Objectives: To estimate the prevalence of urogenital infection with Chlamydia trachomatis and Neisseria gonorrhoeae in persons 18 to 35 years of age in Barbados, and to examine factors associated with infection.
Methods: Cross-sectional survey of randomly selected persons from the voters' register of one electoral district, with the collection of urine samples for testing by polymerase chain reaction.
Results: The response rate was 82%, with 408 persons (195 males and 213 females) having questionnaires completed and urine collected. 397 urine samples were satisfactorily tested. Prevalence of C. trachomatis (CT) and N. gonorrhoeae (NG) urogenital infection was 11.3% (95% confidence interval [CI] +2.9), and 1.8% (95%CI +1.2) respectively, 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 CT and/or NG decreased with increasing age (per year odds ratio [OR] 0.89, 95%CI 0.84-0.96, p=0.001), and decreasing time (<6 months vs. >6months) since last medical consultation (OR 0.44, 95%CI 0.22-0.88, p=0.02). Most (76%) infected persons were asymptomatic. Condom use at last intercourse with a partner not being lived with was (reported by 52%) was not protective (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 persons had ever heard of chlamydia, while 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 persons are aware of this, and screening is introduced.