Introduction
Chlamydia is a sexually transmissible infection (STI), caused by the Chlamydia Trachomatis bacteria. It is somewhat of a silent infection, as those who have it will not even be aware of it as symptoms are often very mild and unnoticeable in the early stages of the infection. Chlamydia is easily treatable by a General Practitioner (GP), who will prescribe antibiotics in order to fight the infection. Early identification is key in avoiding any complications that may occur in the later stages of a chlamydia infection. The main areas affected by the infection is the genital region in both sexes, as well as the eyes and throat. In developed nations such as Australia, chlamydia is most common in the younger population and overall, the rate for 2017 was at 379 infections per 100,000 people (Australian Institute of Health and Welfare, 2018).
Causative Agents
The causative agent of chlamydia is chlamydia trachomatis, which is a bacterium that comes in two distinctive form, elementary and reticulate bodies. Elementary bodies are spore like and are infectious across individuals, while reticulate bodies only reproduce within the host cell (Quinn et al. 1981). Elementary bodies can be passed on through unsafe sex practices and in rare instances through the pregnancy/labour process.
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Epidemiology
Epidemiology involves a diseases incidence, distribution a forms of control that can be applicable. In 2016, chlamydia was the most commonly reported STI in Australia with 71 751 total cases (Australian institute of Health and Welfare, 2018). 15-29 was the most common age group where incidences were recognised, this prevalence among this age group is due to the lack of education in regards to safe sex practices, along with the increasing rates of unprotected sex, due to certain stigmas and myths surrounding enjoyment and satisfaction when using protection. In an age of dying monogamy, individuals are tending to have more then one sexual partner, resulting in more widespread infection rates. Like most STI’s the use of contraceptive measure such as condoms will act as protection against chlamydia while also reducing pregnancy risks ( Holmes et al, 2004). Though the most important form of control is to educate individuals especially those in the younger population about how to make more informed decisions and choices in regards to the sexual undertakings in order to avoid STI’s (David et al, 2008). Finally, the stigma that surrounds going to the doctor in order to be screened and tested for STI’s is one that needs to be squashed, as early detection of STI’s such as chlamydia is what leads to an individual being treated and cleared of the infection in a shorter time period, and also allows them to notify any sexual partners to get themselves tested as well. (Hocking et al, 2018)
Transmission
Like most STI’s, chlamydia’s main form of transmission is through sexual activity involving, the penis, vagina, anus and oral area. Interaction is all that’s necessary for the disease to be transmitted and ejaculation is not necessary for the transmission to occur. Chlamydia can also infect a child during birth if their mother is infected at the time. This transmission during birth consequently can lead to other complications for the child as they can become susceptible to pneumonia and conjunctivitis which takes a greater toll on their already weakened immune systems. Once treated and cleared of the disease, individuals can be infected multiple times, as there is no said cure for the disease only treatments for each individual case (Van Wees et al, 2018).
Symptoms
Chlamydia is the kind of disease that can go unnoticed for weeks and even months, though is beginning to cause significant damage, thus making it a ‘silent killer,’ as no physical symptoms are displayed and individuals are often asymptomatic (Draeger, 2019). The reason as to why symptoms take so long to appear is due to the slow replication cycle of the infected cells throughout the body. In women, chlamydia symptoms can often be confused with other infections or complications in the genital region. Both cervicitis and urethritis share symptomatic similarities with chlamydia as discharge, bleeding and pain in that general area can all be associated with all these said infections (Draeger, 2019). Once the infection has spread to the upper reproductive tract, pelvic inflammatory disease can occur, though often asymptomatic, examination and screening will reveal, tenderness and redness in the area, while pain may still remain in the local area or begin to move up into the abdominal area, causing further discomfort (Batteiger et al, 2010).
For men, chlamydia symptoms are similar to that of women, they will display signs of urethritis, as well as producing a watery/mucus discharge. In some cases, men will develop epididymitis when infected with chlamydia, which leads to testicular pain and swelling (Draeger, 2019). Chlamydia can also infect the anus/rectum in both sexes, and can be through either direct contact (i.e. anal sex) or through the disease spreading from the cervix/ vagina or male genitals. Again, while often asymptomatic, it can cause symptoms of proctitis which involves pain, bleeding and discharge from the anus. Chlamydial conjunctivitis can also be spread throughout both sexes as it only requires the contact with an infected area through secretions or other entry points of an individual.
