Risk factors for Chlamydia trachomatis genital infection in adolescent
Department of Pediatric and Adolescent Gynecology, Family Planning Centre,
Mother and Child Health Care Institute of Serbia, Belgrade
Introduction: Chlamydia trachomatis genital infections (CTIs) are the
commonest bacterial sexually transmitted diseases (STDs) having the highest
age-specific rates in adolescent females. Unfortunately, CTIs are, particularly
in women, mostly difficult to diagnose due to producing few or no symptoms. In
the settings without resources directed toward the whole sexually active
adolescent females population screening, it could be beneficial to single out
those adolescents which are in the high-risk of CTI acquisition.
Objective: The purpose of this study was to estimate the significance
of sexual behaviour indicators and clinical features in predicting CTI in
Design & Methods: The study group was consisted of 300 sexually
active 19 years old girls who had attended the Youth Reproductive Health Service
in The Mother and Child Health Care Institute of Serbia in the period from 1995
to 1997. The participants of this study were interviewed about their health and
sexual behaviours. Gynaecological assessment included microbiological and
colposcopic findings. The cervical CTI was identified by the direct
immunofluorescence staining of smears by application of monoclonal antibodies.
Colposcopic findings were divided in two groups: cervical ectopy and other
findings. Data were statistically analysed by step-wise linear regression, by
Results: The prevalence of CTI in the study group was 30.3%.
Predictors of CTI in adolescent women, according to the stepwise linear
regression analysis, were the following: the presence of cervical ectopy (R2
0.2032), negative attitudes of adolescent girl and her partner toward the condom
use (R2 0.0104 and 0.0256), associated genital infections (R2
0.0122), high coital frequency (R2 0.0066), the sexual experience in
casual relations (R2 0.0064), and the first sexual partner two or
more years older (R2 0.0058). However, the predictive value of these
variables in identifying the adolescent women in higher risk for CTI is limited
(R2 0.2701). The other variables that slightly and insignificantly
increase the likelihood of CTIs were the following: first sexual intercourse
before 17 years of age, three or more sexual partners in sexual history, sexual
experience in casual relations, low level of safe sexual practice, poor
contraceptive behaviour, poor health behaviour, STD symptoms as the reason for
the first gynaecologic examination, and one or more unwanted pregnancies in
Conclusion: This investigation indicates that no risk factors are
reliable predictors of CTI in the majority of infected adolescent girls.
Therefore, screening for the presence of CTI should be conducted in the whole
population of sexually active adolescent females.