Seroprevalence and Risk Factors Associated with Chlamydia trachomatis Infection among Sexually Active Patients Visiting the Buea Regional Hospital, Cameroon
Background:Chlamydia trachomatis is a common sexually transmitted infection (STI) with significant public health implications, particularly among young adults. This study aimed to determine the seroprevalence and risk factors associated with Chlamydia trachomatis infection among sexually active patients attending the Buea Regional Hospital, Cameroon. Methods: A cross-sectional study was conducted, enrolling 247 participants aged 18 - 52 years. Participants were recruited using a consecutive sampling technique. A structured questionnaire was used to collect data on sociodemographic characteristics, sexual behavior, and Chlamydia screening history. Serological tests for IgG and IgM antibodies were performed to determine Chlamydia trachomatis (Monocent, Inc, USA) prevalence. Statistical analysis was conducted to assess associations between infection prevalence and potential risk factors using Chi-square and Multivariate logistics regression analysis with statistical significance set at p < 0.05. Results: The overall seroprevalence of Chlamydia trachomatis was 45.7%, with 42.5% testing positive for IgG and 15.4% for IgM. The highest prevalence was observed among participants aged 18 - 24 years (28.3%; p = 0.009). Female participants exhibited a higher prevalence (31.1%) compared to males. A significant association was found between early sexual debut (15 - 19 years) and Chlamydia prevalence (p = 0.024), with those initiating sexual activity within this age group being 1.92 times more likely to be infected (AOR 1.35 - 8.46, p = 0.027). Vaginal sexual engagement (p = 0.005) and lack of regular screening (p = 0.004) were also significantly associated with higher prevalence. Multivariate analysis showed that individuals aged 25 - 31 years had 3.14 times higher odds of infection (AOR 1.62 - 12.4, p = 0.044) compared to those over 39 years. Conclusion: This study shows a high seroprevalence of Chlamydia trachomatis among sexually active individuals, with young adults, early sexual debut, and lack of screening being key risk factors. Targeted interventions, including increased screening, education on sexual health, and early treatment, are essential to reduce the burden of Chlamydia infections in this population.
References
[1]
Pearce, E., Jolly, K., Harris, I.M., Adriano, A., Moore, D., Price, M., et al. (2021) What Is the Effectiveness of Community-Based Health Promotion Campaigns on Chlamydia Screening Uptake in Young People and What Barriers and Facilitators Have Been Identified? A Mixed-Methods Systematic Review. Sexually Transmitted Infections, 98, 62-69. https://doi.org/10.1136/sextrans-2021-055142
[2]
Workowski, K.A. and Bachmann, L.H. (2022) Centers for Disease Control and Prevention’s Sexually Transmitted Diseases Infection Guidelines. Clinical Infectious Diseases, 74, S89-S94. https://doi.org/10.1093/cid/ciab1055
[3]
World Health Organization (2022) Global Health Sector Strategies on, Respectively, HIV, Viral Hepatitis and Sexually Transmitted Infections for the Period 2022-2030. World Health Organization.
[4]
Saka, H.A. and Damiani, M.T. (2023) Editorial: New Insights in Chlamydia: Host Interactions and Pathogenesis. Frontiers in Cellular and Infection Microbiology, 13, Article 1251582. https://doi.org/10.3389/fcimb.2023.1251582
[5]
Jury, B., Fleming, C., Huston, W.M. and Luu, L.D.W. (2023) Molecular Pathogenesis of Chlamydia Trachomatis. Frontiers in Cellular and Infection Microbiology, 13, Article 1281823. https://doi.org/10.3389/fcimb.2023.1281823
[6]
Sixt, B.S. (2020) Host Cell Death during Infection with Chlamydia: A Double-Edged Sword. FEMS Microbiology Reviews, 45, fuaa043. https://doi.org/10.1093/femsre/fuaa043
[7]
Mabonga, E., Manabe, Y.C., Elbireer, A., Mbazira, J.K., Nabaggala, M.S., Kiragga, A., et al. (2021) Prevalence and Predictors of Asymptomatic chlamydia Trachomatis and Neisseria gonorrhoeae in a Ugandan Population Most at Risk of HIV Transmission. International Journal of STD & AIDS, 32, 510-516. https://doi.org/10.1177/0956462420979799
[8]
Ngandjio, A., Clerc, M., Fonkoua, M.C., Thonnon, J., Njock, F., Pouillot, R., et al. (2003) Screening of Volunteer Students in Yaounde (Cameroon, Central Africa) for Chlamydia trachomatis Infection and Genotyping of Isolated C. trachomatis Strains. Journal of Clinical Microbiology, 41, 4404-4407. https://doi.org/10.1128/jcm.41.9.4404-4407.2003
[9]
Hillier, S.L., Bernstein, K.T. and Aral, S. (2021) A Review of the Challenges and Complexities in the Diagnosis, Etiology, Epidemiology, and Pathogenesis of Pelvic Inflammatory Disease. The Journal of Infectious Diseases, 224, S23-S28. https://doi.org/10.1093/infdis/jiab116
