Avaliação de testes para o diagnóstico de infecções por Chlamydia trachomatis e perfil de pessoas infectadas

Abstract

In the genital tract of infected women, Chlamydia trachomatis can cause cervicitis, urethritis, Pelvic inflammatory disease tube obstructions and infertility. In men, it is responsible for uretritis, epididimitis and prostatitis. Nevertheless, 50% of infected men and 80% of infected women remain asymptomatic. This particular characteristic emphasizes the importance of efficient diagnostic methods and earlier treatment for infected individuals. Those are crucial strategies to prevent the outcomes of thisinfection and also to reduce reservatories among the population. In this present study, we evaluated a male and female population comprised of 169 individuals who were applying for C. trachomatis diagnostic test at Instituto Hermes Pardini. The test used clinical specimens to perform the direct immunofluorescence methodology. This commercialized method was compared to two PCR based tests, PCR-HL1/HL2 designed by our group and PCR-KL1/KL2 which is already in routine use for diagnosis of infection. Besides the prevalence of infection in the study population, weinvestigated the profile of the infected individuals. The prevalence of C. trachomatis infection in the study population was 16.6%, being 32.1% among the male population and 4.3% among the female population. The estimated similarity among the three tests was 82.2%. However, the molecular tests showed a highest sensitivity (50%) with a agreement index of 90,5%. The PCR-HL1/HL2 presented the highest specificity, but lower sensitivity than PCR-KL1/KL2. The symptoms reported by 87.5% of male infected individuals was: urethral secretion (37.5%), pain whileurinating (12.5%) and both (29.2%). It is important to notice that 12.5% of male infected individuals reported themselves as asymptomatic. For female infected individuals, two of four women reported previous abortion experience. It was not possible to find any association between presence of infection and vaginal microbiote alterations. The infection was diagnosed in 78.6% which presented less than five leucocytes per field after Gram staining. The use of preservatives was not correlated to protection against the C. trachomatis infection in 54.2% of male and more frequent in females (50%) that used injectable contraceptives. The age range of 18 to 30 years presented the highest number of infected individuals (64.3%), considering that 58.3% were single males, three from four women were married and both with high educational level. The use of private social security service did not demonstrate to be a determinant factor in the control of C. trachomatis infection. The present study population differs from other populations evaluated in other studies in Brazil which presented high prevalence of C. trachomatis among the male population. Therefore, our data demonstrated the necessity of C. trachomatis infection control in both genders in order to reduce severe outcomes and the transmission of infection to intercourse partners.