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VOL: 100, ISSUE: 28, PAGE NO: 31


- Chlamydia is a sexually transmitted infection (STI).



- It is caused by the intracellular bacterium Chlamydia trachomatis.



- It is one of the most common STIs and the most likely identifiable cause of non-specific urethritis in men.



- It can affect the eyes, throat, and lungs.



- If chlamydia is left untreated, complications may occur.



- It may be carried asymptomatically for months or years. Diagnosis does not necessarily imply recent infection.



- It is the UK’s most common treatable STI.



- It affects one in twelve sexually active women aged 16-24.



- Infection occurs during vaginal, oral or anal sex, or other genital contact with a partner who has chlamydia.



- Newborn babies can acquire the infection during birth.



- A conjunctive infection can follow if discharge is transferred on hands.



Factors linked with a higher risk of infection include:



- Under 25 years of age;



- A new sexual partner;



- Lack of barrier contraception such as having intercourse without condoms;



- Use of oral contraceptive;



- Women having a termination of a pregnancy.



- Chlamydia is often asymptomatic.



- If symptoms occur, they usually start one to three weeks after the infection is acquired.



- Symptoms may stop despite the continued presence of infection.



- Chlamydia can be passed on even when there are no symptoms.



Women may experience the following:



- Abnormal vaginal discharge;



- Painful intercourse;



- Painful urination;



- Occurrence of bleeding between menstrual periods;



- Bartholin glands (producer of sexual lubrication mucus) become inflamed and cysts may form;



- Pain in lower back and pelvic area.



Men may experience the following:



- Yellow urethral discharge;



- Tender and swollen testicles;



- Inflamed joints and eyes.



- Traditionally, diagnosis has been made from male urethral or female cervical swabs.



- DNA amplification tests, such as ligase chain reaction (LCR) and polymerase chain reaction (PCR), have led to less invasive investigations, such as urine testing.



- Antibiotics (100mg doxycycline, administered orally twice a day for seven days; or 1g azithromycin in a single oral dose).



- If the patient is asymptomatic, it is important to emphasise the importance of compliance with treatment as the infection may spread and cause complications.



- Strategies to prevent reinfection, such as practising ‘safer sex’, should be discussed.



- Sexual partners need to be assessed and treated, even if they are asymptomatic.



- Patients should be told to avoid sex until their treatment and that of their partner(s) is complete.



- Ectopic pregnancies.



- Pelvic inflammatory disease (PID).



- Female or male infertility.



- Epididymo-orchitis (inflammation of the testis and epididymis).



- Chronic pelvic pain.



- Fitz-Hugh-Curtis syndrome (perihepatitis).



- Sexually acquired reactive arthritis (SARA).



Possible reasons include:



- STI education is not school-based;



- No high-profile public sexually transmitted disease or infection education campaigns;



- No national screening programme.



PHLS factsheet on chlamydia:

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