title: High rates of Chlamydia trachomatis infections in young Papua New Guinean infants.
abstract: OBJECTIVE
  Determine the importance of Chlamydia trachomatis in the etiology of severe infection in young Papua New Guinean infants.
  
  
  METHODS
  Between March, 1991, and April, 1993, children <3 months old were recruited as outpatients at Goroka Base Hospital, Papua New Guinea, as part of a multicenter study in four developing countries. Children with predefined inclusion criteria were enrolled. C. trachomatis was identified by direct fluorescent antibody staining in nasopharyngeal aspirates (NPAs) collected from children with and without signs of severe disease and eye swabs from children with and without conjunctivitis. Two to three radiologists read chest radiographs without knowledge of clinical and laboratory findings.
  
  
  RESULTS
  Of 3280 outpatients seen 2168 enrolled, 955 NPAs were tested for C. trachomatis and 549 chest radiographs were read. Of 210 eye swabs from children with conjunctivitis 57% were positive for C. trachomatis compared with 8% from 167 children with no conjunctivitis. The prevalence of C. trachomatis in NPAs was 9% in asymptomatic children and 18 and 33% in children with nonsevere or severe pneumonia, respectively. C. trachomatis in NPAs was strongly associated with clinically severe pneumonia [odds ratio (OR), 2.91], reduced arterial oxygen saturation (OR 2.58) and radiographic evidence of pneumonia (OR 5.84) and was also associated with pneumococcal bacteremia (OR 3.48).
  
  
  CONCLUSIONS
  In Papua New Guinea Chlamydia must be considered as a cause when treating pneumonia in infants, and effective treatment and prevention of sexually transmitted diseases are urgently needed for a number of reasons, including the need to curb high rates of chlamydial infection in women and infants.
authors.affiliation: Papua New Guinea Institute of Medical Research, Goroka, Eastern Highlands Province.
authors.forename: D
authors.initials: D
authors.lastname: Lehmann
authors.forename: R C
authors.initials: RC
authors.lastname: Sanders
authors.forename: B
authors.initials: B
authors.lastname: Marjen
authors.forename: A
authors.initials: A
authors.lastname: Rongap
authors.forename: H
authors.initials: H
authors.lastname: Tschäppeler
authors.forename: A C
authors.initials: AC
authors.lastname: Lamont
authors.forename: G M
authors.initials: GM
authors.lastname: Hendry
authors.forename: P
authors.initials: P
authors.lastname: Wai'in
authors.forename: G
authors.initials: G
authors.lastname: Saleu
authors.forename: P
authors.initials: P
authors.lastname: Namuigi
authors.forename: M
authors.initials: M
authors.lastname: Kakazo
authors.forename: S
authors.initials: S
authors.lastname: Lupiwa
authors.forename: D J
authors.initials: DJ
authors.lastname: Lewis
authors.forename: M P
authors.initials: MP
authors.lastname: Alpers
mesh_terms: D002690:Chlamydia Infections / Q000175:diagnosis* / Q000453:epidemiology*; D002692:Chlamydia trachomatis / Q000302:isolation & purification*; D003234:Conjunctivitis, Bacterial / Q000175:diagnosis / Q000453:epidemiology*; D003906:Developing Countries; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010219:Papua New Guinea / Q000453:epidemiology; D018410:Pneumonia, Bacterial / Q000175:diagnosis / Q000453:epidemiology*