[10]
Yusuf, H. and Trent, M. (2023) Management of Pelvic Inflammatory Disease in Clinical Practice. Therapeutics and Clinical Risk Management, 19, 183-192. https://doi.org/10.2147/tcrm.s350750
[11]
Carter, J.D., Espinoza, L.R., Inman, R.D., Sneed, K.B., Ricca, L.R., Vasey, F.B., et al. (2010) Combination Antibiotics as a Treatment for Chronic Chlamydia-Induced Reactive Arthritis: A Double-Blind, Placebo-Controlled, Prospective Trial. Arthritis & Rheumatism, 62, 1298-1307. https://doi.org/10.1002/art.27394
[12]
Zhou, Y., Jiang, T., Li, J., Yin, Y. and Chen, X. (2021) Performance of Point-of-Care Tests for the Detection of Chlamydia trachomatis Infections: A Systematic Review and Meta-Analysis. EClinicalMedicine, 37, Article 100961. https://doi.org/10.1016/j.eclinm.2021.100961
[13]
Van Dyck, E., Ieven, M., Pattyn, S., Van Damme, L. and Laga, M. (2001) Detection of Chlamydia trachomatis and Neisseria gonorrhoeae by Enzyme Immunoassay, Culture, and Three Nucleic Acid Amplification Tests. Journal of Clinical Microbiology, 39, 1751-1756. https://doi.org/10.1128/jcm.39.5.1751-1756.2001
[14]
Sobze, M.S., Donfack, J.H., Onohiol, J., Fokam, J., Dongho, G.B.D., Pete, P.S.N., et al. (2014) Prevalence of HIV, HBV and Chlamydia Infections in Cameroonian University Context: Case of the University of Dschang, in the Western Region. BMC Infectious Diseases, 14, Article No. P3. https://doi.org/10.1186/1471-2334-14-s2-p3
[15]
Monono, E. and Zinyemba, T. (2023) The Challenges of Building Sustainable Cities in Cameroon: Health Issues Associated with a Rapid Urban Population Increase in Buea Municipality. The Academic Research Community Publication, 7, 1-7. https://doi.org/10.21625/archive.v7i1.930
[16]
Nahler, G. (2009) Lorentz-Formula. In: Dictionary of Pharmaceutical Medicine, Springer, 107. https://doi.org/10.1007/978-3-211-89836-9_803
[17]
Martin, S.S., James-Francis, O., Joseph, F., Ghyslaine Bruna, D.D., Patrick Martial, N.P. and Gianluca, R. (2015) Prevalence of HIV, HBV and Chlamydia Infections in Cameroonian University Context: Case of the University of Dschang, in Western Region. International Journal of Epidemiology, 44, i116. https://doi.org/10.1093/ije/dyv096.087
[18]
IBM (2021) SPSS Statistics 20. https://www.ibm.com/support/pages/downloading-ibm-spss-statistics-20
[19]
Rabiepoor, S., Abedi, M. and Yavari, S.A. (2018) A Serological Survey of Chlamydia trachomatis and Its Related Factors in Individuals with High-Risk Sexual Behavior. Mædica, 13, 131-136.
[20]
Tadongfack, T.D., Nitcheu, I.L.S., Ngoune, R., Nkouayep, V.R., Selabi, A.C.N., et al. (2021) Seroprevalence of Chlamydia trachomatis IgA, IgM and IgG Antibodies and Associated Risk Factors among Sexually Active Individuals at Saint Vincent de Paul Hospital in Dschang, West Cameroon. International STD Research & Reviews, 10, 13-21.
[21]
Gerbase, A.C. and Zemouri, C. (2020) Global Epidemiology of Sexually Transmitted Infections in the Twenty-First Century: Beyond the Numbers. In: Sexually Transmitted Infections, Springer, 3-12. https://doi.org/10.1007/978-3-030-02200-6_1
[22]
de Wit, J.B.F., Adam, P.C.G., den Daas, C. and Jonas, K. (2022) Sexually Transmitted Infection Prevention Behaviours: Health Impact, Prevalence, Correlates, and Interventions. Psychology & Health, 38, 675-700. https://doi.org/10.1080/08870446.2022.2090560
[23]
Huai, P., Li, F., Chu, T., Liu, D., Liu, J. and Zhang, F. (2020) Prevalence of Genital Chlamydia Trachomatis Infection in the General Population: A Meta-Analysis. BMC Infectious Diseases, 20, Article No. 589. https://doi.org/10.1186/s12879-020-05307-w
[24]
Gravningen, K., Furberg, A., Simonsen, G.S. and Wilsgaard, T. (2012) Early Sexual Behaviour and Chlamydia trachomatis Infection—A Population Based Cross-Sectional Study on Gender Differences among Adolescents in Norway. BMC Infectious Diseases, 12, Article No. 319. https://doi.org/10.1186/1471-2334-12-319
[25]
Matteelli, A., Capelli, M., Sulis, G., Toninelli, G., Carvalho, A.C.C., Pecorelli, S., et al. (2016) Prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae Infection in Adolescents in Northern Italy: An Observational School-Based Study. BMC Public Health, 16, Article No. 200. https://doi.org/10.1186/s12889-016-2839-x
[26]
Morrill, S., Gilbert, N.M. and Lewis, A.L. (2020) Gardnerella vaginalis as a Cause of Bacterial Vaginosis: Appraisal of the Evidence from in Vivo Models. Frontiers in Cellular and Infection Microbiology, 10, Article 168. https://doi.org/10.3389/fcimb.2020.00168
[27]
Llamosas-Falcón, L., Hasan, O.S., Shuper, P.A. and Rehm, J. (2023) A Systematic Review on the Impact of Alcohol Use on Sexually Transmitted Infections. International Journal of Alcohol and Drug Research, 11, 3-12.
