Restricted accessResearch articleFirst published online 2025-8
Prevalence of Chlamydia trachomatis and associated factors in pregnant adolescent and young adult females from Morelos,Mexico: A cross-sectional study.
Chlamydia trachomatis (Ct) is considered the most common bacterial sexually transmitted infection worldwide, adolescent and young adult female are at high risk of contracting this infection. The aim of this study was to evaluate the prevalence of Ct and associated factors in pregnant adolescents and young adults (PAYA).
Methods
This cross-sectional study was conducted between 2018 and 2020 with Mexican PAYA famales aged 12–24 years, who attended health services for pregnancy care. Ct was detected by PCR of the omp1 gene. The prevalence of Ct was reported with a 95% confidence interval. Factors associated with Ct prevalence were identified by multivariate logistic regression analysis.
Results
The prevalence of Ct was 12.9% (95% CI: 9–15) and 18.5% of them had coinfection with HSV-2 (aOR 3.1; 95% CI: 1.49–6.42). Frequent alcohol consumption (aOR 2.3, 95% CI:1.07–5.08), antibiotic use in the last year (aOR 1.9, 95% CI:1.06–3.39), ≥3 lifetime sexual partners (aOR 0.5, 95% CI:0.24–0.98) and hormonal contraceptive use (aOR 2.2, 95% CI:1.08–4.34) were associated with Ct.
Conclusion
The prevalence of Ct in PAYA is high. Screening should be performed in symptomatic and asymptomatic pregnant females to reduce the risk of vertical transmission and the risk of pelvic inflammatory disease and infertility.
AmmerdorfferAStojanovMGreubG, et al.Chlamydia trachomatis and chlamydia-like bacteria: new enemies of human pregnancies. Curr Opin Infect Dis2017; 30(3): 289–296. DOI: 10.1097/QCO.0000000000000369.
6.
SiakwaMKpikpitseDAzanuW, et al.Chlamydia trachomatis related neonatal sepsis. Int J Res2016; 8(5): 30525–30528.
7.
González-FernándezMDEscarcega-TameMALópez-HurtadoM, et al.Identification of Chlamydia trachomatis genotypes in newborns with respiratory distress. An Pediatr2023; 98(6): 436–445. DOI: 10.1016/j.anpede.2023.04.010.
8.
DutilhBBébéarCRodriguezP, et al.Specific amplification of a DNA sequence common to all Chlamydia trachomatis serovars using the polymerase chain reaction. Res Microbiol1989; 140(1): 7–16. DOI: 10.1016/0923-2508(89)90053-3.
9.
Vergara-OrtegaDNSevilla-ReyesEEHerrera-OrtizA, et al.Real time PCR to evaluate HSV-2 shedding from anal and genital samples among men who have sex with men, living with HIV. J Med Virol2018; 90(4): 745–752. DOI: 10.1002/jmv.25003.
10.
Muñiz-SalgadoJCla CruzGJDVergara-OrtegaDN, et al.Seroprevalence and vaginal shedding of herpes simplex virus type 2 in pregnant adolescents and young women from Morelos, Mexico. Viruses2023; 15(5): 1122. DOI: 10.3390/v15051122.
11.
Conde-FerráezLMartíezJR, et al.Human papillomavirus and Chlamydia trachomatis infection in gyneco-obstetric outpatients from a mexican hospital. Indian J Med Microbiol2017; 35(1): 74–79. DOI: 10.4103/ijmm.IJMM_15_450.
12.
Casillas-VegaNMorfín-OteroRGarcíaS, et al.Frequency and genotypes of Chlamydia trachomatis in patients attending the obstetrics and gynecology clinics in Jalisco, Mexico and correlation with sociodemographic, behavioral, and biological factors. BMC Womens Health2017; 17(1): 83. DOI: 10.1186/s12905-017-0428-5.
13.
López-HurtadoMGarcía-RomeroSEscobedo-GuerraMR, et al.Prevalencia de la infección genital por Chlamydia trachomatis en mujeres que asisten al Instituto Nacional de Perinatología de la Ciudad de México [Prevalence of genital Chlamydia trachomatis infection in women attending in the National Institute of Perinatology from Mexico City]. Rev Chilena Infectol2018; 35(4): 371–376. DOI: 10.4067/s0716-10182018000400371.
