Chlamydia

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Chlamydia is a common sexually transmitted infection (STI).  It is caused by a bacterium called Chlamydia Trachomatis. Chlamydia is very contagious, and can endanger a patient’s fertility or sight. Yet, many patients do not know they are infected, since the symptoms of Chlamydia are not easily detectable. Chlamydia is transmitted through vaginal, anal or oral sex. It can also be transmitted by a mother to her child during vaginal childbirth (1). Ongoing research investigates the performance of the Colli-Pee™ device in the detection and screening of chlamydia.

 

Symptoms of Chlamydia

Unfortunately, Chlamydia often does not produce any symptoms, so it can remain undetected. Some patients do suffer from symptoms, although these cannot easily be distinguished from the symptoms caused by other infections.

Symptoms of Chlamydia for men

Many men infected with Chlamydia never develop symptoms. The most recognizable symptoms of Chlamydia for men are those of a urethra infection:

  • Transparent or white secretion from the penis
  • Burning feeling while urinating
  • Uncomfortable feeling during ejection

After anal sexual contact, symptoms can also include:

  • Anal mucus secretion
  • Anal blood loss
  • Painful stool
  • Abnormal stool patterns

Symptoms of Chlamydia for women

More than 50% of women infected with Chlamydia have no symptoms. If there are any, they usually disappear about 2 weeks after the infection. But an infection with Chlamydia can stay unnoticed for many years.

The following symptoms might indicate that a woman is infected after having had vaginal sex:

  • Vaginal discharge
  • Vaginal bleeding between periods
  • Bleeding after intercourse
  • Pain during intercourse
  • Changes in menstrual pattern
  • Mild lower abdominal pain

 

Prevention of Chlamydia

Like most STIs, Chlamydia can be prevented by using a condom during sexual contact. A condom offers good protection against Chlamydia, since the bacterium (Chlamydia Trachomatis) is present in vaginal or penile discharge (2).

Next to primary prevention, several countries (such as the Netherlands and the UK) provide screenings for chlamydia on a larger scale. In 2004, youngsters from Amsterdam and two other Dutch cities received a self-sampling package by post, allowing men to collect a urine sample and women to collect a vaginal swab at home for testing. In the UK, the National Chlamydia Screening Programme provides a similar service, but offer female participants the choice between a urine sample and a vaginal swab (3).

Colli-Pee™ could improve these types of screening programmes. With Colli-Pee™, the collection of first-void urine is guaranteed, making the option of a urine sample more reliable for both female and male participants. The first-void urine collector is also easy to use. Home-based sampling can reduce feelings of shame connected to chlamydia testing and urine collection in the doctor’s office. With Colli-Pee™, urine samples can be obtained in the home environment.

 

Detection of Chlamydia

Chlamydia can be detected by the examination of a swab specimen (from the cervix for women or from the urethra for men) by a clinician, self-collected vaginal swabs, or of voided urine. The urine sample for detection of Chlamydia has to consist of first-void urine (the first part of the urine stream), as this part of the urine stream contains more DNA particles than other parts, making detection of Chlamydia easier (4)

This urine can easily be collected at home, for example with the Colli-Pee™. This device contains a floater system which captures the first part of the urine stream, or first-void urine. A 'home' test with the Colli-Pee avoids the need for an intimate, and possibly uncomfortable, examination and makes testing much easier for women.

 

Treatment of Chlamydia

Chlamydia infections are treated with antibiotics. The treatment lasts a week (5-6).

The patient’s partner - even if he/she is not infected with Chlamydia - should be treated simultaneously (7).

 

Consequences of Chlamydia

If left untreated, Chlamydia can have serious complications for both men and women.

In women, Chlamydia can cause an infection of the urethra, and inflammation of the cervix. Chlamydia can also lead to Pelvic Inflammatory Disease or PID (an infection of the uterus, ovaries and/or fallopian tubes) or even infertility.  PID can cause infertility and ectopic (tubal) pregnancies later in life. In some cases, Chlamydia also affects the joints (7).

In men, the Chlamydia bacterium could make its way through the spermatic cords towards the epididymis and the scrotum. Often this causes an infection of the epididymis (8)

 

Novosanis' research on Chlamydia and the Colli-Pee™ device

Novosanis is currently collaborating with two different parties to detect Chlamydia infections in first-void urine samples collected using the Colli-Pee™. Next to diagnostic sensitivity and specificity, usability and willingness to use are also assessed. Together with The Institute of Tropical Medicine (Antwerp, BE), we are evaluating the device for STI testing in MSM (men having sex with men). Four STIs are detected in this study, being Chlamydia, Gonorrhea, Mycoplasma Genitalium, and Trichomonas. Samples are taken at home and send to the laboratory using regular mail. In a collaboration with Saltro (Utrecht, NL), Colli-Pee™ is provided via an online platform (Saltro Directlab) for Chlamydia testing in men. Further research will be dedicated to e.g. STI testing in females.

 

References:

  1. Centers for Disease Control and Prevention, website, 2016
  2. Niccolai et al., Sex Transm Infect, 2005. PMID: 16061540
  3. Woodhall et al., Sex Transm Infect, 2016. PMID: 26290483
  4. Jaschek et al., J Clin Microbiol, 1993. PMID: 8501220
  5. Weber et al., Clin Infect Dis, 1995. PMID: 7795110
  6. Hathorn et al., Sex Transm Infect, 2012. PMID: 22517887
  7. Schillinger et al., Sex Trans Dis, 2003. PMID: 12514443
  8. Gratrix et al., Sex Trans Dis, 2016. PMID: 26760180