Prevalence of sexually transmitted infections in women attending antenatal care in Tete province, Mozambique

OBJECTIVE: To determine the prevalence of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and syphilis in pregnant women. METHODS: A cross-sectional study was conducted among women attending antenatal care clinics (ANCs). Blood samples were tested for syphilis using the rapid plasma reagin (RPR) and treponemal haemagglutination (TPHA) tests; CT and NG were diagnosed using a manual polymerase chain reaction assay on first-void urine samples. A socio-demographic questionnaire was completed. Results were compared with previous published data on sexually transmitted infection (STI) prevalence in Mozambique. RESULTS: Blood and urine samples were collected from 1 119 and 835 women, respectively. The prevalence of CT was 4.1%, and that of NG 2.5%. The RPR test was positive in 5.2% of the women, and 7.1% had a positive TPHA test. Active syphilis was found in 4.7%. In univariate analysis, CT was associated with having had any level of education (p<0.05), reactive RPR and TPHA were associated with illiteracy (p<0.05), and TPHA was associated with age >25. Multivariate analysis did not show any significant association. In comparison with published data from 1993, a decline was observed for CT (p<0.05), NG and syphilis (p<0.001). CONCLUSIONS: Compared with available data, a decline of STI prevalence was observed in our setting. This might be the result of community-based education programmes focusing on changes to sexual behaviour, as well as the widespread use of the syndromic approach to managing STIs and the expansion of syphilis screening in primary health care settings. However, STI rates are still high, and the problem needs more concrete and sustained efforts for its control.     

Evaluating HIV prevention efforts using semiparametric regression models: results from a large cohort of women participating in an HIV prevention trial from KwaZulu-Natal,South Africa

Objective

To describe and quantify the differences in risk behaviours, HIV prevalence and incidence rates by birth cohorts among a group of women in Durban, South Africa.

Methods

Cross-sectional and prospective cohort analyses were conducted for women who consented to be screened and enrolled in an HIV prevention trial. Demographic and sexual behaviours were described by five-year birth cohorts. Semiparametric regression models were used to investigate the bivariate associations between these factors and the birth cohorts. HIV seroconversion rates were also estimated by birth cohorts.

Results

The prevalence of HIV-1 infection at the screening visit was lowest (20.0%) among the oldest (born before 1960) cohorts, while the highest prevalence was observed among those born between 1975 and 79. Level of education increased across the birth cohorts while the median age at first sexual experience declined among those born after 1975 compared to those born before 1975. Only 33.03% of the oldest group reported ever using a condom while engaging in vaginal sex compared to 73.68% in the youngest group; however, HIV and other sexually transmitted infection (STI) incidence rates were significantly higher among younger women compared to older women.

Conclusions

These findings clearly suggest that demographic and sexual risk behaviours are differentially related to the birth cohorts. Significantly high HIV and STI incidence rates were observed among the younger group. Although the level of education increased, early age at sexual debut was more common among the younger group. The continuing increase in HIV and STI incidence rates among the later cohorts suggests that the future trajectory of the epidemic will be dependent on the infection patterns in younger birth cohorts.     

Frequency of Chlamydia trachomatis among male patients with urethritis in northeast of Iran detected by polymerase chain reaction

Planning for appropriate preventive measures against Chlamydia trachomatis, a common cause of sexually transmitted disease, requires knowledge of prevalence of infection so that interventions can be targeted in a cost-effective manner. This study was performed on 178 male patients presenting with urethritis in the Mashhad province to determine the prevalence of chlamydial infection in Northeast Iran. A cotton swab and first voided urine specimen were collected according to standard procedures. Polymerase chain reaction (PCR) tests were used for the detection of C. trachomatis in the specimens collected and the results were analyzed using SPSS program. Results showed that 10.6% of male patients in this group were infected with C. trachomatis. This study provides strong evidence that prevalence of Chlamydia in the Northeast Iran is high and suggests that Chlamydia screening as a routine part of STD investigations is highly necessary in this area.     

Marital status and risk of HIV infection in South Africa.

