exudates and Chlamydia-Infections

Chlamydia trachomatis is one of the most common sexually transmitted diseases (STDs) globally. However, data on its prevalence and risk factors in Malaysia is still scarce.. We aimed to identify the prevalence and risk factors of genitourinary C.trachomatis infection among patients attending STD clinics in northern Peninsular Malaysia.. A hospital-based cross-sectional study was conducted in STD clinics of Hospital Pulau Pinang and Hospital Sultanah Bahiyah, Kedah from January to November 2014. Participants were individually interviewed using a structured data collection form followed by a physical examination and laboratory tests. Nucleic Acid Amplification Test (NAAT) was used to detect C.trachomatis infection. Analysis was carried out using SPSS Version 15.. Eighty-three sexually active patients were enrolled, consisting of 51 males and 32 females. The median age was 28.0 years. In general, 32.5% patients were asymptomatic, the remaining presented with genital discharge (41.0%), genital warty lesion (25.3%), genital ulcer (13.3%), dysuria (13.3%), dyspareunia (2.4%), urine hesistancy (1.2%) and genital swelling (1.2%). The prevalence of genitourinary C.trachomatis infection was 21.7% in the study population; 17.6% in males and 28.1% in females. Among the infected females, 44.4% were pregnant. Of those infected 56.6% did not show any symptoms of genital infection, and 77.8% were aged between 18 and 30 years, of which most were females. Among newly diagnosed HIV patients, the prevalence was 14.3%. From multivariable logistic regression analysis, age under 28 years, being married and engagement in oral sex had significantly increased odds of C.trachomatis infection.. C.trachomatis infection was common among patients attending STD clinics in northern Penisular Malaysia especially in the younger age groups. Majority of the infected patients were asymptomatic.

Topics: Adolescent; Adult; Ambulatory Care Facilities; Chlamydia Infections; Chlamydia trachomatis; Cross-Sectional Studies; Female; Humans; Interviews as Topic; Malaysia; Male; Middle Aged; Prevalence; Qualitative Research; Risk Factors; Sexually Transmitted Diseases; Young Adult

The cervical microbiota constitutes an important protective barrier against the invasion of pathogenic microorganisms. A disruption of microbiota within the cervical milieu has been suggested to be a driving factor of sexually transmitted infections. These include Chlamydia trachomatis which frequently causes serious reproductive sequelae such as infertility in women. In this study, we profiled the cervical microbial composition of a population of 70 reproductive-age Malaysian women; among which 40 (57.1%) were diagnosed with genital C. trachomatis infection, and 30 (42.8%) without C. trachomatis infection. Our findings showed a distinct compositional difference between the cervical microbiota of C. trachomatis-infected subjects and subjects without C. trachomatis infection. Specifically, significant elevations of mostly strict and facultative anaerobes such as Streptococcus, Megasphaera, Prevotella, and Veillonella in the cervical microbiota of C. trachomatis-positive women were detected. The results from the current study highlights an interaction of C. trachomatis with the environmental microbiome in the endocervical region.

Topics: Academic Medical Centers; Adult; Bacteria, Anaerobic; Cervix Uteri; Chlamydia Infections; Chlamydia trachomatis; Cohort Studies; DNA, Bacterial; Female; Host-Pathogen Interactions; Humans; Infertility; Malaysia; Metagenomics; Microbiota; Outpatient Clinics, Hospital; RNA, Ribosomal, 16S; Young Adult

Sex workers face a disproportionate burden of human immunodeficiency virus (HIV) and sexually transmitted infections (STI) worldwide. For cisgender women sex workers (CWSW), global HIV prevalence is over 10%, whereas transgender women sex workers (TWSW) face an HIV burden of 19% to 27%.. We used respondent-driven sampling to recruit 492 sex workers, including CWSW (n = 299) and TWSW (n = 193) in Greater Kuala Lumpur, Malaysia. Participants completed an in-depth survey and were screened for HIV, syphilis, Chlamydia trachomatis, and Neisseria gonorrhoeae. Sample characteristics stratified by gender identity and interview site are presented. Bivariate analyses comparing CWSW and TWSW were conducted using independent samples t tests for continuous variables and χ tests for categorical variables.. Pooled HIV prevalence was high (11.7%; 95% confidence interval [CI], 8.8-14.5), and was similar for CWSW (11.1%) and TWSW (12.4%). Rates of syphilis 25.5% (95% CI, 21.6-29.5), C. trachomatis (14.8%; 95% CI, 11.6-18.0) and N. gonorrhoeae (5.8%; 95% CI, 3.7-7.9) were also concerning. Both groups reported lifetime HIV testing (62.4%), but CWSW were less likely to have ever been HIV tested (54.5%) than TWSW (74.6%). Median time since last HIV test was 24 months. Previous screening for STI was low. Inconsistent condom use and drug use during sex work were not uncommon.. High HIV and STI prevalence, coupled with infrequent HIV and STI screening, inconsistent condom use, and occupational drug use, underscore the need for expanded HIV and STI prevention, screening, and treatment efforts among CWSW and TWSW in Malaysia.

