Screenings for Chlamydia trachomatis Antigen among HIV and non-HIV Patients with Symptoms of Urogenital Tract Diseases at The Federal Medical Centre Gombe, Nigeria.

摘要

C. trachomatis a sexually transmitted bacterial pathogen and the leading cause of bacterial sexually transmitted diseases (STDs) world wide can lead to serious complications in women and infants with untreated infections. Symptoms are normally unspecific, as such rapid screening tests with high specificity, though not confirmatory are highly valuable in converting its menace as large number of patients at high risk can be screened within a short period with ease in sample collection and patient management at very low cost. Three hundred urogenital swab samples; including 93 urethral swabs and 207 endocervical swabs were aseptically collected from patients with symptoms of urogenital tract diseases attending federal medical centre Gombe from January to March, 2010. Among them were 33 HIV patients and 267 non-HIV patients. All the swabs were subjected to Chlamydia antigen screening using Nova? One-Step Chlamydia trachomatis rapid immunochromatography antigen screening testing kits. In general, 11(3.7%) patients were found positive in this study. In the non-HIV patients, 2.6% were positive, with highest frequency of 3.1% recorded at the age group 21-30years. However in the HIV-patients, 12.1% were positive, with the highest frequency of 18.2% recorded at the age group 31-40years. The findings from this work has stressed the importance of rapid screening as a presumptive technique and call for use of more reliable confirmatory testing procedures in the prevention of pelvic inflammatory disease (PID), cervical carcinoma and other STDs. We also call for establishing a relationship between Chlamydia trachomatis and HIV infection in the locality. Introduction The Chlamydiales are bacteria that are obligate intracellular parasites of eukaryotic cells sharing greater than 80% sequence identity for the gene that encodes their 16S ribosomal ribosomal ribonucleic acid (rRNA) and/or greater than 80% identity for the gene that encodes their 23S rRNA (1). They also have distinctive biphasic developmental cycle which begins when metabolically inactive but infectious Elementary Bodies (EBs), get in to the host cell, differentiate into noninfectious, but metabolically active Reticulate Bodies (RBs), which multiply within 48 hours and form new EBs which are then released from the cell through exocytosis to initiate a new round of infection (2). C. trachomatis is the most common sexually transmitted pathogen of humans, with an estimated 89 million new cases occurring world wide each year (3) and the leading cause of preventable bacterial sexually transmitted diseases (STDs) world wide, affecting both sexes (4), however as reported by Lentichia (5), young women are at highest risk. It is transmitted person to person by simple contact, via fomites or may require sexual contact, as it may also be transmitted transplacentally to the neonate during delivery (6).Clinical signs due to Chlamydia, may include: low grade fever, exudates from the cervix and enlargement of local lymph nodes. However, these are not specific to Chlamydia as such where possible, laboratory tests should be performed to determine if evidence C. trachomatis is present (7). Untreated, C. trachomatis infections can lead to serious complications as about 40% of women with untreated C. trachomatis infections experience pelvic inflammatory disease (PID) world wide (8). Of these, 20% may become infertile; 18% may experience debilitating and chronic pelvic pain; while up to 9% may have a life-threatening tubal pregnancy (9). As it has been reported that STIs always facilitate HIV transmission through direct biological mechanisms, early diagnosis and treatment of STIs should therefore be part of a high quality and comprehensive HIV prevention strategy (10).Although, the diagnosis of Chlamydia infections evolved rapidly with Nucleic acid amplification tests, such as polymerase chain reaction (PCR), transcription mediated amplification (TMA), and the DNA strand displacement assay (SDA) now a