Chlamydia Trachomatis
Chlamydia Trachomatis
Chlamydia Trachomatis
Abstract
Objective: The purpose of this study was to (1) describe the distribution of Chlamydia trachomatis (CT) and Human
Immunodeficiency Virus (HIV) cases across gender and age groups in Libreville (Gabon); (2) examine Gabonese Sexually
Transmitted Infections (STIs)-related risk behaviour.
Methods: The sampled population was people attending the Laboratoire National de Sante Plublique. Between 2007 and
2011, 14 667 and 9 542 people respectively, were tested for CT and HIV infections. 1 854 of them were tested for both
infections. We calculated CT and HIV rates across gender and age groups. Also analysed was the groups contribution to the
general CT and HIV epidemiology. STIs-related risk behaviours were assessed in 224 men and 795 women (between July
2011 and March 2013) who agreed and answered a questionnaire including questions on their marital status, number of sex
partners, sexual practices, history of STIs, sex frequency and condom use.
Results: Data showed a 24% dropped in the CT infection rate between 2007 and 2010, followed by a 14% increase in 2011.
The HIV infection rates for the same period were between 15% and 16%. The risk of a CT-positive subject getting HIV is
about 0.71 times the risk of a CT-negative subject. Young adult aged between 18 and 35 years old represented 65.2% of
people who had STIs. 80% of women and 66% of men confessed to an inconsistent use of condoms. 11.6% of women and
48% of men declared having multiple sex partners. 61% of questioned women and 67% of men declared knowing their HIV
status.
Conclusions: In this Gabonese setting, the population-aged from18 to 35 years is the most affected by STIs. Other matters
of concern are the inconsistent use of protection and sex with non-spousal or non-life partners.
Citation: Djoba Siawaya JF (2014) Chlamydia trachomatis, Human Immunodeficiency Virus (HIV) Distribution and Sexual Behaviors across Gender and Age Group
in an African Setting. PLoS ONE 9(3): e90174. doi:10.1371/journal.pone.0090174
Editor: Bernhard Kaltenboeck, Auburn University, United States of America
Received October 24, 2013; Accepted January 27, 2014; Published March 3, 2014
Copyright: 2014 Djoba Siawaya. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: The authors have no support or funding to report.
Competing Interests: The author has declared that no competing interests exist.
* E-mail: [email protected]
Introduction
Table 1. Chlamydia trachomatis (CT) and the human immunodeficiency virus (HIV) infections a the Gabonese National Laboratory
of Public Health (2007-2011).
2007
2008
2009
2010
2011
Number of patients
M: 510 (23%)]
M: 709 (20%)]
M: 299 (19.4%)]
M: 667 (20%)]
619 (21%)]
Seropositive
M: 22.4%]
M: 21%]
M: 14%]
M: 15%]
17%]
Active Chlamydia
Infection
M: 25%]
M: 23%]
M: 20%]
M: 19%]
12%]
Seronegative
M: 26%]
M: 24.4%]
M: 24%]
M: 24.5%]
27%]
Number of patients
73 [F: 59 (81%);
M: 14 (19%)]
M: 509 19%]
M: 394 (19%)]
M: 628 (24.4%)]
549 (25.5%)]
Seropositive
12 [16.4%]
M: 25%]
M: 18%]
M: 24.6%]
61 [83.6%]
M: 26.4%]
M: 18,4%]
M: 24%]
Number of patients
20 [F: 14 (70%);
M: 6 (30%)]
M: 101 (21.4%)]
M: 173 (37%)]
M: 121 (25%)]
(22%)]
M: 43%]
M: 28%]
M: 23%]
M: 26%]
M: 0%]
M: 16%]
M: 20%]
M: 13%]
M: 20%]
M: 19%]
M: 50%]
M: 24%]
M: 0%]
M: 18%]
M: 17.4%]
M:19.4%]
Chlamydia
HIV
Seronegative
Chlamydia/HIV
doi:10.1371/journal.pone.0090174.t001
Results
Evolution of CT and HIV infections (table 1)
Chlamydia (+)
83
911
994
8.3%
Chlamydia (2)
97
763
860
11.3%
Total
180
1674
1854
9.7%
CT- prevalence
46.1%
54.4%
53.6%
Table 2. Chlamydia trachomatis (CT) and human immunodeficiency virus (VIH) infection prevalence for the period 20072011.
