Prevalence estimates of genital Chlamydia trachomatis infection in Belgium: results from two cross-sectional studies
Abstract Background Chlamydia trachomatis (chlamydia) is the most diagnosed sexually transmitted infection in Belgium. Screening programs focus on young women, due to the implications of chronic asymptomatic infections for reproductive health. Thereby, the frequency of infections in men and older ad...
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doaj-fd4fa9fab5d54a80b18a1413223cc6b82021-09-19T11:59:39ZengBMCBMC Infectious Diseases1471-23342021-09-0121111310.1186/s12879-021-06646-yPrevalence estimates of genital Chlamydia trachomatis infection in Belgium: results from two cross-sectional studiesNatalie Fischer0Ilse Peeters1Sofieke Klamer2Marion Montourcy3Vicky Cuylaerts4Dominique Van Beckhoven5Irith De Baetselier6Johan Van der Heyden7Wim Vanden Berghe8Service Epidemiology of Infectious Diseases, SciensanoService Epidemiology of Infectious Diseases, SciensanoService Epidemiology of Infectious Diseases, SciensanoService Epidemiology of Infectious Diseases, SciensanoDepartment of Clinical Sciences, National Reference Centre for Sexually Transmitted Infections, Clinical Reference Laboratory, Institute of Tropical MedicineService Epidemiology of Infectious Diseases, SciensanoDepartment of Clinical Sciences, National Reference Centre for Sexually Transmitted Infections, Clinical Reference Laboratory, Institute of Tropical MedicineService Lifestyle and Chronic Diseases, SciensanoService Epidemiology of Infectious Diseases, SciensanoAbstract Background Chlamydia trachomatis (chlamydia) is the most diagnosed sexually transmitted infection in Belgium. Screening programs focus on young women, due to the implications of chronic asymptomatic infections for reproductive health. Thereby, the frequency of infections in men and older adults is underestimated. This study aimed to estimate the point-prevalence of chlamydia in the broader Belgian population, to inform evidence-based prevention and control strategies. Methods We conducted two cross-sectional prevalence studies of chlamydia infection in the population of Belgium aged 16–59 years, 2018–2020. In the CT1 study 12,000 representative individuals were randomly selected from the national register and invited by letter to collect a urine sample at home. The CT2 study used urine samples collected through the Belgian Health Examination Survey. Molecular detection of chlamydia DNA was performed using Xpert® or Abbott Real-Time CT/NG assays. Weighted estimated prevalence and 95% confidence interval (CI) was calculated per gender and age groups of 16/18–29, 30–44 and 45–59 years, relative to the general Belgian population. Data collected on sociodemographic variables and sexual behavior were used to identify potential risk factors for chlamydia infection through calculation of the odds ratio (OR). Results The population-wide weighted estimated prevalence was 1.54% (95% CI 0.78–3) in CT1 and 1.76% (95% CI 0.63–4) in CT2. We observed no statistically significant difference between men and women or age groups. Civil relationship status (OR = 14.1 (95% CI 1.78–112), p < 0.01), sexual intercourse with a casual partner (OR = 6.31 (95% CI 1.66–24.1), p < 0.01) and > 3 sexual partners in the last 12 months (OR = 4.53 (95% CI 1.10–18.6), p = 0.02) were associated with higher relative risk for chlamydia infection. Conclusion Nationwide prevalence studies are relevant to assess the distribution of chlamydia and inform public health actions. The overall low prevalence and heterogeneous distribution of chlamydia in the general Belgian population needs to be considered for future strategies and potential harm of testing and treating asymptomatic individuals need to be taken into account. Effective case management should include appropriate treatment of symptomatic patients and partner notification, and prevention strategies should encourage behaviors such as condom use.https://doi.org/10.1186/s12879-021-06646-yChlamydia trachomatisPrevalenceCross-sectional studyBelgiumSexually transmitted infections |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Natalie Fischer Ilse Peeters Sofieke Klamer Marion Montourcy Vicky Cuylaerts Dominique Van Beckhoven Irith De Baetselier Johan Van der Heyden Wim Vanden Berghe |
