Prevalence of Chlamydia trachomatis infection in Samoan women aged 18 to 29 and assessment of possible risk factors: a community-based study.
BACKGROUND
Knowledge about genital Chlamydia trachomatis (CT) infections in the Pacific is limited. In this study we investigated CT infection in Samoan women.


METHODS
We recruited women having unprotected sex aged 18 to 29 years from 41 Samoan villages. They completed a questionnaire and provided a urine sample for CT testing by PCR. Associations between CT infection and possible risk factors were explored using logistic regression.


RESULTS
Altogether, 239 women were recruited; 86 (36.0%; weighted estimate of prevalence: 41.9%; 95% CI: 33.4-50.5%) were positive for CT infection. A higher proportion of women aged 18 to 24 were positive (54/145; 37.2%) than those aged 25 to 29 (32/94; 34.0%; p=0.20). Being single (OR 1.92; 95% CI: 1.02-3.63) and having two or more lifetime sexual partners (OR 3.02; 95% CI: 1.19-7.67) were associated with CT infection; 27.6% of those with one lifetime partner were positive. Participants who had a previous pregnancy were less likely to be positive (OR 0.49; 95% CI: 0.27-0.87). Primiparous and multiparous women were less likely to be positive than nulliparous women (OR 0.54; 95% CI: 0.30-0.99 and OR 0.46; 95% CI: 0.24-0.89, respectively).


CONCLUSIONS
The prevalence of CT infection in these Samoan women is very high. Further studies, including investigating the prevalence of CT infection in men, and strategies for sustainable control are needed.
Centre for International Health, University of Otago, Dunedin, New Zealand.
Michael S
MS
Walsh
Faculty of Applied Science, National University of Samoa, Samoa.
Eseta
E
Hope
Laboratory Division, National Health Service, Samoa.
Lupeoletalalelei
L
Isaia
Centre for International Health, University of Otago, Dunedin, New Zealand.
Antoinette
A
Righarts
Laboratory Division, National Health Service, Samoa.
Tavita
T
Niupulusu
Centre for Samoan Studies, National University of Samoa, Samoa.
Seiuli V A
SV
Temese
Samoa Family Health Association, Samoa.
Liai
L
Iosefa-Siitia
Faculty of Applied Science, National University of Samoa, Samoa.
Leveti
L
Auvaa
Samoa AIDS Foundation, Samoa.
Siuomatautu A
SA
Tapelu
Samoa National Council of Churches, Samoa.
Maauga F
MF
Motu
Centre for International Health, University of Otago, Dunedin, New Zealand.
Ciaran
C
Edwards
Centre for International Health, University of Otago, Dunedin, New Zealand.
Maya
M
Wernick
Queensland University of Technology, Australia.
Willa M
WM
Huston
Victoria University of Wellington, New Zealand.
Tamasailau
T
Suaalii-Sauni
Centre for International Health, University of Otago, Dunedin, New Zealand Philip.hill@otago.ac.nz.
Philip C
PC
Hill
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D017963:Azithromycin / Q000008:administration & dosage*; D002690:Chlamydia Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000652:urine; D002692:Chlamydia trachomatis / Q000302:isolation & purification*; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D006266:Health Education / Q000458:organization & administration*; D006801:Humans; D008403:Mass Screening / Q000458:organization & administration*; D015995:Prevalence; D060728:Reproductive Health / Q000193:education; D012307:Risk Factors; D018947:Samoa / Q000453:epidemiology; D012725:Sexual Behavior / Q000523:psychology; D012747:Sexual Partners; D011795:Surveys and Questionnaires; D047568:Unsafe Sex
D000900:Anti-Bacterial Agents; D017963:Azithromycin
Chlamydia trachomatis; Genital; Prevalence; Risk factors