protocols were undertaken in Fiji, Kiribati, Samoa, Solomon Islands, Tonga, and Vanuatu between 2004 and 2005. For each country, between 200 and 350 pregnant women aged 15 to 44 years were consecutively recruited from antenatal clinics located in the main hospital of the major urban centre of each Pacific Island Countries and Territories. Consenting participants were interviewed about their socio-demographic characteristics and their sexual behavior, and were tested for HIV, chlamydia, syphilis (Treponema pallidum antibody seroactivity), and gonorrhoea. RESULTS: Amongst the 1618 pregnant women studied, the most prevalent STI was chlamydia with 26.1% of women under 25 and 11.9% of women aged 25 years and over being positive. Highest infection was detected in single teenage women with 38.1% positive for chlamydia. The overall prevalence of gonorrhoea and syphilis was 1.7% and 3.4%, respectively. No case of HIV was detected. Chlamydia infection was independently associated with younger age, being nulliparous, single status, multiple lifetime sexual partners, and commercial sex activity. CONCLUSION: In a population of young women, chlamydia infection was endemic. Regional leadership is needed to implement strategies to prevent the spread of chlamydia and to implement HIV and STI prevention and management. Language: English Keywords: FIJI | TONGA | SOLOMON ISLANDS | SAMOA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | PREGNANT WOMEN | CHLAMYDIA | SEXUALLY TRANSMITTED DISEASE PREVENTION | HIV PREVENTION | ANTENATAL CARE | SOCIOECONOMIC STATUS | SEX BEHAVIOR | HIV TESTING | Developing Countries | Oceania | Research Methodology | Population Characteristics | Demographic Factors | Population | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | HIV Infections | Viral Diseases | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Socioeconomic Factors | Economic Factors | Behavior | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine Document Number: 328642 |
| 26. Title: Urogenital infections in reproductive medicine. Author: Dieterle S Source: Andrologia. 2008 Apr;40(2):117-119. Abstract: Urogenital infections with Chlamydia trachomatis belong to the most prevalent sexually-transmitted bacterial diseases. In women, they can cause chronic salpingitis with subsequent tubal infertility and ectopic pregnancies. In men, C. trachomatis can cause urethritis, prostatitis and epididymitis. Urogenital infections can be symptomatic or asymptomatic. Symptomatic urogenital infections might impair male fertility. In vitro, C. trachomatis affects sperm motility and viability. However, there is no clear evidence that asymptomatic urogenital infections have an adverse effect on male fertility. Because C. trachomatis can be sexually transmitted and lead to female infertility, it is also of significance in male infertility work-up. Because of their high sensitivity, nucleic acid amplification tests should be used to examine first-void urine specimens. Both partners should be treated. The role of Ureaplasma urealyticum in reproductive medicine has been discussed controversially. There is no evidence that U. urealyticum has a significant impact on female or male infertility. (author's) Language: English Keywords: GERMANY | RESEARCH REPORT | MEN | CHLAMYDIA | UROGENITAL EFFECTS | INFERTILITY | REPRODUCTIVE HEALTH | Europe, Central | Europe | Developed Countries | Demographic Factors | Population | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Urogenital System | Physiology | Biology | Reproduction | Health Document Number: 325934 |
| 27. Peer Reviewed Title: Increasing chlamydia positivity in women screened in family planning clinics: Do we know why? Author: Fine D; Dicker L; Mosure D; Berman S Source: Sexually Transmitted Diseases. 2008 Jan;35(1):47-52. Abstract: Following a 9-year 60% decline, chlamydia positivity increased 46% from 1997 through 2004 among young sexually active women screened in Region X family planning clinics. The objective of this analysis was to systematically examine the influences of risk factors, changing laboratory test methods, and interclinic variability on chlamydia positivity during this period. We analyzed data from 520,512 chlamydia tests from women aged 15 to 24 years screened in 125 family planning clinics. Multivariate logistic regression modeling was used to adjust the annual risk of chlamydia for the demographic, clinical, and sexual risk behavior characteristics associated with infection and for the increasing use of more sensitive laboratory test methods. A generalized linear mixed model was used to adjust for interclinic variability. We found a significant 5% annual increase in the risk of chlamydia even after adjusting for risk factors including laboratory test characteristics (odds ratio 1.05, 95% confidence interval: 1.04, 1.06). Variability among the clinics where screening occurred did not account for the increase. Based on a review of all available data, we concluded that there was a true increase in chlamydia positivity over the 8-year period. (author's) Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | METHODOLOGICAL STUDIES | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | MULTIVARIATE ANALYSIS | WOMEN | CHLAMYDIA | SCREENING | FAMILY PLANNING CENTERS | RISK FACTORS | LABORATORY EXAMINATIONS AND DIAGNOSES | RISK ASSESSMENT | SEX BEHAVIOR | RISK BEHAVIOR | Developed Countries | North America | Americas | Research Methodology | Data Analysis | Demographic Factors | Population | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Health Facilities | Biology | Evaluation | Behavior Document Number: 323228 |
