RESUMO
OBJECTIVES: Better information on the prevalence of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infection is needed in many world areas. STUDY DESIGN: Cross-sectional study of population-based samples of nonpregnant women aged 15 to 44 years in Nigeria, Colombia, Argentina, Vietnam (2 areas), China, Thailand (2 areas), Korea, and Spain. 5,328 consenting women aged 15 to 44 years participated. Exfoliated cervical cells were collected and testing for CT and NG and human papillomavirus (HPV) was done using PCR-based assays. RESULTS: Age-standardized CT prevalence ranged between 0.2% (95% confidence interval, CI: 0.0-0.7%) in Spain and 5.6% (95% CI: 3.4-7.8%) in Nigeria. NG ranged between 0% (with broad CIs) in several areas and 2.6% (95% CI: 1.0-4.2%) in Nigeria. Prevalence of CT in all areas combined was greater in women aged 15 to 24 (4.5; 95% CI: 3.4-5.8%) than 25 to 44 (2.6; 95% CI: 2.1-3.1%), whereas NG prevalence was similar in the 2 age groups (0.3%). The only significant risk factors were NG infection (for CT), CT infection (for NG) and infection with high-risk HPV types (for both). CONCLUSIONS: The prevalence of CT and, most notably, NG was relatively low in a variety of countries. Our findings, however, do not apply to subsets of high-risk women who are likely to be underrepresented in our population-based samples.
Assuntos
Infecções por Chlamydia/epidemiologia , Chlamydia trachomatis , Gonorreia/epidemiologia , Doenças do Colo do Útero/epidemiologia , Adolescente , Adulto , Ásia/epidemiologia , Infecções por Chlamydia/etiologia , Infecções por Chlamydia/prevenção & controle , Colômbia/epidemiologia , Estudos Transversais , Feminino , Gonorreia/etiologia , Gonorreia/prevenção & controle , Humanos , Neisseria gonorrhoeae , Nigéria/epidemiologia , Prevalência , Fatores de Risco , Espanha/epidemiologia , Doenças do Colo do Útero/etiologia , Doenças do Colo do Útero/prevenção & controleRESUMO
Objetivo: Describir la prevalencia, incidencia y persistencia de infecciones cervicales por virus del papiloma humano (VPH), C. trachomatis y sus factores de riesgo en mujeres de una cohorte en Bogotá, Colombia. Materiales y métodos: Se revisaron 6 artículos publicados de una cohorte de 1.845 mujeres bogotanas con edades entre 13 y 85 años, con citología normal y seguimiento de 5 años.Resultados: La prevalencia de infección por VPH fue 14,9por ciento. Los virus de alto riesgo fueron tres veces más comunes que los de bajo riesgo (9,0por ciento/3,2por ciento). La mayor prevalencia se observó en menores de 20 años (26 por ciento). Para tipos de bajo riesgo, la mayor prevalencia fue en mayores de 55 años (7,6por ciento). La incidencia de infección por VPH fue de 6,2 por 100 mujeres-año, 5,0 para los de alto riesgo y 2,0 para los de bajo riesgo. Siete por ciento de las infecciones prevalentes e incidentes aún estaban presentes a los 5 años de seguimiento.La eliminación de la infección por VPH16 fue más lenta que la de tipos de bajo riesgo (RR=0,47; IC95por ciento, 0,32 a 0,72) e infecciones por uno o múltiples tipos virales tuvieron tasas de eliminación similares.La prevalencia de infección por C. trachomatis fue 5,5por ciento, con un pico en mujeres menores de 20 años (8,1por ciento). Su principal factor de riesgo fueron infecciones múltiples por VPH (OR=2,8; IC95por ciento, 1,2 a 6,0). 94por ciento de las mujeres habían eliminado la infección a los 4 años de seguimiento. Las serovariantes del grupo B y el C tuvieron tasas de eliminación más lentas que el grupo intermedio (RR=0,4; IC95por ciento, 0,1 a 0,9). Conclusión: El estudio de la historia natural de la infección por VPH y C. trachomatis en un país en desarrollo contribuye significativamente al conocimiento biológico, clínico y epidemiológico de estos agentes. La prevalencia y la incidencia de VPH por tipos específicos y por edad es información necesaria para plantear nuevas estrategias de prevención del cá...