OBJECTIVE: Available evidence on the relationship between marital status and HIV is contradictory. The objective of this study was to determine HIV prevalence among married people and to identify potential risk factors for HIV infection related to marital status in South Africa. METHODS: A multistage probability sample involving 6 090 male and female respondents, aged 15 years or older was selected. The sample was representative of the South African population by age, race, province and type of living area, e.g. urban formal, urban informal, etc. Oral fluid specimens were collected to determine HIV status. A detailed questionnaire eliciting information on socio-demographic, sex behaviour and biomedical factors was administered through face-to-face interviews from May to September 2002. RESULTS: HIV prevalence among married people was 10.5% compared with 15.7% among unmarried people (p-value < 0.001). The risk of HIV infection did not differ significantly between married and unmarried people (odds ratio (OR) = 0.85, 95% confidence interval (CI): 0.71 - 1.02) when age, sex, socio-economic status, race, type of locality, and diagnosis of a sexually transmitted infection (STI) were included in the logistical regression model. However, the risk of HIV infection remained significantly high among unmarried compared with married people when only sex behaviour factors were controlled for in the model (OR 0.55; 95% CI: 0.47 - 0.66). CONCLUSIONS: The relationship between marital status and HIV is complex. The risk depends on various demographic factors and sex behaviour practices. Increased prevention strategies that take socio-cultural context into account are needed for married people.     

Sexually transmitted infections and increased risk of co-infection with human immunodeficiency virus

The incidence of trichomoniasis (Trichomonas vaginalis) in the United States is estimated at 5 million cases annually; chlamydia (Chlamydia trachomatis) at 3 million; gonorrhea (Neisseria gonorrhoeae), 650,000; and syphilis (Treponema pallidum), 70,000. However, most sexually transmitted infections (STIs) are asymptomatic-contributing to underdiagnosis estimated at 50% or more. Diagnosis of an STI signals sexual health risk because an STI facilitates the transmission and acquisition of other STIs, including human immunodeficiency virus (HIV). In fact, comorbid STIs increase patients' susceptibility of acquiring and transmitting HIV by two- to fivefold. Several studies have shown that aggressive STI prevention, testing, and treatment reduces the transmission of HIV. The authors discuss common clinical presentations, screening, diagnosis, and treatment for trichomoniasis, chlamydia, gonorrhea, syphilis, and herpes simplex virus.     

The prevalence of Chlamydia trachomatis infections in new patients at the Infertility Clinic, UOFS, Bloemfontein

Chlamydia trachomatis is a common sexually transmitted agent causing infertility. Routine screening tests or empirical antibiotic treatment of infertile couples may be justified by the prevalence of this organism. In this study the female partner of 40 consecutive infertile couples was investigated. As a screening test direct immunofluorescence (DIF) was performed on fixed smears from endocervical swabs. Of a total of 40 specimens, 11 (27.5%) were positive, 25 (62.5%) were negative and 4 (10.0%) were equivocal. DIF was repeated on smears from 3 of the last 4 patients and all 3 specimens were positive for C. trachomatis. One patient was lost to follow-up and excluded from the study. Of a total of 39 specimens the final results yielded 14 (35.9%) positive and 25 (64.1%) negative. Statistical analysis showed no correlation between the clinical history and the presence of C. trachomatis infection.     

Sexual behaviour and dysfunction and help-seeking patterns in adults aged 40-80 years in the urban population of Asian countries

OBJECTIVE: To study sexual activity, the prevalence of sexual dysfunction and related help-seeking behaviour among middle-aged and elderly people in Asia. SUBJECTS AND METHODS: A random population survey was carried out in 2001-2002 among urban residents aged 40-80 years in China, Taiwan, South Korea, Japan, Thailand, Singapore, Malaysia, Indonesia and The Philippines, with interviews based on a standardized questionnaire covering demographic details, health, relationships, and sexual behaviours, attitudes and beliefs. An intercept method of sampling was used in all countries except Japan, where questionnaires were mailed to a sample drawn from telephone directories. Sexual dysfunction was defined as persistent sexual problems. RESULTS: The questionnaire was completed by 6700 people (3350 men and 3350 women), giving a response rate of 27%. Across all countries, 82% of men and 64% of women had engaged in sexual intercourse during the year preceding the interview. Most of the respondents considered satisfactory sex an essential means of maintaining a relationship. More than 20% of men and 30% of women complained of having at least one sexual dysfunction, although there were marked variations among the countries. The sexual dysfunctions most frequently reported were early ejaculation (20%; 95% confidence interval, CI, 18-21) and erectile dysfunction (15%, 14-17) among men; and a lack of sexual interest (27%, 25-29), lubrication difficulties (24%, 22-25), and an inability to reach orgasm (23%, 22-25) among women. Of the 948 men and 992 women who were sexually active and reported sexual dysfunctions, 45% did sought no help or advice and only 21% sought medical care. CONCLUSION: Men and women in Asian countries continue to show sexual interest and activity into middle age and beyond. Although sexual dysfunction is prevalent in this age group, several sociocultural and economic factors appear to be preventing individuals from seeking medical help for these problems.     