Populations Affected
Chlamydia is a disease that does not discriminate the rich and poor and quite often, people in higher socio economic countries can be more susceptible to contracting chlamydia, due to the higher number of sexual partners and unsafe practices. Those most at risk are in the 16-29 year old age group, due to lack of education and other above listed reasons. The World Health Organisation (WHO) estimated that roughly 127 million new cases of chlamydia were recorded during 2016 alone. For countries like the US approximately 1.5million cases were reported during 2015 which equated to roughly 478 per 100,000 infected in the population ( CDC,2016). While for Australia, chlamydia is the most commonly reported STI overall, especially in the younger population where rates of infection remained on a gradual rise of 13% between 2015-17 (Kirby Institute, 2018). Generally the rate of Chlamydia infection is higher in females over males as in 2017 there was 441 females opposed to 349 infected males per 100,000. While for female Aboriginals and Torres Strait Islanders the rate of infection was about 3 times greater at 1,193 per 100,000 while for men it was 427 (Kirby Institute, 2018).
Conclusion
In conclusion, Chlamydia is one of the most commonly reported STI’s across the globe. It is caused by the Chlamydia Trachomatis bacteria, and it is quite often that those infected won’t even know they have it, as symptoms tend to not even appear until after 7 weeks. The main areas affected are the genital region of both males and females as well as the throat and eyes. Though once the diagnosis of chlamydia has been completed treatment is often quick and easy through a course of antibiotics. The prevalence of Chlamydia affects both low and high socio economic populations due to a lack of sexual health education, multiple sexual partners and stigma around getting tested.
Reference List
- Australian Institute of Health and Welfare. 2019. Australia's health 2018, Incidence of sexually transmissible infections and blood-borne viruses - Australian Institute of Health and Welfare. [ONLINE] Available at: https://www.aihw.gov.au/reports/australias-health/australias-health-2018/contents/indicators-of-australias-health/sexually-transmissible-infections-bloodborne-virus. [Accessed 19 October 2019].
- Batteiger BE, Tu W, Ofner S. Repeated Chlamydia trachomatis genital infections in adolescent women. The Journal of infectious diseases, 2010 pp.42-51.
- CDC. Sexually Transmitted Disease Surveillance, 2017. Atlanta, GA: Department of Health and Human Services; September 2018.
- Cunningham SD, Kerrigan DL, Jennings JM, Ellen JM. Relationships between perceived STD-related stigma, STD-related shame and STD screening among a household sample of adolescents. Perspectives on sexual and reproductive health, 2009 pp.225-30.
- David G. Regan, David P. Wilson and Jane S. Hocking (2008) ‘Coverage Is the Key for Effective Screening of Chlamydia trachomatis in Australia’, The Journal of Infectious Diseases, 198(3), p. 349.
- Draeger, E. (2019) ‘Diagnosis and management of chlamydia: a guide for GPs’, Prescriber, 30(1), pp. 12–15.
- Hocking, J. S. 2018 ‘Population effectiveness of opportunistic chlamydia testing in primary care in Australia: a cluster-randomised controlled trial’, The Lancet, 392(10156), pp. 1413–1422.
- Holmes KK, Levine R, Weaver M. Effectiveness of condoms in preventing sexually transmitted infections. Bulletin of the World Health Organization, 2004 pp.454-61.
- Kirby Institute 2018, HIV, viral hepatitis and sexually transmissible infections in Australia Annual surveillance report 2018. Sydney: Kirby Institute, UNSW.
- Mabey, D. 2014 ‘Epidemiology of sexually transmitted infections: worldwide’, Medicine, 42(6), pp. 287–290
- Quinn TC, Goodell SE, Mkrtichian E, et al. Chlamydia trachomatis proctitis. The New England journal of medicine, 1981 pp.195-200.
- Van Wees, D. A. ‘Double trouble: modelling the impact of low risk perception and high-risk sexual behaviour on chlamydia transmission’, Journal of the Royal Society Interface 2018, pp. 15(141)
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