Trichomonas vaginalis and Chlamydia trachomatis Prevalence,Incidence and Associated Factors in Pregnant Adolescents from Belém City,in the Brazilian Amazon

Background: Adolescents are disproportionally affected by sexually transmitted infections (STI). Chlamydia trachomatis (CT) and Trichomonas vaginalis (TV) are the most frequent curable STI in adolescents, causing serious consequences for their reproductive health. Therefore, we aimed to determine the prevalence and incidence of CT and TV, as well as their risk factors in pregnant adolescents from Belém, northern Brazilian Amazon. Methods: This prospective study enrolled 199 adolescents up to 20 weeks of pregnancy. They were scheduled for follow-up visit between 28 and 29 weeks of pregnancy. Sociodemographic and behavioral data were obtained by interview. Cervicovaginal samples were taken to test for TV, CT, Neisseria gonorrhoeae and bacterial vaginosis. Univariate and multivariate analyses were performed to test the association of prevalent/incident CT and TV with the variables. Results: Prevalence of cervical CT infection was 33.7% (n = 67/ 199), and for trichomoniasis it was 4.0% (n = 8/199). Cervical ectopy increased the risk for prevalent CT (OR, 1.93;95% CI, 1.01 - 3.70), while having treated vaginal discharge in the past (OR, 0.51;95% CI, 0.26 - 0.98) and being married (OR, 0.10;95% CI, 0.01 - 0.83) were protective against current CT and TV, respectively. Among the 95 (47.7%) adolescents who completed follow-up, 15 cases of incident CT were identified. Incident CT was associated with having a formal or informal job (OR, 28.4;95% CI, 2.1 - 391.6) and bacterial vaginosis treatment at the baseline (OR, 0.08;95% CI, 0.01 - 0.69). Conclusion: Prevalence and incidence rates of TV and CT are high in this population devoid of STI routine screening. Treatment of bacterial vaginosis may benefit this population by reducing risk for CT acquisition.

Screenning of Chlamydia trachomatis Infection among Women Attending Outpatient Clinic of Infertility

Objective: The goal of this study was to determine the prevalence of C. trachomatis in women diagnosed with infertility attending the Outpatient Clinic of Infertility from Botucatu Medical School, UNESP, Brazil. Patients and Methods: This molecular study enrolled a total of 112 women. Among these patients, 62 presented primary infertility while 50 presented secondary infertility. The criteria for eligibility included women who were: reproductive-aged;no prior report of seroconversion for HIV;no antibiotic or vaginal cream used in the preceding 30 days;and abstinence from sexual intercourse for 72 hours before the visit. The women were submitted to a gynecological examination and cervical samples were collected with an endocervical cytobrush for molecular analysis of C. trachomatis. Results: The prevalence of chlamydial infection was 8% with similar prevalence between primary (8.1%) and secondary (8.0%) infertility. Conclusion: Considering the asymptomatic nature of chlamydial infection and its association with tubal factor infertility, there is a pressing need to incorporate the screening of C. trachomatis infection as part of the routine investigation for infertility. The early diagnostic by screening can minimize complications and reduce Public Health costs with Assisted Reproductive Technology.