Perceptions and knowledge about the acquired immunodeficiency syndrome among students in university residences

Using an anonymous questionnaire to obtain baseline data on sexual behaviour and knowledge of the acquired immunodeficiency syndrome (AIDS) among students in university residences, the following information was obtained: Knowledge of AIDS was found to be high, although misconceptions regarding transmission of the virus were prevalent. Mosquito bites (15%) and the donating of blood (31%) were incorrectly identified as methods of transmission of the virus. Deep kissing was recognised by only 27% of the students as a possible method of transmission while 22% and 13% of the students, respectively, failed to identify the sharing of razor blades and blood transfusions as possible means of contracting HIV infection. The students' knowledge had not greatly affected sexual behaviour. Two-thirds of the respondents had previously had sexual contact; 38% were sexually active at the time of the study, and of these 74% had engaged in unprotected intercourse with casual partners in the previous 6 months. There was a negative attitude towards condom use and over 80% of sexually active students did not perceive themselves to be at risk of contracting AIDS. Campus Health (82%), State health services (51%), and public advertisements (60%) were preferred sources of AIDS information. Newspapers/magazines (80%) and leaflets (69%) were identified as the preferred media. In reality, significantly fewer students obtained their information from Campus Health (15%; P less than 0.05), State health services (19%, P less than 0.05) and leaflets (44%; P less than 0.05). It can be concluded that education programmes should be developed by credible organisations to ensure that an awareness of AIDS results in appropriate sexual behaviour.     

Sexual and reproductive health service needs of university/college students: updates from a survey in Shanghai, China

AIM: To promote the provision of reproductive health services to young people by exploring the attitudes and perceptions of university students in Shanghai, China, toward reproductive health. METHODS: From July 2004 to May 2006, 5 243 students from 14 universities in Shanghai took part in our survey. Topics covered the demands of reproductive health-care services, attitudes towards and experience with sex, exposure to pornographic material, and knowledge on sexual health and sexually transmitted infections (STIs)/AIDS. RESULTS: Of the 5 067 students who provided valid answer sheets, 50.05% were female and 49.95% were male, 14.86% were medical students, and 85.14% had non-medical backgrounds. A total of 38.4% of respondents had received reproductive health education previously. The majority of students supported school-based reproductive health education, and also acquired information about sex predominantly from books, schoolmates, and the Internet. Premarital sexual behavior was opposed by 17.7% of survey participants, and 37.5% could identify all the three types of STIs listed in the questionnaire. Although 83.7% knew how HIV is transmitted, only 55.7% knew when to use a condom and 57.8% knew that the use of condoms could reduce the risk of HIV infection. CONCLUSION: The reproductive health service is lagging behind current attitudes and demands of university students. Although students' attitudes towards sexual matters are liberal, their knowledge about reproductive health and STIs/AIDS is still limited. It is therefore necessary to provide effective and confidential reproductive health services to young people.     

How common and frequent is heterosexual anal intercourse among South Africans? A systematic review and meta‐analysis

Background : HIV is transmitted more effectively during anal intercourse (AI) than vaginal intercourse (VI). However, patterns of heterosexual AI practice and its contribution to South Africa's generalized epidemic remain unclear. We aimed to determine how common and frequent heterosexual AI is in South Africa. Methods : We searched for studies reporting the proportion practising heterosexual AI (prevalence) and/or the number of AI and unprotected AI (UAI) acts (frequency) in South Africa from 1990 to 2015. Stratified random‐effects meta‐analysis by sub‐groups was used to produce pooled estimates and assess the influence of participant and study characteristics on AI prevalence. We also estimated the fraction of all sex acts which were AI or UAI and compared condom use during VI and AI. Results : Of 41 included studies, 31 reported on AI prevalence and 14 on frequency, over various recall periods. AI prevalence was high across different recall periods for sexually active general‐risk populations (e.g. lifetime = 18.4% [95%CI:9.4–27.5%], three‐month = 20.3% [6.1–34.7%]), but tended to be even higher in higher‐risk populations such as STI patients and female sex workers (e.g. lifetime = 23.2% [0.0–47.4%], recall period not stated = 40.1% [36.2–44.0%]). Prevalence was higher in studies using more confidential interview methods. Among general and higher‐risk populations, 1.2–40.0% and 0.7–21.0% of all unprotected sex acts were UAI, respectively. AI acts were as likely to be condom protected as vaginal acts. Discussion : Reported heterosexual AI is common but variable among South Africans. Nationally and regionally representative sexual behaviour studies that use standardized recall periods and confidential interview methods, to aid comparison across studies and minimize reporting bias, are needed. Such data could be used to estimate the extent to which AI contributes to South Africa's HIV epidemic.     

