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
- Prevention of chlamydia
- Detection of chlamydia
- Treatment of chlamydia
- Consequences of chlamydia
- Novosanis' research on chlamydia and the Colli-Pee device
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.
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
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
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.
- Standarized and volumetric collection of first-void urine.
- More reliable urine sampling for both female and male participants.
- Easy to use first-void urine collector.
- Suitable for home-based sampling which can reduce feelings of shame connected to STI testing and urine collection in the doctor’s office.
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 more sensitive (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.
The patient’s partner - even if he/she is not infected with Chlamydia - should be treated simultaneously (7).
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).
During an evaluation of home based samples collected with Colli-Pee versus a clinic-based urine collection cup, 11 additional infections were found in home-based samples collected with Colli-Pee. 3 Chlamydia trachomatis (CT), 2 Neisseria gonorrhoeae (NG), 6 Mycoplasma genitalium (MG) infections, compared to the clinic-collected samples. A total of three STIs (1 CT and 2 MG infections) were not detected in the home-based sample (9).
- Centers for Disease Control and Prevention, website, 2016
- Niccolai et al., Sex Transm Infect, 2005. PMID: 16061540
- Woodhall et al., Sex Transm Infect, 2016. PMID: 26290483
- Jaschek et al., J Clin Microbiol, 1993. PMID: 8501220
- Weber et al., Clin Infect Dis, 1995. PMID: 7795110
- Hathorn et al., Sex Transm Infect, 2012. PMID: 22517887
- Schillinger et al., Sex Trans Dis, 2003. PMID: 12514443
- Gratrix et al., Sex Trans Dis, 2016. PMID: 26760180
- De Baetselier et al. BMJ Open 2019