Prevalência da infecção por Chlamydia trachomatis em mulheres jovens assintomáticas acompanhadas em um hospital universitário público

Abstract

One of the most common sexually transmitted infections (STI) in the world is the one caused by Chlamydia trachomatis (CT), a gram-negative bacterium, mostly asymptomatic, that can cause various urogenital symptoms, being transmitted sexually almost exclusively, although vertical transmission is also possible in childbirth. Age below 24 years, sexual life initiation at an early age, large number of sexual partners, irregular use of condoms, change of sexual partners, use of drugs and alcohol and other sexually transmitted infections history are described in the literature as risk factors associated with increased prevalence of Chlamydia infection. The infection can be asymptomatic or can present symptoms such as urethritis, vaginal and urethral discharge, intermenstrual bleeding, among others. If left untreated, it can cause several consequences in a woman's reproductive life, in addition to becoming a reservoir for transmission to new sexual partners. The diagnosis can be clinical, but when dealing with an asymptomatic infection, other diagnostic methods must be used. Nucleic acid amplification tests (NAATs) are the most sensitive ones for the evaluation of these samples, being recommended for diagnosis. The objective of this study was to determine the prevalence of CT infection in young asymptomatic female patients who have been assisted in the gynecology service outpatient facility of the University Hospital of the Federal University of Juiz de Fora (HU/UFJF). It is a cross-sectional study, for which samples of endocervical material were collected in order to be analyzed using the DNA amplification technique, known as NAAT by Polymerase Chain Reaction (PCR), from patients treated at the gynecology service at HU/UFJF, from February 2022 to April 2024. The patients answered a questionnaire to assessment of the risk profile. The data were analyzed by the SPSS 20.0® program. Frequency and central tendency measurements were obtained. The outcome variable (positive or not for CT) was associated with the explanatory variables using the Chisquare test with Fischer correction, when necessary, and by comparing medians (Mann Whitney). Logistic regression analysis allowed the control of confounding variables. A significance level of 5% was adopted. The sample consisted of patients mostly black and brown (33% both), single (88%) and with incomplete high school (67%). The prevalence of CT infection found in this research was 7%, similar to what was obtained in other studies conducted in Brazil and in other developing countries. The associated variables were married or stable union marital status; other STIs history and previous smoking history, showing the importance of including this infection in the list of compulsory notification infections, in addition to encouraging the screening of patients with profile associated with the infection as well as their partners. Since it is about an infection with multiple gynecological and obstetric complications, screening strategies must be developed, as investment in early diagnosis and in adequate treatment of CT infections will represent a reduction in the financial impact of expenses with worsening of the population’s health, especially in women and children. In Brazil, the real epidemiological situation of this disease is not well known, as it is not compulsory to report. Hence, research like this becomes even more necessary.