Genital chlamydial infection in Taiwan

Chlamydial infection is the most common sexually transmitted infection (STI), and is caused by the bacterium Chlamydia trachomatis; however, its overall prevalence rate is not available because it is not a notifiable disease, i.e., it is not reported by government authorities. Therefore, based on the reports of the limited studies available, the prevalence rate of chlamydial infection among patients visiting STI and genitourinary clinics was found to be approximately 16–18%. The risk factors for chlamydial infection are younger age (age ≤30 years), inconsistent condom use, being symptomatic (dysuria or urethral discharge) at the time of testing, and having Neisseria gonorrhoeae infection. In Taiwan, the most commonly reported strain of Chlamydia is genotype E, which is followed by genotypes D and Da, F, K, J, G, and H. C. trachomatis infection is detected using nucleic acid amplification test (NAAT), cell culture, direct immunofluorescence, enzyme immunoassay, and nucleic acid hybridization test. Among these tests, NAAT is the most sensitive Food and Drug Administration-approved urine test for diagnosing the C. trachomatis infection. The primary treatment for chlamydial infection includes either the administration of azithromycin (single dose of 1 g orally) or doxycycline (100 mg twice daily for 7 days); both being equally effective. Chlamydia-infected women and men should be retested approximately 3 months after the initial treatment. For pregnant women, however, the test should be repeated 3 weeks after the completion of therapy to ensure therapeutic cure.