Rising prostate cancer rates in South Korea

BACKGROUND: Prostate cancer incidence and mortality rates in South Korea are relatively low, but rising steadily. METHODS: We examined age-standardized incidence and mortality trends of prostate cancer in South Korea to gain further insight into prostate cancer etiology. RESULTS: Although prostate cancer incidence has been low (7.9 per 100,000 man-years), it has increased up to 28.2% between 1996-1998 and 1999-2001. Prostate cancer mortality increased 12.7-fold over a 20-year period. Despite the increase in prostate cancer incidence and mortality rates, marked differences in rates remain for Koreans, Korean Americans, and Caucasian Americans. CONCLUSIONS: The rising rates of prostate cancer in South Korea cannot be attributed entirely to PSA screening due to the low PSA screening prevalence; this trend is most likely related to increased westernization among Koreans. Interdisciplinary epidemiological studies incorporating the collection of biological samples are needed to clarify the extent to which lifestyle and genetic factors contribute to the observed racial disparity.     

Antibodies to Chlamydia trachomatis in patients presenting with ectopic pregnancy at Groote Schuur Hospital.

OBJECTIVES: To determine the prevalence of antibodies to Chlamydia trachomatis in women presenting with ectopic pregnancies to Groote Schuur Hospital. METHODS: C. trachomatis antibody titres were measured using a modified micro-immunofluorescence test in women presenting with ectopic pregnancy. Control subjects were drawn from women with term pregnancies and an uneventful reproductive history. RESULTS: Seventy-four patients and controls were studied. Demographic variables were controlled for at time of entry into the study. A significant association between the number of lifetime sexual partners and exposure to C. trachomatis was noted (P = 0.001). Patients with ectopic pregnancies had significantly higher antibody titres than control subjects (P = 0.001), and in both groups the prevalence of background antichlamydial antibody was high (ectopic pregnancies 59%, pregnant controls 32%). CONCLUSIONS: While the role of C. trachomatis infection in women who develop ectopic pregnancies needs to be explored further, it seems wise to treat them all with empirical antibiotics at the time of presentation.     

Reduced Chlamydial Infection and Gonorrhea among Commercial Sex Workers in Fukuoka City, Japan

Background: Until recently, epidemiologic studies of sexually transmitted diseases (STDs), including human immunodeficiency virus type-1 (HIV-1) infection, amongjapanese female commercial sex workers and their patterns of condom use have been rare. We investigated trends in STDs among female commercial sex workers and their condom use patterns in Fukuoka, Japan, from 1990 through 1995.
Methods: The study group consisted of 1218 female commercial sex workers who attended an STD clinic to undergo screening for major STDs including chlamydial infection, gonorrhea and HIV-1 infection from 1990 through 1995. Endocervical smear specimens were taken from the women to detect Chlamydia trachomatis and Neisseria gonorrhoeae and blood samples were obtained for the serologic diagnosis of HIV-1. Also, the commercial sex workers were interviewed concerning their condom use patterns.
Results: The annual infection and detection rates of C. trachomatis declined significantly from 58.1 % in 1990 to 46.2% in 1995 and from 16.3% in 1990 to 10.0% in 1995, respectively, while the annual infection and detection rates of N. gonorrhoeae also declined significantly from 13.2% in 1990 to 3.5% in 1995 and from 1.5% in 1990 to 0.4% in 1995, respectively. None were found to be seropositive for HIV-1 during the 6-year period. The proportion of commercial sex workers using condoms significantly increased during 1992–1993 and 1994–1995 periods, as compared with the 1990–1991 period.
Conclusion: Reductions in the prevalence of major STDs among female commercial sex workers may be related to an increase in the frequency of condom use.     