VenkateshKKVan der StratenAMayerKH, et al.African women recently infected with HIV-1 and HSV-2 have increased risk of acquiring Neisseria gonorrhoeae and Chlamydia trachomatis in the Methods for Improving Reproductive Health in Africa trial. Sex Transm Dis2011; 38(6): 562–570. DOI: 10.1097/OLQ.0b013e31820a8c2c.
16.
VanoverJSunJDekaS, et al.Herpes simplex virus co-infection-induced Chlamydia trachomatis persistence is not mediated by any known persistence inducer or anti-chlamydial pathway. Microbiology (Read)2008; 154(Pt 3): 971–978. DOI: 10.1099/mic.0.2007/012161-0.
17.
StonerMCDEdwardsJKMillerWC, et al.Effect of schooling on age-disparate relationships and number of sexual partners among young women in rural South Africa enrolled in HPTN 068. J Acquir Immune Defic Syndr2017; 76(5): e107–e114. DOI: 10.1097/QAI.0000000000001544.
18.
HwangLYMaYMoscickiAB. Biological and behavioral risks for incident Chlamydia trachomatis infection in a prospective cohort. Obstet Gynecol2014; 124(5): 954–960. DOI: 10.1097/AOG.0000000000000429.
19.
TamarelleJPenaudBTyssandierB, et al.Effects of azithromycin and doxycycline on the vaginal microbiota of women with urogenital Chlamydia trachomatis infection: a substudy of the Chlazidoxy randomized controlled trial. Clin Microbiol Infect2023; 29(8): 1056–1062. DOI: 10.1016/j.cmi.2023.04.020.
20.
NavarroCJollyANairR, et al.Risk factors for genital chlamydial infection. Can J Infect Dis2002; 13(3): 195–207. DOI: 10.1155/2002/954837.
21.
AkterTFestinMDawsonA. Hormonal contraceptive use and the risk of sexually transmitted infections: a systematic review and meta-analysis. Sci Rep2022; 12(1): 20325. DOI: 10.1038/s41598-022-24601-y, Published 2022 Nov 25.
22.
TadesseETeshomeMAmsaluA, et al.Genital Chlamydia trachomatis infection among women of reproductive age attending the gynecology clinic of hawassa university referral hospital, southern Ethiopia. PLoS One2016; 11(12): e0168580. DOI: 10.1371/journal.pone.0168580, Published 2016 Dec 22.
23.
OttMAAdlerNEMillsteinSG, et al.The trade-off between hormonal contraceptives and condoms among adolescents. Perspect Sex Reprod Health2002; 34(1): 6–14.
24.
HolmesKKLevineRWeaverM. Effectiveness of condoms in preventing sexually transmitted infections. Bull World Health Organ2004; 82(6): 454–461.
25.
Gutiérrez-CamposRGutiérrez-SantillánEABravo-AguirreDE, et al.[Association between early miscarriage and Chlamydia trachomatis infection in Aguascalientes, Mexico]. Rev Med Inst Mex Seguro Soc2020; 58(1): 21–27.
26.
Arteaga-TroncosoGLópez-HurtadoMYescas-BuendíaG, et al.Identifying the impact of Chlamydia trachomatis screening and treatment on mother-to-child transmission, and respiratory neonatal outcomes in Mexico. Pathogens2024; 13(10): 843. DOI: 10.3390/pathogens13100843.
27.
[Mexican Official Standard NOM-007-SSA2-2016. For the care of women during pregnancy, childbirth and postpartum and of the newborn] Norma Oficial Mexicana NOM-007-SSA2-2016. Para la atención de la mujer durante el embarazo, parto y puerperio y del recién nacido. https://www.dof.gob.mx/nota_detalle_popup.php?codigo=5432289
28.
[Clinical practice guide. Sexually transmitted diseases in adolescents and adults that cause genital ulcers: herpes, syphilis, chancroid, lymphogranuloma venereum, and granuloma inguinale. Mexico: Ministry of Health; 2009] Guía de práctica clínica. Enfermedades de transmisión sexual en el adolescente y adulto que producen úlceras genitales: herpes, sífilis, chancroide, linfogranuloma venéreo y granuloma inguinal. México: Secretaría de Salud, 2009. https://www.cenetec-difusion.com/CMGPC/IMSS-094-08/ER.pdf