| 28. Title: Prevalence of genital Chlamydia in Iranian males with urethritis attending clinics in Mashhad. Author: Ghanaat J; Afshari JT; Ghazvini K; Malvandi M Source: Eastern Mediterranean Health Journal. 2008 Nov-Dec;14(6):1333-7. Abstract: Chlamydia trachomatis is a common cause of sexually transmitted disease which can cause severe consequences. Effective prevention requires knowledge of prevalence of infection in order to target interventions in a cost-effective manner. To determine the prevalence of chlamydial infection in Mashhad, northeastern Islamic Republic of Iran, this study was performed among male patients with urethritis. Urethral discharge was collected from 150 patients. Cell culture was established for diagnosis of Chlamydia in genital specimens. Cell culture showed that 9.3% of patients in this study were infected with Chlamydia. This study provides strong evidence that prevalence of Chlamydia in our region is quite high, which necessitates screening and treatment for the infection. Language: English Keywords: IRAN | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | MEN | PREVALENCE | CHLAMYDIA | GENITAL EFFECTS, MALE | Middle East | Developing Countries | Research Methodology | Demographic Factors | Population | Measurement | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Genitalia, Male | Genitalia | Urogenital System | Physiology | Biology Document Number: 330303 |
| 29. Peer Reviewed Title: Effectiveness of cellulose sulfate vaginal gel for the prevention of HIV infection: results of a Phase III trial in Nigeria. Author: Halpern V; Ogunsola F; Obunge O; Wang CH; Onyejepu N; Oduyebo O; Taylor D; McNeil L; Mehta N; Umo-Otong J; Otusanya S; Crucitti T; Abdellati S Source: PloS One. 2008;3(11):e3784. Abstract: BACKGROUND: This trial evaluated the safety and effectiveness of 6% cellulose sulfate vaginal gel in preventing male-to-female vaginal transmission of HIV, gonorrhea and chlamydial infection. METHODS: This Phase III, double-blind, randomized, placebo-controlled trial was conducted between November 2004 and March 2007 in Lagos and Port Harcourt, Nigeria. We enrolled 1644 HIV-antibody negative women at high risk of HIV acquisition. Study participants were randomized 1:1 to cellulose sulfate or placebo and asked to use gel plus a condom for each act of vaginal intercourse over one year of follow-up. The participants were evaluated monthly for HIV, gonorrhea and chlamydial infection, and for adverse events. RESULTS: The trial was stopped prematurely after the data safety monitoring board of a parallel trial concluded that cellulose sulfate might be increasing the risk of HIV. In contrast, we observed fewer infections in the active arm (10) than on placebo (13), a difference that was nonetheless not statistically significant (HR = 0.8, 95% CI 0.3-1.8; p = 0.56). Rates of gonorrhea and chlamydial infection were lower in the CS group but the difference was likewise not statistically significant (HR = 0.8, 95% CI 0.5-1.1; p = 0.19 for the combined STI outcome). Rates of adverse events were similar across study arms. No serious adverse events related to cellulose sulfate use were reported. CONCLUSIONS: Cellulose sulfate gel appeared to be safe in the evaluated study population but we found insufficient evidence that it prevented male-to-female vaginal transmission of HIV, gonorrhea or chlamydial infection. The early closure of the trial compromised the ability to draw definitive conclusions about the effectiveness of cellulose sulfate against HIV. TRIAL REGISTRATION: ClinicalTrials.gov NCT00120770. Language: English Keywords: NIGERIA | RESEARCH REPORT | CLINICAL TRIALS | WOMEN | VAGINAL GEL | GONORRHEA | CHLAMYDIA | HIV INFECTIONS | CONTRACEPTIVE SAFETY | CONTRACEPTIVE EFFECTIVENESS | PROGRAM EVALUATION | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Clinical Research | Research Methodology | Demographic Factors | Population | Vaginal Spermicides | Contraceptive Methods | Contraception | Family Planning | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Viral Diseases | Safety | Public Health | Health | Programs | Organization and Administration Document Number: 341596 |
| 30. Peer Reviewed Title: Hormonal contraception and the risks of STI acquisition: Results of a feasibility study to plan a future randomized trial. Author: Hubacher D; Raymond ER; Beksinska M; Delany-Moretlwe S; Smit J Source: Contraception. 2008 May;77(5):366-370. Abstract: Because of limitations in observational studies, a randomized controlled trial (RCT) would help clarify whether hormonal contraception increases the risks of acquiring a sexually transmitted infection (STI). However, the feasibility of such a trial is uncertain. We conducted a study to assess the feasibility of conducting a RCT that would compare the acquisition risk for Chlamydia trachomatis and Neisseria gonorrhoeae in women randomized to an intrauterine device (IUD) or depot medroxyprogesterone acetate (DMPA). In our cross-sectional survey conducted at three clinics, we gave information on a potential RCT to clients, asked them questions to assess comprehensibility and finally asked respondents whether they would consider enrolling in such a trial. In addition, the 190 participants provided urine or endocervical swab specimens so we could estimate the prevalence of STIs. Overall, 70% of participants stated that they would take part in a future trial and accept randomization to either the IUD orDMPA. Participant understanding of the trial requirements was high. Twenty-nine percent of the participants were infected with either N. gonorrhoeae or C. trachomatis. With a high prevalence of STI in this population and the apparent willingness of appropriate candidates to participate, an RCT to measure risks of incident STI infection from hormonal contraception appears feasible. (author's) Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | CLINICAL RESEARCH | |