Risk factors for Chlamydia trachomatis genital infection in adolescent females

Risk factors for Chlamydia trachomatis genital infection in adolescent


K. Sedlecki

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

adolescent females.

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

SAS application.

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

reproductive history.

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.

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