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Caracterização de infeção por Neisseria gonorrhoeae e Chlamydia trachomatis em utentes de unidades de rastreio de infeção pelo VIH e outras infeções sexualmente transmissíveis
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Resumo(s)
As Infeções Sexualmente Transmissíveis (IST) são um problema de saúde
pública, sendo frequentemente assintomáticas. Quando diagnosticadas e tratadas atempadamente quebra-se a cadeia de transmissão e evitam-se as suas complicações.
Os objetivos do estudo foram avaliar a prevalência das infeções causadas por Chlamydia trachomatis e Neisseria gonorrhoeae, co-infeções entre as mesmas e as outras IST e os factores sociodemográficos associados, em vários grupos populacionais.
A pesquisa de C. trachomatis e de N. gonorrhoeae foi realizada por uma técnica de PCR Multiplex em Tempo Real. As amostras em que a pesquisa de DNA de C. trachomatis foi indeterminada ou positiva foram analisadas por técnica de Nested-PCR e posteriormente submetidas a sequenciação. As amostras em que foi identificado DNA de N. gonorrhoeae foram confirmadas por técnica de RFLP. A pesquisa de anticorpos para outras IST foi executada pelas técnicas recomendadas.
A prevalência de infeção por C. trachomatis foi de 3,4% e idêntica entre os
géneros, sendo mais frequente em mulheres com idade <25 anos. A prevalência global da infeção por N. gonorrhoeae foi de 1%, maioritariamente no sexo masculino. 50%
apresentavam co-infeção por C. trachomatis. A relação entre infeção passada e atual por N. gonorrhoeae foi estatisticamente significativa. A percentagem de assintomáticos em ambas as infeções foi de 90% vs 83,3%, respetivamente. A maioria dos infetados referiram mais do que um parceiro sexual nos seis meses anteriores, 70% vs 83,3%, e utilização inconstante do preservativo, 80% vs 83,3%, respetivamente.
O presente estudo verificou existir uma necessidade de reforçar o rastreio de IST em determinadas populações, não só devido à sua prevalência, como pelo seu carácter maioritariamente assintomático. As associações entre os indivíduos infetados e os comportamentos de riscos, como o uso inconstante do preservativo e a multiplicidade de parceiros sexuais, estão intimamente ligadas com o maior risco de aquisição destas IST.
Sexually transmitted infections (STI) are a public health issue which are often asymptomatic. When diagnosed and treated timely, the transmission chain is broken, avowing its complications. The objectives of this study were to assess the prevalence of infections caused by Chlamydia trachomatis and Neisseria gonorrhoeae, co-infections between the two and with other STI and associated demographic factors in different population groups. C. trachomatis and N. gonorrhoeae, infections was diagnosed through a multiplex Real-Time PCR. Samples in which C. trachomatis DNA was present or indeterminate were analysed by a Nested-PCR technique and genotyped through sequencing. Every sample in which N. gonorrhoeae DNA was identified were confirmed by RFLP technique. The presence of antibodies against the other STI coinfections was performed with recommended techniques. The overall prevalence of C. trachomatis infection was 3,4%, and identical between genders, more often in woman <25 years old. The overall prevalence of infection with N. gonorrhoeae was 1% mostly in males. Which 50% had a co-infection with C. trachomatis. We found that N. gonorrhoea infection was associated with a diagnosis of gonorrhoea in the past. The proportion of asymptomatic individuals in both infections was high 90% vs 83,3%, respectively. Most of the people infected had more than one sexual partner in the previous 6 months, 70% vs 83,3%, and an inconstant condom use of 80% vs 83,3%, respectively. This study suggests that STI systematic screening could be beneficial in certain population groups, not only because they are present, but also mostly asymptomatic. The associations found among infected individuals with high risk and behaviour such as inconsistent condom use and multiplicity of sexual partners are very worrying, significantly increases the risk of getting these STI.
Sexually transmitted infections (STI) are a public health issue which are often asymptomatic. When diagnosed and treated timely, the transmission chain is broken, avowing its complications. The objectives of this study were to assess the prevalence of infections caused by Chlamydia trachomatis and Neisseria gonorrhoeae, co-infections between the two and with other STI and associated demographic factors in different population groups. C. trachomatis and N. gonorrhoeae, infections was diagnosed through a multiplex Real-Time PCR. Samples in which C. trachomatis DNA was present or indeterminate were analysed by a Nested-PCR technique and genotyped through sequencing. Every sample in which N. gonorrhoeae DNA was identified were confirmed by RFLP technique. The presence of antibodies against the other STI coinfections was performed with recommended techniques. The overall prevalence of C. trachomatis infection was 3,4%, and identical between genders, more often in woman <25 years old. The overall prevalence of infection with N. gonorrhoeae was 1% mostly in males. Which 50% had a co-infection with C. trachomatis. We found that N. gonorrhoea infection was associated with a diagnosis of gonorrhoea in the past. The proportion of asymptomatic individuals in both infections was high 90% vs 83,3%, respectively. Most of the people infected had more than one sexual partner in the previous 6 months, 70% vs 83,3%, and an inconstant condom use of 80% vs 83,3%, respectively. This study suggests that STI systematic screening could be beneficial in certain population groups, not only because they are present, but also mostly asymptomatic. The associations found among infected individuals with high risk and behaviour such as inconsistent condom use and multiplicity of sexual partners are very worrying, significantly increases the risk of getting these STI.
Descrição
Palavras-chave
Microbiologia médica Epidemiologia médica Doenças sexualmente transmissíveis Terapêutica Neisseria gonorrhoeae Comportamento de risco, Preservativo Multiplicidade de parceiros sexuais
Contexto Educativo
Citação
Editora
Instituto de Higiene e Medicina Tropical