4C 5 Enhanced Laboratory Testing Reduces Chlamydia Trachomatis Infections in Yap, Federated States of Micronesia

Wednesday, June 11, 2014: 3:40 PM
Maria Marfel, Laboratorian1, James Edilyong, Doctor2, Cyril Yinnifel, NA1, Carol Farshy, MPH3, Roxanne Barrow, MD, MPH4 and John Papp, PhD5, 1Public Health, Yap Ministry of Health, Colonia, Yap, Micronesia, 2Public Health, Yap State Health Services, Colonia, Yap, Micronesia, 3Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, 4NCHHSTP, DSTDP, Centers for Disease Control and Prevention (CDC), Atlanta, GA, 5Laboratory Reference and Research Branch, Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA

Background: Chlamydia trachomatis and Neisseria gonorrohoeae are among the most commonly identified sexually transmitted infections worldwide yet little are known regarding the burden of these infections in the Pacific Islands.  The lack of quality laboratory tests in the region limits the ability for comprehensive assessments of the epidemiology of these infections.   In 2008, the Yap State Department of Health Services initiated a program with the assistance of the Centers for Disease Control and Prevention (CDC) to better understand the rates of C. trachomatis and N. gonorrhoeae infections.

Methods: Universal screening of sexually active men and women residing in Yap State ≥14 years of age for C. trachomatis and N. gonorrhoeae commenced September 2008 and analysis was limited to complete calendar year data sets.  A total of 6468 vaginal or urine specimens were collected from women and men between 2009 and 2012 and shipped to CDC for testing using the Aptima Combo 2 assay (Gen-Probe).  Patients that tested positive for either C. trachomatis and/or N. gonorrhoeae were treated as recommended by CDC.  Sex partners were also offered treatment if identified.

Results: Overall, the prevalence of C. trachomatis infections decreased from 17.3% (328/1896) in 2009 to 11.42% (174/1521) in 2012. The decrease was most noted in 10-29 year olds from which the number of C. trachomatis infections fell to 14.9% (102/690) in 2012 from 26.1% (241/922) in 2009. N. gonorrhoeae prevalence remained low throughout the study period and ranged from 0.7% to 1.4%.

Conclusions: We report that C. trachomatis is endemic in Yap and high prevalence’s were discovered in young women who may be at risk of infertility if these infections are left untreated.  There was a marked decrease in C. trachomatis prevalence as screening continued which highlights the importance of consistent laboratory testing.