2007
2009
2010
Chlamydia
HIV
Chlamydia
HIV
Chlamydia HIV
Chlamydia
HIV
Chlamydia
HIV
All subjects
1657
12
2546
398
1248
285
1554
388
1809
323
Under 18 years
101 (6.1%)
0 (0%)
138 (5.4%)
20 (5%)
113 (9%)
15 (5.3%)
35 (2%)
2 (0.5%)
23 (1.3%)
11 (3.4%)
old
2008
2011
1910 (75%)
1025 (66%)
211 (54.4%)
1099 (60.7%)
498 (19.6%)
494 (32%)
175 (45.1%)
667 (37%)
163 (50.5%)
Pupils or
0 (0%)
1224 (48%)
95 (24%)
504 (32.4%)
36 (9.3%)
391 (21.6%)
21 (6.5%)
450 (27.1%)
149 (46.1%)
Students
doi:10.1371/journal.pone.0090174.t002
Figure 1. Sex with multiple partners. (a) Number of sex partners by gender groups: men had in average 1.9 sex partners and women 1.1. The
difference between the groups was statistically significant (p = 0.0001; [Mann Whitney test]). (b) Percentage of men and women with one, two and
three or more sex partners: a higher rate of men engaged in sex with multiple partners compared than women.
doi:10.1371/journal.pone.0090174.g001
condoms. 32% declared practicing cunnilingus (oral sex). 67% a history of STIs. 64% of women declared practicing cunnilingus
of
(oral sex); multiple sex partners were the highest in educated
men declared knowing their HIV status, whereas 33% declared workingwomen (14.3%) followed by female students (13%)
not knowing their HIV status. Multiple sex partners were the
(table 5).
highest in male students (59%) followed by educated
workingmen
Discussion
(53%). More details on age and social groups behaviours are
The Gabonese National Laboratory of Public Health is the
confined in table 4.
countrys first medical laboratory with 50 000 to 70 000 medical
STIs-related risk behaviours in women. 795 sexually
laboratory tests realised per year. The present study set at the
active women from different backgrounds aged between 14
National Laboratory of Public Health in Gabon gives us a general
years
trend on the CT and HIV evolution over the past years. It also
old and 55 years old were included in this study (table 5).
gives a particular view on how population groups are affected by
11.6%
declared having more than one sexual partner. 8.5% of women both CT and HIV infections. Although data from this study
engaged in a committed relationship had sex with non-spousal provides important information on STIs distribution and trends
across gender and age groups, the LNSP prevalence rates cannot
or
non-life partners. 78% of single women declared the
inconsistent
use of protection when engaged in sexual activities. 61% of the
questioned women declared knowing their HIV status, whereas
39% declared not knowing their HIV status. 58.4% of women
had
Figure 2. History of STIs in men and women. Overall the percentages of male and female with a history of STIs were similar. Within the male
group, student and unemployed male were less affected by STIs (31.6% and 50% respectively). Among females student and less educated employed
women were less affected by STIs (51% and 56.6% respectively).
doi:10.1371/journal.pone.0090174.g002
N = 224
Marital Status
Use of condoms
Single (S)
Engaged
Married
49.3%
29.3%
21.4%
54%
38%
60%
N: 36%]
2 or more sexual
partners
Sex Frequency
month
Social status
Use of condoms
53.5%
25.5%
21%
Unemployed
Student
Employed (a)
Employed (b)
6 (2.7%)
22 (9.9%)
111 (49.8%)
84 (37.6%)
33%
59%
53%
39%
1835
Over 35
102 [CR: %; S: %]
N: 50%]
2 or more sexual
partners
Age groups
Use of condoms
N: 33.6%]
2 or more sexual
partners
49%
46%
(a): teachers, nurses, assistants, managers, engineers etc.; (b) domestic workers, street traders without a degree etc.; CR: committed relationship, S: single; A: always; O:
often; ST: sometime; N: never, (*) more than 3 sexual partners.
doi:10.1371/journal.pone.0090174.t004
N = 795
Marital Status
Use of condoms
Single (S)
Engaged
Married
36%
10%
[A: 4.3%; O: 24%; ST: 39.1%; N: 32.6%][A: 0.5%; O: 21.3%; ST: 45.2%; N: 33%]
54%
7.4%
14%
partners
Sex Frequency
Social status
Use of condoms
33%
26.7%
40.3%
Unemployed
Student
Employed (a)
Employed (b)
173 (22.2%)
392 (50.3%)
132 (17%)
82 (10.5%)
[A: 1.6%; O: 16%; ST: 39%; N: 43.4%] [A: 0%; O: 17.7%; ST: 25.3%; N:
35.7%]
22.2%]
57%]
13%
14.3%
5%
1317
1835
Over 35
[A: 1.4%; O: 20%; ST: 48%; N: 30.6%] [A: 1.7%; O: 11.5%; ST: 36.7%; N:
partners
Age groups
Use of condoms
50.4%]
2 or more sexual 22%
11.6%
10.4%
partners
(a): teachers, nurses, assistants, managers, engineers etc.; (b) domestic workers, street traders etc.; CR: committed relationship, S: single; A: always; O: often; ST:
sometime; N: never.
doi:10.1371/journal.pone.0090174.t005
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Acknowledgments
I wish to acknowledge the help provided by Mrs. Madeleine DIANOU and
Mr. Pascal LOSSANGOYE. I would like to thank them for their assistance
with the collection of my data. I also want to thank the Ms. Amandine
MVEANG-NZOGHE serology service and the bacteriology service of the
LNSP.
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Source:
Siawaya, J. F. (2014). Chlamydia trachomatis, human immunodeficiency virus (HIV) distribution and
sexual behaviors across gender and age group in an african setting. PLoS One, 9(3)
doi:http://dx.doi.org/10.1371/journal.pone.0090174