sodium-ethylxanthate and Chlamydia-Infections

Topics: Chlamydia Infections; Chlamydia trachomatis; Costs and Cost Analysis; Female; Health Promotion; Humans; Male; Mass Screening; Reproductive Medicine; Research; Sex; Sex Education; Sexuality; Social Responsibility

To identify the predictors of chlamydial infection and gonorrhea among patients tested by general practitioners.. Prospective study.. General private practice, family planning and abortion clinic, adolescent clinic, sexually transmitted disease (STD) clinic and community health clinic in downtown Montreal.. The 2856 patients were included because of symptoms compatible with an STD, a history of sexual contact with a person known or suspected to have chlamydial infection, a history of a nonexclusive sexual relationship or presentation for an abortion.. Patient information was obtained by the attending physician on a standard form. Enzyme immunoassay (EIA) for Chlamydia trachomatis and culture for Neisseria gonorrhoeae were performed on cervical (female) or urethral (male) samples. Stepwise logistic regression was used to identify the predictors of infection.. The EIA results were positive in 11.1% of the cases and the culture results in 2.3%. Among the males chlamydial infection was independently associated with low age (odds ratio [OR] = 0.88 per year), heterosexuality (OR = 4.99), urethral discharge (OR = 3.74) and the absence of a history of gonorrhea (OR = 0.51). Gonorrhea was associated with urethral discharge (OR = 24.3) and homosexuality (OR = 3.68). Among the females chlamydial infection was associated with low age (OR = 0.79 per year), a history of sexual contact with a person known to have chlamydial infection (OR = 2.30), multiple sexual partners in the previous 12 months (OR = 1.60) and a reason for the test other than screening purposes (OR = 0.60). Gonorrhea was associated with a reason other than screening (OR = 0.24) and low age (OR = 0.74 per year). Among the patients tested for screening purposes age was the only significant predictor of chlamydial infection (OR = 0.79 per year), and the prevalence of gonorrhea was 0.4%. The actual rate of chlamydial infection was 11.8% among the patients younger than 25 years, 5.7% among those 25 to 34 years and 0.6% among those over 34.. Age alone can be used as a criterion to screen for chlamydial infection among asymptomatic patients without a history of sexual contact with a person known or suspected to have such infection and with a history of a nonexclusive relationship. The prevalence in our population justifies screening people up to 34 years of age.

Topics: Adolescent; Adult; Age Factors; Chlamydia Infections; Chlamydia trachomatis; Female; Gonorrhea; Humans; Male; Neisseria gonorrhoeae; Predictive Value of Tests; Prospective Studies; Quebec; Sex; Sex Factors

Chlamydial disease in adolescent women is a serious public health problem, but secondary preventive efforts through early detection and treatment are encumbered by the cost and complexity of mass screening. This study was undertaken to identify clinical predictors of infection that might narrow the scope of screening adolescent populations. Demographic/clinical data and endocervical smears for the direct-specimen fluorescein-conjugated monoclonal antibody test for Chlamydia trachomatis were collected from 244 consecutive women, 21 years of age or less, attending an adolescent health clinic. Positive direct-specimen fluorescein-conjugated monoclonal antibody test for C trachomatis results were associated with a past history of chlamydial infection, multiple sexual partners, sexual contact with men with urethritis, nonuse of condoms, metrorrhagia, exocervicitis, mucopurulent endocervical discharge, abnormal cervical cytologic features, and isolation of Neisseria gonorrhoeae from the endocervix. These variables were entered into a discriminant analysis to predict direct-specimen fluorescein-conjugated monoclonal antibody test for C trachomatis results. The discriminant function was statistically significant but explained only 17% of between-group variance. Two variables alone, exocervicitis and partners with urethritis, correctly predicted direct-specimen fluorescein-conjugated monoclonal antibody test for C trachomatis results in 79% of all cases (negative predictive value 90%; positive predictive value 35%). When routine screening with reliable laboratory tests is not feasible, selective testing or empirical treatment of adolescent women with either risk factor may be cost-effective alternatives.

Topics: Adolescent; Adult; Chlamydia Infections; Chlamydia trachomatis; Female; Humans; Predictive Value of Tests; Risk Factors; Sex; Uterine Cervicitis; Vaginal Smears

In a study of 225 women with acute salpingitis verified by laparoscopy or laparotomy we investigated the prevalence of gonococcal and chlamydial infection in the lower genital tract. Neisseria gonorrhoeae was isolated from 18.9% of the women and Chlamydia trachomatis from 38.5%. Women with positive cultures were significantly younger (p less than 0.01) than those with negative cultures. A trend toward more severe inflammatory changes of the tubes was found in women with positive cultures compared with those with negative cultures. The majority of women with positive cultures stated they had only one sexual partner during the preceding 6 months. Single women had more partners (mean 1.9) than those cohabiting (mean 1.2). The ratio of single/multiple partners for women with Chlamydia was 2.5:1, and for those with gonorrhea 1:1 (p less than 0.05). Of the men, 60% could be examined and about 50% had positive cultures. Microbiologic investigation of both partners is necessary in order to prevent reinfection of the woman.

