Background Chlamydia trachomatis (CT), the most common bacterial STD and asymptomatic in most women, causes significant adverse outcomes in pregnancy but no programmes routinely conduct prenatal screening in Latin America. To prepare for a clinical trial of CT screening and treatment in pregnancy, we determined the feasibility and acceptability of routine chlamydia screening, patient and partner adherence to treatment, and chlamydia prevalence in pregnant women in Lima, Peru.
Methods We conducted a prospective study of pregnant women > 16 years of age at two large urban maternity hospitals in Lima. We offered chlamydia screening to pregnant women during their first prenatal visit using self-collected vaginal swabs with APTIMA Combo 2® Assay (Hologic Gen-Probe, San Diego, CA). CT positive patients were contacted within 14 days of testing and were asked to bring partner(s) for counselling and offered concurrent patient partner treatment (CPPT) with 1 gramme of oral azithromycin. Unaccompanied patients received counselling and treatment in the clinic and expedited partner therapy (EPT) for partners. We performed a test of cure > 3 weeks after treatment.
Results Over 2 months, we approached 646 women for the study and enrolled 603 (93.5%). The average (+/- standard deviation) age was 27.2 + 6.9 years with an average 2.3 + 2.5 lifetime partners and an average gestational age of 26.3 + 10.5 weeks. Chlamydia prevalence was 10.0% + 3.9%. Of 39 CT positive patients contacted so far, 35 (90%) have received treatment. Of those, 46% received CPPT, 49% EPT and 5% had no contactable partners. Treatment and test of cure are ongoing.
Conclusion Chlamydia screening in pregnancy was feasible and highly acceptable in two large urban maternity hospitals in Peru. The prevalence of CT infection was high. Our settings are optimal for a clinical trial of CT screening and treatment to prevent adverse pregnancy outcomes.
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