Article Text

Download PDFPDF
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}


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.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • 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.