Prevalence of Chlamydia Among Pregnant Adolescents in La Romana, Dominican Republic

Pilar Bancalari

Name: Pilar Bancalari
School: Mailman School of Public Health, Class of 2021
Mentor: Silvia Cunto-Amesty, MD, MPH, MSEd

 

 

 

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Abstract

The global prevalence of chlamydia among 15-49-year-old women is 3.8%, with pregnant adolescents being at particularly high risk of infection and subsequent complications. Sexually transmitted infection (STI) surveillance data is urgently needed to inform public health efforts in early detection and treatment, both of which are key to reducing HIV/STI morbidity. This study seeks to estimate the prevalence and explore predictors of oral, genital and anorectal chlamydia infection among a sample of pregnant adolescents, given their high risk for STIs and associated sequelae. 200 pregnant adolescents 15-24 years old were recruited by systematic random sampling during their first prenatal visit from a maternal care unit in La Romana, Dominican Republic. A sociodemographic and behavioral questionnaire was administered and blood, urine, and oral/anal swabs were collected and tested for chlamydia (CT). Descriptive analyses were performed and associations assessed between outcomes (anorectal chlamydia infection) and predictors (demographic characteristics and risk behaviors). The prevalence of oral, genital and anorectal chlamydia was 5.7%, 15.1%, and 23.3%, respectively. Of the examined variables, anorectal chlamydia was associated with income. The high prevalence of anorectal chlamydia in this sample of pregnant adolescents suggests that anal intercourse is common. Untreated anorectal chlamydia can lead to proctitis, reinfection and ongoing transmission. More research is needed to understand sexual behaviors and anal STI risk factors among heterosexual adolescent women. Given the high prevalence of anorectal chlamydia, STI screening protocol for pregnant and sexually active adolescents in La Romana should include testing of all three sites.