Assuntos
Chlamydia trachomatis , Estudos de Coortes , Seguimentos , Infecções por Papillomavirus/epidemiologia , História Natural , Neoplasias do Colo do Útero/prevenção & controle , ColômbiaRESUMO
The natural course of Chlamydia trachomatis infection and its risk factors were studied in Colombian women with normal cytological results, during a 5-year period. Eighty-two women who were found to be positive for C. trachomatis at the start of the study were studied at 6-month intervals. At each visit, a cervical scrape sample was obtained for detection of C. trachomatis by use of C. trachomatis endogenous-plasmid polymerase chain reaction (PCR)-enzyme immunoassay and VD2-PCR-reverse line blot assay. Of the women studied, 67% had a single-serovar infection, 10% had a mixed-serovar infection, and 23% had an infection with an unidentified type. An inversed rate of clearance of C. trachomatis infection was observed with oral contraceptive use (hazard ratio [HR], 1.7 [95% confidence interval {CI}, 1.1-2.7]) and first sexual intercourse at >/=20 years of age (HR, 4.3 [95% CI, 2.3-8.0]). Serovars of group B (B, D, and E) and C (H, I, J, and K) had a decreased rate of clearance (rate ratio, 0.4 [95% CI, 0.1-0.9]), compared with that for serovars of the intermediate group (F and G). At 4 years of follow-up, 94% of the women had cleared their infections.
Assuntos
Infecções por Chlamydia/fisiopatologia , Chlamydia trachomatis/classificação , Chlamydia trachomatis/isolamento & purificação , Adolescente , Adulto , Colo do Útero/microbiologia , Infecções por Chlamydia/imunologia , Infecções por Chlamydia/microbiologia , Chlamydia trachomatis/genética , Colômbia , Feminino , Seguimentos , Humanos , Técnicas Imunoenzimáticas , Plasmídeos/genética , Reação em Cadeia da Polimerase/métodos , Fatores de Risco , Sorotipagem , Manejo de Espécimes/métodosRESUMO
Introducción: El virus del papiloma humano es el principal factor de riesgo asociado con el desarrollo de cáncer cervical, uno de los cánceres más comunes en mujeres colombianas. En Colombia, donde las tasas de incidencia de cáncer cervical son altas, se tiene poca información acerca de la prevalencia de la infección y no se tienen datos de seguimiento sobre la persistencia o eliminación de la infección y los factores de riesgo asociados. En este reporte se presentan los resultados de la prevalencia de la infección por HPV y los factores de riesgo asociados en mujeres que tuvieron una citología normal al comienzo del estudio así como el seguimiento de 227 mujeres positivas para la infección por HPV durante un periodo de cinco años, en la ciudad de Bogotá, Colombia
Assuntos
Papiloma , Neoplasias do Colo do Útero , História Natural das DoençasRESUMO
Little is known about the factors that influence clearance of human papillomavirus (HPV), the primary cause of cervical carcinoma. A total of 227 women cytologically normal and HPV positive at baseline were identified from a population-based cohort of 1,995 Bogota, Colombia, women aged 13-85 years followed between 1993 and 2000 (mean follow-up, 5.3 years). HPV DNA detection and viral load determination were based on a GP5+/GP6+ polymerase chain reaction enzyme immunoassay. Rate ratio estimates for HPV clearance were calculated by using methods for interval-censored survival time data. Analyses were based on 316 type-specific HPV infections. HPV 16 had a significantly lower clearance rate than infections with low-risk types (rate ratio (RR) = 0.47, 95% confidence interval (CI): 0.32, 0.72), HPV types related to HPV 16 (types 31, 33, 35, 52, 58) had intermediate clearance rates (RR = 0.62, 95% CI: 0.47, 0.94), and other high-risk types did not show evidence of slower clearance compared with low-risk types. Infections with single and multiple HPV types had similar clearance rates. There was no evidence of a dose-response relation between clearance and viral load. Observed was slower clearance in parous women (RR = 0.64, 95% CI: 0.47, 0.89) and faster clearance in ever users of oral contraceptives (RR = 1.38, 95% CI: 1.07, 1.77).