南京地区高危人群性传播疾病感染情况分析

目的 :了解南京地区高危人群中性传播疾病 (STD)的流行状况。　方法 :对南京市 15 39例高危人群进行体检及淋病奈瑟菌 (GN)、梅毒螺旋体 (SY)、尖锐湿疣 (CA)、沙眼衣原体 (Ct)、溶脲脲原体 (Uu)以及人类免疫缺陷病毒(HIV)抗体实验室检查。　结果 :GN、SY、CA、Ct、Uu的感染率分别为 13.5 %、10 .3%、2 .3%、35 .9%、2 2 .4 % ,发现 0例HIV抗体阳性者。非淋菌性尿道炎是感染率最高的STD。　结论 :加强对高危人群STD的筛查是防治STD传播的重点。     

Risky behaviours among young people living with HIV attending care and treatment clinics in Dar Es Salaam,Tanzania: implications for prevention with a positive approach

Introduction

Prevention with a positive approach has been advocated as one of the main strategies to reduce new instances of HIV infection. Risky sexual behaviours among people living with HIV/AIDS are the cornerstone for this approach. Understanding the extent to which infected individuals practice risky behaviours is fundamental in designing appropriate population-specific interventions. With the HIV infection transmission rates remaining high among young people in sub-Saharan Africa, continued prevention among them remains a priority. This study therefore seeks to describe the magnitude and determinants of risky sexual behaviours among young people living with HIV.

Methods

A cross-sectional study was conducted between June and July 2010 in selected Care and Treatment Clinics (CTCs) in Dar Es Salaam, Tanzania. A total of 282 HIV-positive patients aged 15–24 were interviewed about their sexual behaviours using a questionnaire.

Results

Prevalence of unprotected sex was 40.0% among young males and 37.5% among young females (p<0.001). Multiple sexual partnerships were reported by 10.6% of males and 15.9% of females (p<0.005). More than 50% of the participants did not know about the HIV status of their sexual partners. A large proportion of participants had minimal knowledge of transmission (46.7% males vs. 60.4% females) and prevention (65.3% males vs. 73.4% females) of sexually transmitted infections (STIs). Independent predictors of condom use included non-use of alcohol [adjusted odds ratio (AOR), 0.40 95% confidence interval (CI); 0.17–0.84] and younger age (15–19 years) (AOR, 2.76, 95% CI: 1.05–7.27). Being on antiretroviral therapy (AOR, 0.38, 95% CI: 0.17–0.85) and not knowing partners’ HIV sero-status (AOR, 2.62, 95% CI: 1.14–5.10) predicted the practice of multiple sexual partnership.

Conclusions

Unprotected sex and multiple sexual partnerships were prevalent among young people living with HIV. Less knowledge on STI and lack of HIV disclosure increased the vulnerability and risk for HIV transmission among young people. Specific intervention measures addressing alcohol consumption, risky sexual behaviours, and STI transmission and prevention knowledge should be integrated in the routine HIV/AIDS care and treatment offered to this age group.     

Sexual abuse in adolescents--data from a psychiatric treatment centre for adolescents.

OBJECTIVES: To determine the prevalence of sexual abuse in a large sample of adolescent psychiatric patients and to compare sexually abused patients with non sexually abused patients, the latter category including non-sexual physically abused and non-abused patients. DESIGN: A retrospective analysis of the patient records at the William Slater Centre for Adolescents, University of Cape Town Medical School/Groote Schuur Hospital. SETTING: The William Slater Centre (WSC) is an outpatient psychiatric treatment centre for adolescents with emotional and behavioural problems. SUBJECTS: Nine hundred and thirty-four adolescent and young adult patients referred to the WSC in Cape Town from February 1990 to April 1997. METHODS: The WSC Assessment form, a semi-structured interview schedule, was used to focus on depressive symptoms, suicidal ideation and parasuicide, eating disorders, substance abuse, psychosexual history, sexual abuse and physical abuse, and Diagnostic and Statistical Manual i.v. diagnosis. RESULTS: One-third of all patients admitted to the centre from February 1990 to April 1997 reported some form of sexual abuse. More sexually abused patients than expected received a diagnosis of depression. On average sexually abused patients scored higher on depression rating scales than non sexually abused patients. Logistic regression showed that the presence of suicidal symptoms and alcohol use are to some extent independently associated with sexual abuse. CONCLUSION: The problem of sexual abuse among South African youth is confirmed by this study. The association between sexual abuse and depression, suicidal symptoms and alcohol use is supported. The country's dwindling psychiatric services therefore face an increasingly challenging future.     

