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Risk behaviour, healthcare access and prevalence of infection with Chlamydia trachomatis and Neisseria gonorrhoeae in a population-based sample of adults in Barbados
  1. O P Adams1,
  2. A O Carter2,
  3. P Prussia1,
  4. G McIntyre1,
  5. S L Branch3
  1. 1
    School of Clinical Medicine and Research, The University of the West Indies, Cave Hill, Barbados
  2. 2
    Department of Community Health and Epidemiology, Queen’s University, Kingston, Ontario, Canada
  3. 3
    Ladymeade Reference Unit, Ministry of Health, Barbados
  1. P Adams, Lecturer in Family Medicine, School of Clinical Medicine and Research, The University of the West Indies, Queen Elizabeth Hospital, Martindales road, Barbados; padams{at}uwichill.edu.bb

Abstract

Objectives: To estimate the prevalence of urogenital infection with Chlamydia trachomatis and Neisseria gonorrhoeae in people 18 to 35 years of age in Barbados, and to examine factors associated with infection.

Methods: Cross-sectional survey of randomly selected people from the voters’ register of one electoral district and the collection of urine samples for testing by PCR.

Results: The response rate was 82%; 408 people (195 males and 213 females) completed a questionnaire and had their urine collected. 397 urine samples were satisfactorily tested. Prevalence of C trachomatis urogenital infection was 11.3% (95% CI ±2.9) and N gonorrhoeae 1.8% (95% CI ±1.2) with 12.6% (95% CI ±3.1) having either or both infections. The difference in prevalence by gender was not significant. Multivariate logistic regression showed that prevalence of C trachomatis and/or N gonorrhoeae decreased with increasing age (per year OR 0.89, 95% CI 0.84 to 0.96, p = 0.001), and decreasing time (⩽6 months vs >6 months) since last medical consultation (OR 0.44, 95% CI 0.22 to 0.88, p = 0.02). Most (76%) infected people were asymptomatic. Condom use at last intercourse with a partner not being lived with was not protective (reported by 52%, p = 0.617). The usual source of health care was evenly distributed between the public and private sectors and was not associated with infection. Only 30% of people had ever heard of chlamydia, whereas 92% were aware of gonorrhoea.

Conclusions: Asymptomatic infection with C trachomatis is an important reservoir of infection, which will remain undetected unless physicians and young people are made aware of this and screening is introduced.

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Footnotes

  • Contributors: Conception and design: OPA, PP, GM; acquisition of data: OPA, SLB; analysis and interpretation of data: OPA, AOC; drafting the article: OPA, AOC; revising the article critically: OPA, AOC, PP, GM; final approval: OPA, AOC, PP, GM, SLB.

  • Funding: This research was funded by a Caribbean Health Research Council grant. Roche Diagnostics provided some of the test kits and Pfizer additional funding.

  • Competing interests: None.

  • Ethics approval: Ethics approval was obtained from the Ministry of Health.

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