Topics: Adult; Aged; Chlamydia Infections; Condoms; Female; Gonorrhea; Health Knowledge, Attitudes, Practice; HIV Infections; Humans; Malaysia; Male; Mass Screening; Middle Aged; Prevalence; Sampling Studies; Sex Workers; Sexual Partners; Substance-Related Disorders; Syphilis; Transgender Persons; Unsafe Sex; Young Adult

The 7.5 kb cryptic plasmid of Chlamydia trachomatis has been shown to be a virulence factor in animal models, but its significance in humans still remains unknown. The aim of this study was to investigate the prevalence and potential involvement of the C. trachomatis cryptic plasmid in causing various clinical manifestations; including infertility, reproductive tract disintegrity, menstrual disorder, and polycystic ovarian syndrome (PCOS) among genital C. trachomatis-infected patients.. A total of 180 female patients of child bearing age (mean 30.9 years old, IQR:27-35) with gynecological complications and subfertility issues, who visited Obstetrics and Gynecology clinics in Kuala Lumpur, Malaysia were recruited for the study. Prevalence of genital chlamydial infection among these patients was alarmingly high at 51.1% (92/180). Of the 92 chlamydia-infected patients, 93.5% (86/92) were infected with plasmid-bearing (+) C. trachomatis while the remaining 6.5% (6/92) were caused by the plasmid-free (-) variant. Our data showed that genital C. trachomatis infection was associated with infertility issues, inflammation in the reproductive tract (mucopurulent cervicitis or endometriosis), irregular menstrual cycles and polycystic ovarian syndrome (PCOS). However, no statistical significance was detected among patients with plasmid (+) versus plasmid (-) C. trachomatis infection. Interestingly, plasmid (+) C. trachomatis was detected in all patients with PCOS, and the plasmid copy numbers were significantly higher among PCOS patients, relative to non-PCOS patients.. Our findings show a high incidence of C. trachomatis infection among women with infertility or gynecological problems in Malaysia. However, due to the low number of plasmid (-) C. trachomatis cases, a significant role of the plasmid in causing virulence in human requires further investigation of a larger cohort.

Topics: Adult; Chlamydia Infections; Chlamydia trachomatis; Cohort Studies; Female; Gynecology; Humans; Malaysia; Obstetrics; Plasmids; Pregnancy; Prevalence

There is still substantial uncertainty concerning the association between Chlamydia pneumoniae and ischemic heart disease. This may partly be explained by the adjustment for potential confounders in different population studies. This is the first study in Singapore to look at the association of C. pneumoniae seropositivity with ischemic heart disease in a multivariate analysis. A random sample of 714 persons aged between 35 and 69 years was selected from the participants of the Singapore National Health Survey conducted in 1998. Data on clinical measurements and conditions were collected using biochemical tests and interviewer-based questionnaires. Ischemic heart disease was defined by the Rose questionnaire and included history suggestive of angina and/or myocardial infarction. Immunoglobulin G antibodies for C. pneumoniae were detected using an indirect microimmunofluorescence test, and seropositivity was defined as IgG titers > or = 1:16. There were no statistically significant differences in the prevalence rates of seropositivity to C. pneumoniae among the three ethnic groups, that is, Chinese (80.4%), Malays (74.0%), and Asian Indians (73.2%). There was no association between seropositivity and ischemic heart disease after adjustment for age alone (OR 1.00, 95% CI 0.54-1.83) or for age, sex, and other risk factors of atherosclerosis (OR 0.99, 95% CI 0.53-1.84). C. pneumoniae Immunoglobulin G seropositivity was not associated with an increased risk of ischemic heart disease as defined by the Rose angina questionnaire in Singapore.

Topics: Adult; Aged; Antibodies, Bacterial; China; Chlamydia Infections; Chlamydophila pneumoniae; Ethnicity; Female; Humans; Immunoglobulin G; India; Malaysia; Male; Middle Aged; Multivariate Analysis; Myocardial Ischemia; Risk Factors; Singapore

The incidence of Chlamydia pneumoniae and Chlamydia trachomatis infection was studied among infants and young children admitted to hospital for the management of lower respiratory tract infections, over a 12 month period.. Respiratory secretions were examined for chlamydiae by cell culture, enzyme-linked immunosorbent assay and polymerase chain reaction-enzyme immunoassay. Sera were tested by micro-immunofluorescence for chlamydial IgG, IgM and IgA. Other bacterial and viral pathogens were also looked for by standard cultural and serological methods.. Of 87 patients aged 2 months-3 years, an aetiologic diagnosis was made in 41 (47.1%). C. pneumoniae and C. trachomatis were each detected in 1 (1.2%) of the patients. Among common bacterial pathogens, Haemophilus influenzae (13.8%) and Streptococcus pneumoniae (8.1%) were the most frequently identified. Respiratory viruses and elevated Mycoplasma pneumoniae antibodies were found in 10.3% and 9.1% of patients, respectively.. Chlamydiae are infrequent causes of community-acquired acute lower respiratory tract infections in infants and very young children in Malaysia.

