P113 Identifying High Rates of Chlamydia Trachomatis Infection in Yap State, Federated States of Micronesia

Tuesday, March 9, 2010
Pre-Function Lobby & Grand Ballroom D2/E (M4) (Omni Hotel)
James Edilyong, Doctor1, Cyril Yinnifel2, Maria Marfel, Laboratorian2, Naty Malagarsch, Nurse2, Roxanne Barrow, MD, MPH3, Carol Farshy, MPH3 and John Papp, PhD3, 1Public Health, Yap State Health Services, Colonia, Yap, Micronesia, 2Public Health, Yap Ministry of Health, Colonia, Yap, Micronesia, 3NCHHSTP, DSTDP, Centers for Disease Control and Prevention (CDC), Atlanta, GA

Background: Chlamydia and gonorrhea prevalence are assumed to be very high in the Pacific Islands based on small screening studies.  In 2006 a large population-based survey conducted by WHO on 7 islands found overall 20% prevalence of these infections among pregnant women receiving antenatal services.  However, in the United States Affiliated Pacific Islands the burden of chlamydia and gonorrhea infections are not well defined.  

Objectives: To measure the positivity of chlamydia and gonorrhea among inhabitants in Yap.  

Methods:  A mass screening program for chlamydia and gonorrhea was initiated in 2008 using self- or clinician-collected vaginal swabs or urine specimens.  Men and women were offered testing through outreach, Community Health Center and Hospital services.  These specimens were tested with the GenProbe Aptima Combo2 assay.  Age, reason for visit, presence or absence of symptoms and location were recorded.  All patients that tested positive were offered treatment according to CDC recommendations.

Results:  A total of 2439 specimens were tested with an overall positivity of 18.4% and 1.8% for chlamydia and gonorrhea, respectively.  Twice as many women were tested than men with similar infection rates being observed.  Chlamydia positivity was highest among women aged 14 to 24 years with approximately 30% being infected.  The majority of individuals sought testing following a media campaign and outreach program to the neighboring islands.  Up to 15% of these individuals tested positive for chlamydia.  

Conclusions:  A screening program has identified high rates of chlamydial infection in Yap.  Prior services of testing during antenatal visits provided limited information on the true rates of infection.  

Implications for Programs, Policy, and/or Research:  Programs that lack sophisticated laboratory equipment require a modest amount of assistance to be successful in reaching underserved communities and identifying highly endemic infections.  The infection rates in Yap and approaches to control may provide insight in the effectiveness of chlamydial screening programs through linkages to sequelae rates.

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