CHLAMMYDIA

Chlamydia infection is a sexually transmitted infection caused by the

bacterium, Chlamydia Trachomatis. It is the most common STI with
prevalence is highest in young adults age group.

Mode of transmission:
1. Unprotected sex – vaginal, anal, oral
2. Mother to infant during child birth
3. Direct contact – vagina to eye

Epidemiology:
Globally, as of 2015, sexually transmitted Chlamydia affects approximately 61
million people. It is more common in women (3.8%) than men (2.5%). In 2015
it resulted in about 200 deaths.

Incubation period:
7 – 21 days
 Pathophysiology of Chlamydia
- Must live inside host cell to reproduce

• Chlamydia enters the body

• Elementary body was ingested by WBC by

phagocytosis

• Become a reticulate body and its replicate

• Infect another cell

• Cell will burst and die

 Clinical manifestation:
Female Male

Asymptomatic (60-70%) Asymptomatic (50-60%)

Mucopurulent discharge (30-40%) Urethral discharge

Hypertrophic ectopy (oedematous, Post gonococcal urethritis (dual

congested cervix, bleeds easily + infections)
postcoital bleeds 20%)

Lower abdominal pain Signs of epididymitis and prostatitis

Dysuria, dyspareuria Dysuria

Signs & Symptoms of PID - infertility Rectal & pharyngeal symtoms in MSM

• Conjunctivitis & trachoma

• Ano-rectal discomfort
• Arthralgia
•Reiter’s syndrome (cant see, cant pee, cant climb a tree)
 Investigations:

Swab sample
Male: urethral smear or first void urine

Female: endocervical smear or first void urine

 PCR – Nucleic Acid Amplification Test (NAAT) – fast, sensitive and specific

 Gram stain to visualize chlamydia – but it hard too see

 Culture & sensitivity – too long 5 days

Treatment:
1. For Uncomplicated urethral, rectal or endocervical infection:
- Doxycycline 100mg BD PO for 7 days or
- Azithromycin 1g single dose PO

Alternative
- Ofloxacin 300mg BD PO for 7 days or
- Erythromycin 500mg QID PO for 7 days

Chlamydial Infections among infants:

- Prenatal screening

Contact Tracing
- Medication should be given to the partner.
Prevention:
Primary Prevention:
• Behavioral changes that reduce the risk of acquiring or transmitting infection
should be promoted (e.g., delaying age at first intercourse, decreasing the number
of sex partners, partner selection, and the use of condoms).
• Early treatment of infected person before they infect their partners or their babies
(must be completed).

Secondary Prevention Strategies

• To prevent complications ; Salpingitis and its potential sequelae (i.e., ectopic
pregnancy, tubal infertility, and chronic pelvic pain) by
a) Screening
b) Complete treatment, individual and partner/s

Target Population
• All sexually active adolescents and young adults.

Community-Based Strategies
• Public Awareness. Sex education/ programs in schools? What about Out- of –
School Adolescents?
• Free Screening/ public examination? In KK/ public areas? Pregnant females?
• Risk Reduction Counseling.
• Distribution of condoms?