Introduction Knowledge about genital Chlamydia trachomatis (CT) infection in the Pacific is limited to studies of antenatal women. We approached studying CT infection in Samoan women by using a maternal and family health focus, investigating both CT and infertility amongst women exposed to pregnancy risk.
Methods Women having unprotected intercourse aged 18–29 years were recruited from 41 Samoan villages. They were answered a behavioural questionnaire and provided a urine sample for CT testing by nucleic acid amplification. Associations between CT infection and possible risk factors were explored using logistic regression.
Results 239 women were recruited; 86 (36.0%; weighted estimate: 41.9%; 95% CI: 33.4–50.5%) were positive for CT infection. Being single (OR 1.92; 95% CI, 1.02–3.63) and having two or more lifetime sexual partners (OR 3.02; 95% CI, 1.19–7.67) were both associated with CT infection. However, a very high prevalence was still seen in those reporting only one lifetime partner (27.6%). Participants who had a previous pregnancy were less likely to be positive (OR 0.49; 95% CI, 0.27–0.87). Although a slightly higher proportion of women aged 18–24 were positive than those aged 25–29, age was not significantly associated with infection.
Conclusion Whilst this sample may be considered high risk, use of barrier protection in Samoa has previously been found to be extremely uncommon and women had reported relatively few partners within the current study. Therefore, this study confirms findings from World Health Organization antenatal surveys: the prevalence of CT infection in Samoan women is likely to be very high. Studies with further assessment of the impact of CT on pelvic inflammatory disease and infertility, studies including men and strategies for sustainable control are needed.
Disclosure of interest statement This study was funded by The New Zealand Aid Programme and The University of Otago. The Secretariat of the Pacific Community provided the Chlamydia test kits for free. No pharmaceutical grants were received in the development of this study.
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