Prevalence of Chlamydia trachomatis infection in pregnant women from Durban, South Africa

Abstract

Introduction: The Sub-Saharan African region has some of the world's highest prevalence of sexually transmitted infections (STIs). These infections are considered a major public health concern. Previous studies on the prevalence of C. trachomatis infection in Sub-Saharan Africa have reported rates ranging from 3.1% to 36.8% in pregnant women. This study investigated the prevalence and risk factors associated with C. trachomatis infection in pregnant women.

Methods: This study included 735 stored clinical samples that were collected from pregnant women attending the antenatal clinic at King Edward VIII Hospital in Durban from 2018 -2021. C. trachomatis was detected using the Applied Biosystems^TM TaqMan^® Assays from stored DNA samples.

Results: A total of 81/735 (11%) samples tested positive for C. trachomatis infection. The overall median (Q1-Q3) age of the women was 29.0 years (24.0-35.0). The majority of the women who tested positive for C. trachomatis were younger, median (Q1-Q3) age 26.0 years (23.0-32.0) vs 30.0 years (25.0-35.0) for the negative women (p < .001). Of the positive women, 96.3% were unmarried (p=0.014). Older women were less likely to test positive for C. trachomatis infection (OR: 0.93; 95% CI 0.89-0.96 p = .001). Women who were married (OR: 0.25; 95% CI 0.06-0.70; p = .022), co-habiting with their partner (OR: 0.60; 95% CI 0.36-0.98; p = .048) and started having sex at older than 15 years (OR:0.26; 95% CI 0.09-0.87; p = .018) were less likely to test positive for C. trachomatis compared to their counterparts.

Conclusion: This study showed that behavioural and clinical factors were associated with prevalent infections. In order to reduce prevalent infections, stronger risk reduction counselling messages need to be provided from the educational and public health sector.

Keywords: Chlamydia (Chlamydia trachomatis); sexual behaviour; women.