Sexually transmitted diseases are major epidemiological barrier to achieving standard “health for all”. This category of diseases affects both the developing and developed worlds though with different forms of diseases and epidemiology. Several strategies have been instituted to control the disorder in terms of prevalence and incidence however, prevention still remain the key. Chlamydia infection, a sexually transmitted infection caused bacteria known as chlamydia trachomatis is a major STI affecting a considerable population of both developing and developed worlds. This infection affects majorly human genital organs and the eye.
The infection is usually transmitted by sexual activities such as vaginal, anal or oral sex. It has also been found to be transmitted from the mother to the child during childbirth. The major concern as regards to Chlamydia infection is the resultant infertility found to be associated with the untreated cases. Sexually active individuals are at greater risk of contacting the infection.
The greater number of partners an individual has increased the chances of being infected. The infection tends to occur in a symptomless state making those that are actually infected not to be aware that they are really infected. This makes the condition a dangerous sexual transmitted infection hence with various complications especially infertility. The conjunctivitis caused by Chlamydia is also a major cause of blindness worldwide. Antibiotics are available for cure however the control of the infection seem to be the major global health issues.
Epidemiology
The genital form of chlamydia infection is now found to be the most common and frequently reported STI in Europe (ECDC, 2009). The available data by the EU shows the number of confirmed cases to be 253 386 with overall rate of 122.6 per 100,000 population (ECDC, 2009). The report also shows the infection to affect more women between the ages of 15-24 years when compared to other age group and sex. The trachoma which is mainly caused by the chlamydia trachomatis was found to affects approximately 500 million people in developing countries as at 2004 (Numazaki, 2004).
A report by CDC from the United States shows 1,307, 893 chlamydial infections and most of those patients are aware of being infected (CDC fact sheet, 2010). 1 in 4 men with the infection has been found to have no symptoms that could indicate the presence of the infection (PubMed health, 2012). Findings also reported an estimated 2.8 million infections occurring annually in the U.S (CDC, 2012). Researchers have also found women to be more prone to reinfection because of their infected partners that has remain untreated.
Signs and symptoms
Chlamydia infections affect different body systems or organs. The major ones are the; Genital disease, eye disease, perinatal infections, and rheumatological conditions. The genital and eye disease are the most common of the disease caused by the bacteria. Cervicitis is the commonest of the genital disease caused by the bacteria in women. Commonly asymptomatic hence leading to pelvic inflammatory disease which now shows different signs and symptoms such as pelvic pain. The chlamydia infection is usually considered as "silent epidemic" simply because of the highlighted course of infection. In men, the most important infection caused is Urethritis which is associated with painful or burning sensation in the group of patient that has symptoms. Fever, penile discharge, swollen testicles are the common symptoms. The nature of the discharge is a pointer that could help in diagnosis. This discharge is usually purulent, lighter in color with less viscosity when compared to the discharge in patients with gonorrhea. Complications are epididymitis and prostatitis in men.
Conjunctivitis or trachoma is caused by chlamydia in cases of eye infection and this is a major cause of blindness globally. Infants or newborn contact it from mother while adults by infected fingers to eye, and sharing of cloths such as towel. In cases of rheumatological conditions caused by chlamydia, the most common is reactive arthritis which is characterized by triad of symptoms such as conjunctivitis, urethritis and arthritis (Avert.org, 2012). The perinatal infections caused by the bacteria could lead to complications such as spontaneous abortion or premature birth. The affected newborn could show signs of conjunctivitis which could later lead to blindness.
Treatment
The managing health care practitioner may prescribe antibiotics. This is a simple and effective treatment especially once a definitive diagnosis has been made. The single dose antibiotics are of short course duration which within five days taken normally provides 95 percent cure rate. The usual single dose antibiotics are tetracycline, azithromycin or erythromycin. In managing patients with chlamydia infections, such patients must be screened for other infections such as gonorrhea or syphilis or other forms of sexually transmitted diseases simply because the infection increase the risk of other STIs. Sexual partners must also be treated so as to prevent reinfection after treatment for the treated partner. An important aspect of the management is the follow-up evaluation which must be done a month after to ensure the effectiveness of the treatment.
Prognosis is usually very good once you are sure of effective use of the antibiotics and if the therapy was instituted early. This helps prevent long term complications that have been found to be associated with the infection.
Outlook for cure and control
Researchers are conducting different researches and tests to achieve a control program that could help lead to serious decline in the incidence of chlamydial infections. Control programs focusing on early diagnosis, targeted screening and effective treatment have been considered essential for the goal of global decline in infection rate to be achieved. Entirely new approaches to preventive measures and treatment protocols (which include vaccine strategy and antimicrobial interventions) have also been suggested because of the importance in helping to decrease the rate of infection.
In search for control, Chlamydia Rapid Test is being worked on to improve the detection of the genital chlamydia. The cost effectiveness of the procedure is being evaluated to know the merits of the test (Hislop et al, 2010). An adoption of national chlamydia control strategy has been suggested by European center for disease prevention and control as one of the step required to achieve a national control of chlamydia infection (ECDC, 2009). This control program is made up of different levels which include; primary prevention, case management, opportunistic testing and screening program. Each level has three components which include; essential activities, essential policies and evaluation. This program can be instituted globally to achieve a better cure and control of chlamydial infections.
References
Avert.org, 2012. Chlamydia: Symptoms, Signs, Treatment & Testing. Averting HIV and AIDS.
Retrieved 4 April, 2012 from http://www.avert.org/chlamydia.htm
CDC, 2010. Chlamydia-CDC Fact Sheet. Sexually transmitted Diseases (STDs).
Retrieved 4 April, 2012 from http://www.cdc.gov/std/chlamydia/stdfact-chlamydia.htm
ECDC, 2009. Chlamydia control in Europe. ECDC GUIDANCE.
Retrieved 4 April, 2012 from http://www.ecdc.europa.eu/en/publications/Publications/0906_GUI_Chlamydia_Control_in_Europe.pdf
Hislop et al, 2010. Systematic review of the clinical effectiveness and cost-effectiveness of rapid point-of-care tests for the detection of genital chlamydia infection in women and men. PubMed.
Retrieved 4 April, 2012 from http://www.ncbi.nlm.nih.gov/pubmed/20557810
NHS, 2012. Treating Chlamydia. Choices.
Retrieved 4 April, 2012 from http://www.nhs.uk/Conditions/Chlamydia/Pages/Treatment.aspx
Numazaki, 2004. Current problems of perinatal chlamydia trachomatis infections. Biomed central.
Retrieved 4 April, 2012 from http://www.biomedcentral.com/1476-8518/content/2/1/4
PubMed Health, 2010. Chlamydia. Diseases and Conditions.
Retrieved 4 April, 2012 from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002321/