Accurate detection of male subclinical genital tract infection via cervical culture and DNA hybridization assay of the female partner

The accuracy of the PACE2 DNA hybridization assay of the cervix and cervical culture in female partners for the diagnosis of male subclinical genital tract infection were assessed in a male infertility population. A total of 184 men were screened for the presence of Chlamydia trachomatis, Ureaplasma urealyticum and Mycoplasma hominis. Seventy-one men were identified with a positive test for one or more of the above mentioned micro-organisms. The overall prevalence of bacterial infection was 39%. Female partners of all men were tested with the PACE2 DNA hybridization assay to detect a C. trachomatis infection. Sensitivity was 100% and specificity was 100%. In 67 female partners (94%) of men who tested positive for U. urealyticum and/or M. hominis, a cervical swab culture was performed. The sensitivity of the cervical swab culture was 100%. In view of the high prevalence of U. urealyticum and M. hominis in the male genital tract and the role these sexually transmitted pathogens may play in infertility, one might question whether all couples should be screened for the presence of these pathogens. Transurethral swab culture after digital prostatic massage is disincentive to men. The cervical culture in their female partner, performed as part of the routine fertility work-up, is a suitable alternative to detect the presence of these micro-organisms in the male genital tract.     

Survey of incidence of urological cancer in South Korea: A 15-year summary

BACKGROUND: Although the pattern of cancer incidence in South Korea is not the same as that of western countries, urological cancer will become one of the major cancers in South Korea in the near future. The pattern of cancer in South Korea is becoming steadily similar to that in western countries. It is, therefore, important to understand the epidemiological features of cancer. Surveillance of cancer incidence and mortality trends provides clues to etiology and helps to assess the effects of improved diagnostic, screening and intervention measures. METHODS: The subjects of the study were 13,208 patients living in South Korea, newly diagnosed with urological cancer during the period of 1985-1999. The data were analyzed by age, sex, geography and period of diagnosis (1985-1989; 1990-1994; 1995-1999). RESULTS: Bladder cancer was the most common urological cancer in South Korea (6,867 cases, 52.0%). The incidence of prostate cancer and renal cell carcinoma was similar. Male patients outnumbered female patients by a ratio of 5.4 : 1. In both sexes, the peak incidence of urological cancer in South Korea was noted in the 70+ age group. The geographic distribution of urological cancer across seven residential areas was similar. The incidence rate of all urological cancer (except urethral and penile cancer) had increased remarkably, especially in the last several years. The crude incidence rate of urological cancer among Koreans in South Korea was estimated to be 46.55 per 100,000 males, 8.64 per 100,000 females and 27.67 per 100,000 across both sexes. CONCLUSION: Although this survey is not definitive, these data should be useful in showing general patterns or changes of incidence of urological cancer in South Korea. The elevated incidence of urological cancer noted in our survey also indicates the need for continued promotion of urological cancer screening programs. Moreover, these results may be useful in indicating directions for future research of urological cancer.     

Sexual and physical abuse among Korean female inpatients with schizophrenia

The study reports the prevalence and correlates of sexual and physical abuse in a sample of 100 female inpatients with schizophrenia in South Korea. Clinical assessment interviews consisted of the Positive and Negative Syndrome Scale, the Scale for the Assessment of Positive Symptoms, an interview assessing history of sexual and repeated physical abuse, and demographic and psychosocial factors. Lifetime prevalence of severe sexual or physical abuse was 52%. Compared with nonabused patients (n = 48), the abused patients (n = 52) showed more nonpsychotic symptoms (i.e., anxiety, depression) and higher levels of distress, but no difference in psychotic symptoms. This study failed to note significant differences in positive symptoms addressed in previous Western studies.     

Chlamydial infection of the urinary tract in children and adolescents with hematuria

Urogenital infection with Chlamydia trachomatis in adults and adolescents is a common sexually transmitted disease. The purpose of this study was to investigate whether isolated microhematuria in children and adolescents is associated with Chlamydia trachomatis infection of the urinary tract. The study group included 37 children and adolescents with isolated nonglomerular microhematuria. Urethral smears for the isolation of Chlamydia trachomatis in cell culture were taken at the time of cystourethroscopy from all patients. Polymerase chain reaction (PCR) for the detection of chlamydial DNA in urine was carried out in 25 of 37 (68%) patients and direct immunofluorescence (DIF) of urine in 16 of 37 (43%) patients. The control group included 33 children and adolescents without hematuria; PCR and DIF of urine were carried out in all controls. Chlamydia trachomatis infection of the urinary tract was confirmed in 8 of 37 (22%) patients in the study group, and in none in the control group (0 of 33, P<0.001). Further studies of larger groups of patients should be conducted, before recommending testing for Chlamydia trachomatis infection of the urinary tract in children and adolescents with unexplained microhematuria. Received: 26 January 2000 / Revised: 26 April 2000 / Accepted: 2 May 2000