spellingShingle |
Natalie Fischer Ilse Peeters Sofieke Klamer Marion Montourcy Vicky Cuylaerts Dominique Van Beckhoven Irith De Baetselier Johan Van der Heyden Wim Vanden Berghe Prevalence estimates of genital Chlamydia trachomatis infection in Belgium: results from two cross-sectional studies BMC Infectious Diseases Chlamydia trachomatis Prevalence Cross-sectional study Belgium Sexually transmitted infections |
author_facet |
Natalie Fischer Ilse Peeters Sofieke Klamer Marion Montourcy Vicky Cuylaerts Dominique Van Beckhoven Irith De Baetselier Johan Van der Heyden Wim Vanden Berghe |
author_sort |
Natalie Fischer |
title |
Prevalence estimates of genital Chlamydia trachomatis infection in Belgium: results from two cross-sectional studies |
title_short |
Prevalence estimates of genital Chlamydia trachomatis infection in Belgium: results from two cross-sectional studies |
title_full |
Prevalence estimates of genital Chlamydia trachomatis infection in Belgium: results from two cross-sectional studies |
title_fullStr |
Prevalence estimates of genital Chlamydia trachomatis infection in Belgium: results from two cross-sectional studies |
title_full_unstemmed |
Prevalence estimates of genital Chlamydia trachomatis infection in Belgium: results from two cross-sectional studies |
title_sort |
prevalence estimates of genital chlamydia trachomatis infection in belgium: results from two cross-sectional studies |
publisher |
BMC |
series |
BMC Infectious Diseases |
issn |
1471-2334 |
publishDate |
2021-09-01 |
description |
Abstract Background Chlamydia trachomatis (chlamydia) is the most diagnosed sexually transmitted infection in Belgium. Screening programs focus on young women, due to the implications of chronic asymptomatic infections for reproductive health. Thereby, the frequency of infections in men and older adults is underestimated. This study aimed to estimate the point-prevalence of chlamydia in the broader Belgian population, to inform evidence-based prevention and control strategies. Methods We conducted two cross-sectional prevalence studies of chlamydia infection in the population of Belgium aged 16–59 years, 2018–2020. In the CT1 study 12,000 representative individuals were randomly selected from the national register and invited by letter to collect a urine sample at home. The CT2 study used urine samples collected through the Belgian Health Examination Survey. Molecular detection of chlamydia DNA was performed using Xpert® or Abbott Real-Time CT/NG assays. Weighted estimated prevalence and 95% confidence interval (CI) was calculated per gender and age groups of 16/18–29, 30–44 and 45–59 years, relative to the general Belgian population. Data collected on sociodemographic variables and sexual behavior were used to identify potential risk factors for chlamydia infection through calculation of the odds ratio (OR). Results The population-wide weighted estimated prevalence was 1.54% (95% CI 0.78–3) in CT1 and 1.76% (95% CI 0.63–4) in CT2. We observed no statistically significant difference between men and women or age groups. Civil relationship status (OR = 14.1 (95% CI 1.78–112), p < 0.01), sexual intercourse with a casual partner (OR = 6.31 (95% CI 1.66–24.1), p < 0.01) and > 3 sexual partners in the last 12 months (OR = 4.53 (95% CI 1.10–18.6), p = 0.02) were associated with higher relative risk for chlamydia infection. Conclusion Nationwide prevalence studies are relevant to assess the distribution of chlamydia and inform public health actions. The overall low prevalence and heterogeneous distribution of chlamydia in the general Belgian population needs to be considered for future strategies and potential harm of testing and treating asymptomatic individuals need to be taken into account. Effective case management should include appropriate treatment of symptomatic patients and partner notification, and prevention strategies should encourage behaviors such as condom use. |
topic |
Chlamydia trachomatis Prevalence Cross-sectional study Belgium Sexually transmitted infections |
url |
https://doi.org/10.1186/s12879-021-06646-y |
work_keys_str_mv |
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