Pooling of urine samples for molecular detection of Chlamydia trachomatis, Neisseria gonorrhoeae and Mycoplasma genitalium as a screening strategy among young adults in Catalonia.

INTRODUCTION: Bacterial sexually transmitted infections (STIs) have an important impact on reproductive health, highlighting the increase in Chlamydia trachomatis infection rates among young people. To reduce the costs of STI detection, the pooling strategy is beneficial for high-throughput tests in low-prevalence populations using non-invasive samples. OBJECTIVES: (1) To describe the performance of a 7-STI PCR assay using the pooling of three urine samples to detect C. trachomatis, Neisseria gonorrhoeae and Mycoplasma genitalium; (2) to estimate the cost saving of the pooling strategy; (3) to describe the prevalence, risk factors and coinfections of C. trachomatis, N. gonorrhoeae and M. genitalium in young people ≤25 years in Catalonia. METHODS: cross-sectional prevalence study conducted in 2016 among young people ≤25 years of age seen in sexual and reproductive health centres throughout Catalonia from pools of three urine samples. A standardized questionnaire was used to collect clinical-epidemiological and behavioural variables. RESULTS: 1032 young people were tested. The prevalence of C. trachomatis, N. gonorrhoeae and M. genitalium was 8.5%, 0.6% and 3.5%, respectively. The pooling strategy provided a 33% savings in reagent costs. CONCLUSIONS: The pooling strategy implemented for epidemiological studies in our context provides a savings that has an impact on the viability of STI detection programmes. In the same way, this study shows that C. trachomatis prevalence continues to increase in this population and, for the first time in Catalonia, the prevalence of M. genitalium in young people is shown.

Sexual behaviour of inmates with Chlamydia trachomatis infection in the prisons of Catalonia, Spain.

OBJECTIVE: To determine the prevalence of Chlamydia trachomatis (CT) and high risk factors for acquisition in preventive prisoners in Catalonia. METHODS: Cross-sectional study of a convenience sample of 478 prisoners aged between 18 and 35 years was analysed using real-time polymerase chain reaction. A standardized questionnaire was used to collect behavioural data. Significant differences were analysed in the descriptive study using Pearson's χ(2). The association between CT and its determinants was analysed using the Mantel-Haenszel test and a multivariate logistic regression model. RESULTS: The overall prevalence of CT was 5.4%. The independent risk factors for infection by CT were as follows: foreign origin, having had concurrent sexual partners, and alcohol consumption. CONCLUSIONS: This is the first study performed in prisons of Catalonia that shows the prevalence of CT in young prisoners. The high mobility of young detainees could explain the similarity in prevalence obtained about young people in Catalonia. Systematic monitoring of CT infection in young preventive prisoners is important in order to prevent further problems in themselves and in the general population, since they become a 'bridge population' in sexually transmissible infection spreading.

[Prevalence and determining factors of acquiring C. trachomatis infection among adolescents and young adults in Catalonia]. / Prevalencia de la infección por C. trachomatis y N. gonhorroeae y determinantes para su adquisición en jóvenes y adultos-jóvenes en Cataluña.

OBJECTIVE: To determine the prevalence of Chlamydia trachomatis (C. trachomatis) and Neisseria gonorrhoeae (N. gonhorroeae) infections and the risk factors for acquiring them in individuals under 35 years-old attending sexual health clinics in Barcelona province in 2006. METHODS: Cross-sectional study of a convenience sample of 500 adolescents and young adults aged between 16 and 35 years. A total of 423 samples were analysed using real-time PCR. A standardised questionnaire was used to collect clinical, epidemiological, and behavioural data on the participants. Significant differences were analysed in the descriptive study using Pearson's ((2). The association between C. trachomatis infection and its determining factors was analysed using the Mantel-Haenszel test and a multivariate logistic regression model. RESULTS: The overall prevalence of C. trachomatis was 4%, and was significantly higher in those under 25 years of age. The overall prevalence of N. gonhorroeae was 0.2%. The independent risk factors for infection by C. trachomatis were as follows: foreign origin (OR: 3.74; CI 95%: 1.10-12.72), having had a sexual partner in the last 3 months (OR 3.91; CI 95%: 1.30-11.81), and tobacco use the last 12 months (OR: 4.99; CI 95%: 1.34-18.59). CONCLUSIONS: This is the first study performed in Catalonia that shows high prevalence of C. trachomatis in young people, thus confirming trends in the rest of Europe. Systematic monitoring of C. trachomatis infection in sentinel populations will provide valid information allowing us to assess the relevance of proposing targeted screening programs in our setting.

Prevalence of human immunodeficiency virus, Chlamydia trachomatis, and Neisseria gonorrhoeae and risk factors for sexually transmitted infections among immigrant female sex workers in Catalonia, Spain.

OBJECTIVES: To determine the prevalence of human immunodeficiency virus (HIV), Chlamydia trachomatis (CT), and Neisseria gonorrhoeae (NG) among immigrant female sex workers (FSW) according to their geographic area of origin and identify possible risk factors independently associated with current infection with CT and/or NG. STUDY DESIGN: Cross-sectional study of 357 FSW in Catalonia in 2005. Information on sociodemographic and sex work characteristics, use of alcohol and drugs, sexual practices, and the use of social and health care services was collected. Oral fluid and urine samples were collected to determine the prevalence of HIV and CT/NG, respectively. Factors independently associated with CT/NG were assessed using multivariate logistic regression models. RESULTS: A total of 36.4% of women were from Eastern Europe, 34.5% from Latin America, and 29.1% from Africa. Overall CT and NG prevalence were 5.9% [95% confidence interval (CI): 3.7-8.9] and 0.6% (95% CI: 0.1-2.0), respectively. No differences were observed by geographic origin. Three African women were HIV positive (overall HIV prevalence was 0.8%, 95% CI: 0.2-2.4). In multivariate analysis, younger age and unprotected sex with clients were associated with the presence of CT/NG. CONCLUSIONS: The prevalence of sexually transmitted infections among FSW in Catalonia was lower than in other European countries. Even though the prevalence of HIV was only 0.8%, it could increase in the future given the high vulnerability of these women and their wide geographic mobility. It is necessary to continue with the work carried out by nongovernmental organizations (harm reduction programs, outreach programs, and safe sex workshops) as well as to facilitate the access to health centers, especially for the youngest women.