Topics: Adolescent; Adult; Age Factors; Chlamydia Infections; Chlamydia trachomatis; Female; Genital Diseases, Female; Gonorrhea; Humans; Iceland; Laparoscopy; Middle Aged; Neisseria gonorrhoeae; Salpingitis; Sex

The occurrence of urogenital involvements in female sexual partners of males with Reiter's syndrome (RS) or suspicion of RS (SRS) was studied. The possible etiological role of Chlamydia trachomatis (Ct) was demonstrated by isolation and by immunofluorescence (IF) serology. Evidence of chlamydial infection (positive isolation and/or IF titre greater than or equal to 64) was found in 35 out of 56 (62,5%) males with RS and in 9 out of 16 (56,3%) males with SRS. 43 female sexual partners of these men were studied. Evidence of present or past chlamydial infection was demonstrated in 23 of these 43 females (53,5%). This was a significantly higher frequency than that evidenced among controls studied, 14/77 verified serologically and 3/81 by isolation, p less than 0.0025 and p less than 0.005, respectively. A history of dysuria occurred in 10 out of 43 female sexual partners and in only 20 out of 364 interviewed randomly selected controls (p less than 0.00025). Abnormal urinary findings were also more frequent among the sexual partners than among the controls (p less than 0.025). The results emphasize the role of Ct as a triggering factor in RS and stress the importance of urogenital investigations among couples with RS.

Topics: Adolescent; Adult; Antibodies, Bacterial; Arthritis, Reactive; Chlamydia Infections; Chlamydia trachomatis; Female; Fluorescent Antibody Technique; Genital Diseases, Female; Humans; Immunoglobulin G; Male; Middle Aged; Sex; Urologic Diseases

To examine the occurrence of signs and symptoms of Reiter's syndrome (RS) in female sexual partners of males with RS we have investigated 43 female consorts of 42 males, originating from 72 consecutive patients suffering from RS or suspicion of RS (SRS). Anamnestic mono-, oligo- or polyarthritis occurred in 14 of the 43 females (32,6%) as compared to 28 out of 311 randomly selected interviewed controls (9,0%). Five of the 43 females had RS and 7 had SRS, (27,9%). However, the diagnosis could have been possible with only anamnestic information in 6 (14%) as compared to 7 out of 311 controls (2,3%). Taking into consideration the 30 males whose sexual partners were not investigated, the theoretically counted values still differ significantly from those of the controls (p less than 0.01). A history of urogenital and, on the other hand, nasopharyngeal or pulmonary infections involvements preceded equally frequently the first or further joint attacks. Evidence of chlamydial infection was found in 53,5% (32/43) of the partners while Yersinia antibodies measured by ELISA occurred with the same frequency as among healthy blood donors. We would like to stress the importance of various infectious involvements, especially sexually transmitted diseases, as etiological agents in joint attacks in females who are sexual partners of males with RS.

Topics: Adolescent; Adult; Antibodies, Bacterial; Arthritis, Reactive; Bone Diseases; Chlamydia Infections; Chlamydia trachomatis; Enzyme-Linked Immunosorbent Assay; Female; Humans; Immunoglobulins; Male; Middle Aged; Muscular Diseases; Sex; Yersinia

With sexually transmitted rheumatic diseases in mind we investigated 37 male sexual partners of females with Reiter's syndrome (RS) or suspicion of RS (SRS). Controls were 219 randomly selected interviewed males. A history of urogenital involvements was found in 19/37 (51,4%) as compared to 65/219 (29,7%). Anamnestic nonspecific urethritis, dysuria, gonorrhoea, condylomata acuminata and prostatitis occurred more frequently in the 37 males than in the controls (p less than 0.05 - p less than 0.025). Six out of 37 as compared to 5 of 219 had a history of balanitis (p less than 0.0025). Anamnestic synovitis was found in 8/37 (21,6%) and in 9/219 (4,1%) (p less than 0.001) RS or SRS was diagnosed in 6/37 (16,2%). Taking into consideration the consecutive females with RS or SRS, whose sexual partners were not investigated, the theoretical counting still shows clear differences in the anamnestic occurrence of synovitis and balanitis between the 37 males and the controls (p less than 0.0125 - p less than 0.05). The results emphasize the important role of sexually acquired and maintained RS in rheumatology.

Topics: Adolescent; Adult; Arthritis, Reactive; Bone Diseases; Chlamydia Infections; Chlamydia trachomatis; Female; Genital Diseases, Male; Humans; Male; Medical History Taking; Middle Aged; Sex; Urologic Diseases