Topics: Child, Preschool; Chlamydia Infections; Chlamydia trachomatis; Chlamydophila pneumoniae; Community-Acquired Infections; Enzyme-Linked Immunosorbent Assay; Humans; Incidence; Infant; Malaysia; Polymerase Chain Reaction; Respiratory Tract Infections

The microbial aetiology of genital ulcers was studied in 249 patients (241 men and 8 women) attending a Sexually Transmitted Disease Clinic in Kuala Lumpur, Malaysia. Herpes simplex virus type 2 was isolated in 48 (19.2%) patients, Haemophilus ducreyi from 22 (8.8%), Neisseria gonorrhoeae from seven (2.8%) and Chlamydia trachomatis from four (1.6%). Syphilis was diagnosed in 18 (7.2%) patients on the basis of dark field microscopy. Two (0.8%) patients were found to have both chancroid and syphilis and one (0.5%) had both gonorrhoea and syphilis. No organism was isolated in the remaining 151 (61.5%) patients. Overall, the accuracy of clinical diagnosis was 58% for single infection, 67% for herpes, 63% for syphilis, 47% for chancroid and 0% for lymphogranuloma venereum. Therefore, our study confirms the need for laboratory tests to diagnose accurately the aetiology of genital ulcer disease.

Topics: Adolescent; Adult; Chlamydia Infections; Chlamydia trachomatis; Female; Genital Diseases, Female; Genital Diseases, Male; Gonorrhea; Haemophilus Infections; Herpes Genitalis; Humans; Malaysia; Male; Middle Aged; Ulcer

A single antigen indirect immunofluorescence test was used to screen for chlamydial antibody among Malaysian infants, children, sexually active adults and prostitutes. Of 794 serum samples tested, 361 (45.5%) were positive. Seropositivity increased with age and sexual activity and ranged from 10 to 16% among children under 10 years old to 94.4% among prostitutes. Pregnant women and female adolescents showed a higher antibody prevalence than nonpregnant and older women. Six (13%) infants under 6 months of age were positive for chlamydial IgM.. 794 sera from urban Malaysians (Kuala Lumpur and Petaling Jaya) were screened for Chlamydia with an indirect immunofluorescence kit (Chlamydia-Spot IF Kit, BioMerieux, France) between August 1988-July 1989. 86% of the donors were Chinese: 251 asymptomatic males and 234 females; 101 women attending prenatal clinics; 46 infants under 6 months; 97 female and 11 male prostitutes; and 54 men attending a clinic for sexually transmitted diseases (STDs). Sera were tested at a single dilution: 1/16 for men, 1/64 for women and neonates, and 1/8 for chlamydial IgM testing and infants. The overall seropositivity rates were 43.3 for m en, 24.8% for women, 34.7% for pregnant women, 94.4% for prostitutes, and 72.2% for men with STDs. Positive titers increased from 16.2 to 72.2% with age in men. They were highest in women aged 11-20, 25.6% and 50, 66.7%. 13% of the infants were positive for IgM anti-chlamydial antibodies, possibly suggestive of intrauterine infection, and 39% were positive for IgG, porbably from placentral transfer.

Topics: Adolescent; Adult; Antibodies, Bacterial; Child; Child, Preschool; Chlamydia; Chlamydia Infections; Female; Fluorescent Antibody Technique; Humans; Immunoglobulin M; Infant; Infant, Newborn; Malaysia; Male; Middle Aged; Pregnancy; Prevalence; Sex Work; Sexual Behavior

The prevalence of sexually transmitted diseases was determined among 370 prostitutes in Kuala Lumpur, Malaysia. Chlamydial cervicitis (26.5%) was detected more frequently than gonorrhoea (14.25%) and was associated more often with pelvic inflammatory disease. Concurrent infections and asymptomatic infections were common. Seropositivity to hepatitis B and syphilis were 66.3% and 13.6% respectively. Women under 20 years of age had significantly higher rates of infection with Chlamydia trachomatis and hepatitis B virus than older women.

Topics: Adolescent; Adult; Chlamydia Infections; Female; Gonorrhea; Hepatitis B; Humans; Malaysia; Middle Aged; Pelvic Inflammatory Disease; Prevalence; Sex Work; Sexually Transmitted Diseases; Syphilis