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Prevalence and risk factors of chlamydia and gonorrhea among rural Nepali women
  1. P Christian1,
  2. S K Khatry2,
  3. S C LeClerq1,
  4. A A Roess1,
  5. L Wu1,
  6. J D Yuenger3,
  7. J M Zenilman3
  1. 1Department of International Health, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, MD, USA
  2. 2Society for Prevention of Blindness, Tripureswor, Kathmandu, Nepal
  3. 3Infectious Diseases Division, School of Medicine, The Johns Hopkins University, Baltimore, MD, USA
  1. Correspondence to:
 Parul Christian
 Department of International Health, The Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Room W2041, Baltimore, MD 21205, USA;


Objectives: The epidemiology of sexually transmitted infections (STI) in rural, developing world populations is poorly understood. We estimated the prevalence and risk factors of Neisseria gonorrhoeae and Chlamydiatrachomatis in a female population in rural Nepal.

Methods: We conducted a cross sectional study in a sample of 1177 postpartum women participating in a micronutrient supplementation trial in Nepal. Urine samples were collected to test for the two infections using the ligase chain reaction (LCR).

Results:C trachomatis was detected in 1.0% (95% confidence intervals (CI): 0.4 to 1.5) and N gonorrhoeae in 2.3% (95% CI: 1.2 to 3.4) of women. None of the women tested positive for both. Self report of all three symptoms of lower abdominal pain, pain and burning on urination, and vaginal discharge was associated with the presence of gonorrhoea (odds ratio (OR): 12.1, 95% CI: 1.3 to 115.0). Neonatal eye discharge was associated with maternal gonococcal infection (OR = 5.2, 95% CI: 1.1 to 24.9). Incidence of low birth weight was not related to these maternal infections, but very preterm delivery (<32 weeks) was higher among women positive for gonorrhoea (OR = 4.7, 95% CI: 1.0 to 22.0). In a multivariable analysis, low body mass index (<18.5) and cattle ownership were associated with gonorrhoea (p <0.05), whereas woman’s literacy was associated with chlamydia (p = 0.06).

Conclusion: We found the rates of N gonorrhoeae and C trachomatis to be low among women in this rural population of Nepal.

  • LCR, ligase chain reaction
  • STI, sexually transmitted infections
  • chlamydia
  • gonorrhoea
  • Nepal

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  • There are no competing interests to declare.