Pacific chlamydia burden amongst highest in world

Pacific chlamydia burden amongst highest in the world

Wednesday 17 March, 2010, SPC Headquarters, Noumea, New Caledonia - “This should be a day for celebrating progress made in the Pacific towards gender equality and women’s rights,” said Dr Jimmie Rodgers, Director General of the Secretariat of the Pacific Community (SPC) speaking last week on International Women’s Day (8 March).

“Sadly, the reality is that many women in our region still face inequality, cultural taboos and limited access to health care. One result of these attitudes is that the number of women affected by chlamydia, a sexually transmitted infection (STI) with serious health implications, is extraordinarily high.”

Dr Rodgers, a former medical practitioner, said one in every three or four young people aged 15–24 may be infected with chlamydia. Recent evaluations of three national testing and treatment programmes show that in some countries, chlamydia prevalence is as high as 35 per cent among pregnant women.

Chlamydia is often called the ‘silent infection’ as most people infected, men or women, have few or no obvious symptoms. Symptoms may be subtle, such as vaginal discharge or pelvic pain. But if left untreated it can lead to pelvic inflammatory disease and infertility. If a pregnant woman has chlamydia, her newborn may develop lung and eye infections. Chlamydia is spread when a person has vaginal, anal or oral sex with an infected person without using a condom.

In January 2010, the Regional Sexually Transmitted Infections Working Group, made up of representatives of SPC, WHO, UNFPA, UNICEF, OSSHM and CDC, met in Fiji to discuss options for strong public health action in response to the chlamydia epidemic.

“We have gathered enough epidemiological data now to be able to make informed, evidenced-based decisions in terms of a public health strategy,” said Gillian Duffy, HIV & STI Surveillance Officer at SPC. “One of the recommendations put forward to countries to overcome this problem is ‘epidemiological treatment’.”

International research has shown that a possible solution in countries where high rates of chlamydia are detected among certain groups is to target these groups for treatment. Chlamydia is usually found at higher rates in people under 25 years and with multiple sexual partners, but in the Pacific many women are being infected by their husband or only sexual partner.

“At the moment, nearly half of the people who test positive for chlamydia in some Pacific countries do not come back for treatment,” said Ms Duffy. “With epidemiological treatment, we can ensure that everyone is treated and bypass recall system issues.”

In addition, epidemiological treatment of some groups alleviates pressure on laboratories, freeing up capacity to offer testing to the wider community. And if detected early, chlamydia is easy to treat with a single dose of antibiotics. Partners of patients also need to be treated to prevent re-infection.

However, Ms Duffy stressed “Popping a pill is not enough to solve the problem. Epidemiological treatment will only be effective in the long term if it is accompanied by behaviour change. People need to use condoms, particularly with new or casual partners, and ask for a test if they think they may have put themselves at risk.”

“Remember, a person can look healthy and still have a sexually transmitted infection. Most people with chlamydia have no symptoms and do not know they are infected, but the long-term consequences can be serious, including infertility.”

For Dr Rodgers, behaviour change extends to include gender relations. “Chlamydia is an STI which, like HIV, increases its spread thanks to gender inequality and gender-based violence. Having only one partner or being married does not protect women from chlamydia, and women should not be made to feel scared about insisting on using a condom.”

ENDS