Introital swab testing for Chlamydia trachomatis in a resource-poor setting: an Indian perspective.
OBJECTIVE
Chlamydia trachomatis (CT) is implicated both in tubal infertility and in cervical dysplasia. Early detection of this infection is uncommon due to its asymptomatic nature and to lack of adequate health care facilities, leading to irreversible sequelae. This study evaluates the use of an introital specimen from women attending the Institute's infertility clinic to detect CT by polymerase chain reaction (PCR) and to correlate it with intraepithelial changes (IEC) of the cervix by Pap smears.


METHODS
Introital and endocervical swab specimens were taken from 100 infertile women for PCR. An endocervical smear was taken for Pap staining.


RESULTS
The CT infection rate was 34%. Sensitivity of introital and endocervical specimens for detection of CT was 82.4% and 85.3%, respectively (P > 0.05); both had 100% specificity. Sixty-seven percent of infected women were less than 30 years of age and only 15% of these reported discharge. Vaginitis/cervicitis was observed in 35% of the positive cases. IEC suggesting inflammation was seen in 74% of the infected women, as compared to 48% of subjects with normal cytology (p = 0.016). Being noninvasive, self collection of an introital specimen can be advocated in large-scale settings in our country for detection of CT in order to contain the infection and its complications.
Gokral
Jyotsna S
JS
National Institute for Research in Reproductive Health, Indian Council of Medical Research, Parel, Mumbai, India.
Mania-Pramanik
Jayanti
J
Meherji
Pervin K
PK
Mali
Bapurao N
BN
D000328:Adult; D001431:Bacteriological Techniques / Q000706:statistics & numerical data; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000453:epidemiology* / Q000382:microbiology; D002692:Chlamydia trachomatis / Q000302:isolation & purification*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D007247:Infertility, Female / Q000517:prevention & control; D065006:Papanicolaou Test; D016133:Polymerase Chain Reaction / Q000379:methods; D011203:Poverty; D011322:Primary Prevention / Q000706:statistics & numerical data; D012307:Risk Factors; D019035:Rural Health Services / Q000706:statistics & numerical data; D014626:Vaginal Smears / Q000379:methods*; D016387:Women's Health