Risk Factors for Chlamydia trachomatis Pelvic Inflammatory Disease among Sex Workers in Nairobi, Kenya
| Autor: | Ian Maclean, Julius Oyugi, Francis A. Plummer, Kelly S. MacDonald, Job J. Bwayo, Joshua Kimani, Gregory Maitha, Nicolaas J. D. Nagelkerke, Rosanna W. Peeling, Robert C. Brunham, Mary Cheang |
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| Rok vydání: | 1996 |
| Předmět: |
Adult
medicine.medical_specialty Population Chlamydia trachomatis medicine.disease_cause Uterine Cervical Diseases Gonorrhea Risk Factors Internal medicine HIV Seropositivity Pelvic inflammatory disease medicine Humans Immunology and Allergy Chlamydiaceae Longitudinal Studies Risk factor education Gynecology education.field_of_study Chlamydia biology business.industry Histocompatibility Testing Odds ratio Chlamydia Infections Middle Aged biology.organism_classification medicine.disease Kenya Sex Work Infectious Diseases Chlamydiales Female business Pelvic Inflammatory Disease |
| Zdroj: | Journal of Infectious Diseases. 173:1437-1444 |
| ISSN: | 1537-6613 0022-1899 |
| DOI: | 10.1093/infdis/173.6.1437 |
| Popis: | Beginning in April 1991 in a special treatment clinic in Nairobi Kenya 302 commercial sex workers were enrolled in a prospective study designed to examine the role of immunologic factors in Chlamydia trachomatis. They were followed for 17.6 months. The study was also intended to identify risk factors for the development of clinical pelvic inflammatory disease (PID) among women with cervical chlamydial infection. 46% (140) of the women had 317 C. trachomatis infections. 70% (102) of these women did not have chlamydial PID. 23 women had chlamydial PID. Independent risk factors for C. trachomatis PID included multiple C. trachomatis infection (odds ratio [OR] = 1.8; p = 0.0004) antibody to C. trachomatis heat-shock protein 60 (OR = 3.9; p = 0.04) and number of episodes of nongonococcal nonchlamydial PID (OR = 1.7; p = 0.02). Oral contraceptive use had an independent protective effect against chlamydial PID (OR = 0.28; p = 0.048). Among HIV-positive women a CD4 lymphocyte count of less than 400 sq m was one more independent risk factor for chlamydial PID (OR = 21.7; p = 0.036). Among human leukocyte antigen (HLA)-typed women HLA-A31 was one more independent risk factor for chlamydial PID (OR = 5.6; p = 0.043). These findings suggest that immunologic factors and oral contraceptives change host susceptibility to clinical PID among women with newly acquired C. trachomatis infection. |
| Databáze: | OpenAIRE |
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