OBJECTIVES:
Chlamydia
trachomatis is the most common bacterial sexually transmitted infection and is
frequently asymptomatic; ocular C. trachomatis strains cause trachoma. Mass
drug administration (MDA) of azithromycin for trachoma might also reduce the
prevalence of genital C. trachomatis. In a survey conducted in the Solomon
Islands in 2014, prior to MDA, the prevalence of genital C. trachomatis was
20.3% (95% CI 15.9% to 25.4%). We conducted a survey to establish the impact of
MDA with azithromycin on genital C. trachomatis.
METHODS:
Women
attending three community outpatient clinics, predominantly for antenatal care,
10 months after MDA with azithromycin given for trachoma elimination, were
enrolled in this survey. Self-taken high vaginal swabs were for C. trachomatis
and Neisseria gonorrhoeae using the BD Probetec strand displacement assay.
RESULTS:
298 women
were enrolled. C. trachomatis infection was diagnosed in 43 women (14.4%, 95%
CI 10.6% to 18.9%) and N. gonorrhoeae in 9 (3%, 95% CI 1.4% to 5.7%). The
age-adjusted OR for C. trachomatis infection was consistent with a significant
decrease in the prevalence of C. trachomatis following MDA (OR 0.58, 95% CI
0.37 to 0.94, p=0.027). There was no change in the prevalence of N. gonorrhoeae
between following MDA (OR 0.51, 95% CI 0.22 to 1.22, p=0.13).
CONCLUSIONS:
This
study demonstrated a 40% reduction in the age-adjusted prevalence of genital C.
trachomatis infection following azithromycin MDA for trachoma elimination.
- 1Faculty of Infectious and Tropical Diseases, Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK Hospital for Tropical Diseases, University College London Hospitals NHS Trust, London, UK.
- 2Department of Infectious Diseases Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
- 3Nursing Division, Honiara City Council, Honiara, Solomon Islands.
- 4National Referral Hospital, Honiara, Solomon Islands.
- 5Faculty of Infectious and Tropical Diseases, Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK.
- 6Eye Health Department, Ministry of Health and Medical Services, Honiara, Solomon Islands.
- 7Department of STI and HIV Prevention, Ministry of Health and Medical Services, Honiara, Solomon Islands.
- Sex Transm Infect. 2016 Feb 17. pii: sextrans-2015-052439. doi: 10.1136/sextrans-2015-052439.
