Chlamydia trachomatis incidence and re-infection among young women - behavioural and microbiological characteristics

Jennifer Walker*, Sepehr N. Tabrizi, Christopher K. Fairley, Marcus Y. Chen, Catriona S. Bradshaw, Jimmy Twin, Nicole Taylor, Basil Donovan, John M. Kaldor, Kathleen McNamee, Eve Urban, Sandra Walker, Marian Currie, Hudson Birden, Francis Bowden, Jane Gunn, Marie Pirotta, Lyle Gurrin, Veerakathy Harindra, Suzanne M. GarlandJane S. Hocking

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    105 Citations (Scopus)

    Abstract

    Background: This study aimed to estimate rates of chlamydia incidence and re-infection and to investigate the dynamics of chlamydia organism load in prevalent, incident and re-infections among young Australian women. Methods: 1,116 women aged 16 to 25 years were recruited from primary care clinics in Australia. Vaginal swabs were collected at 3 to 6 month intervals for chlamydia testing. Chlamydia organism load was measured by quantitative PCR. Results: There were 47 incident cases of chlamydia diagnosed and 1,056.34 person years of follow up with a rate of 4.4 per 100 person years (95% CI: 3.3, 5.9). Incident infection was associated with being aged 16 to 20 years [RR = 3.7 (95%CI: 1.9, 7.1)], being employed [RR = 2.4 (95%CI: 1.1, 4.9)] and having two or more new sex partners [RR = 5.5 (95%CI: 2.6, 11.7)]. Recent antibiotic use was associated with a reduced incidence [RR:0.1 (95%CI: 0.0, 0.5)]. There were 14 re-infections with a rate of 22.3 per 100 person years (95%CI: 13.2, 37.6). The median time to re-infection was 4.6 months. Organism load was higher for prevalent than incident infections (p<0.01) and for prevalent than re-infections (p<0.01). Conclusions: Chlamydia is common among young women and a high proportion of women are re-infected within a short period of time, highlighting the need for effective partner treatment and repeat testing. The difference in organism load between prevalent and incident infections suggests prevalent infection may be more important for ongoing transmission of chlamydia.

    Original languageEnglish
    Article numbere37778
    JournalPLoS ONE
    Volume7
    Issue number5
    DOIs
    Publication statusPublished - 25 May 2012

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