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The work described in this thesis was conducted In rural Gambia and builds a body of evidence Incriminating the fly Musca sorbens as a vector of the blinding disease, trachoma, which is caused by ocular infection with Chlamydia trachomatis. Literature on hygiene promotion, environmental change and flies and trachoma is reviewed in the context of the SAFE strategy for trachoma control advocated by the World Health Organization M. sorbens was present throughout the year in trachoma endemic communities; was responsible for the majority of fly-eye contacts; C. trachomatis DNA was found on it; and trachoma transmission dropped when they were removed from the environment. In a large cluster-randomised trial communities receiving fly control with insecticide for six months had a mean reduction in trachoma prevalence of 56% (95% Cl 19-93%; P=0.01) compared to controls and 37% (4-70%; P=0.068) fewer new prevalent cases of trachoma. Breeding media choice experiments showed that isolated human faeces were the preferred larval medium for M. sorbens and were capable of supporting the production of large numbers of adults. However, other animal faeces were also able to support M. sorbens development. This suggested that a community-based strategy to reduce the quantity of human faeces on the soil surface by providing latrines would have the effect of reducing the population of M. sorbens, and hence reduce fly-eye contact and trachoma transmission. The provision of latrines gave encouraging results, which were not statistically significant; 30% less active trachoma than controls after six months (-22-81%; P=0.210) and 28% (-5-60%; P=0.146) fewer new prevalent cases. Provision of latrines warrants further investigation as a method to control trachoma, particularly when used in conjunction with other control methods. The potential role of fly control in the SAFE strategy for trachoma control is discussed.

Chlamydia trachomatis is a bimorphic, obligate intracellular parasite that develops entirely within a membrane-bound vacuole. Chlamydiae manipulate eukaryotic hosts by translocating effector proteins into the host cell. Chlamydia genomes encode a type III secretion system (T3SS) which is a likely mechanism for delivery of these effectors. The infectious chlamydial elementary body (EB) is metabolically inactive yet possesses a functional T3S apparatus capable of translocating effector proteins into the host cell to facilitate invasion and other early-cycle events. For example, the T3S-dependent chlamydial substrate Translocated actin-recruiting phosphoprotein (Tarp) is present in infected cells as early as 5 minutes post infection, and it is likely that EBs translocate other proteins in a T3S-dependent manner. Evidence is presented herein that the C. trachomatis protein CT694 represents an early-cycle-associated effector protein. CT694 is secreted by the heterologous Yersinia T3SS and immunodetection studies of infected HeLa cultures indicate that CT694-specific signal accumulates directly adjacent to, but not completely overlapping with EBs during invasion. Yeast two hybrid analyses revealed an interaction of CT694 with the repeat region and C-terminus of human AHNAK and the C-terminus of AHNAK2. Immunolocalization studies of CT694 ectopically expressed in HeLa cells were consistent with an interaction with endogenous AHNAK. In addition, expression of CT694 in HeLa cells resulted in alterations in the detection of stress fibers that correlated with the ability of CT694 to interact with AHNAK. Domain differentiation studies indicated that the C-terminus of CT694 is required to interact with AHNAK and a domain within the N-terminus localizes CT694 to the plasma membrane and triggers aberrant morphological changes in HeLa cells. CT694 function is conserved in other C. trachomatis serovars and C. muridarum, but not by similarly positioned genes of C. pneumoniae or C. caviae. These data indicate that CT694 is a novel T3S-dependent substrate unique to C. trachomatis, and that its interaction with host proteins such as AHNAK may be important for aspects of invasion or development unique to this species.

Diss. (sammanfattning) Göteborg : Göteborgs universitet, 2009. / Härtill 4 uppsatser.

Background: Annual screening of sexually active women aged 15 -24 years for Chlamydia trachomatis has been widely advocated. Goal: Examine relationships between physician characteristics and reported rates of sexual history taking, testing patients for chlamydia, and contact tracing activities taken. Study Design: Two hundred and forty one physicians in Nova Scotia completed a mailed questionnaire. Results: Contextual factors associated with the patient visit, demographic characteristics of the physician, and their beliefs, attitudes and perceptions were associated with rates of sexual history taking, and of annually testing for chlamydia. Further, physicians in Nova Scotia did not perform as well as might be expected with respect to contact tracing activities. Conclusion: The frequency of sexual history taking and patient testing were below recommended levels. Both modifiable and non-modifiable characteristics held by physicians were associated with these reported rates. Physicians may be failing to adequately assess and manage patients infected with chlamydia.

Thesis (M.S.)--University of Wisconsin-Madison. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 61-65).

Proefschrift Universiteit van Amsterdam. / Met bibliogr., lit. opg. - Met samenvatting in het Nederlands.

Proefschrift Universiteit Maastricht. / Met lit. opg. - Met samenvatting in het Nederlands.

TELES, Rosiane Alves de Sousa. Infecção genital por Chlamydia trachomatis em mulheres jovens : prevalência, fatores de risco e achados citopatológicos e colposcópicos associados. 2012. 64 f. Dissertação (Mestrado em Patologia) - Universidade Federal do Ceará. Faculdade de Medicina, Fortaleza, 2012. / Submitted by denise santos (denise.santos@ufc.br) on 2013-05-10T15:58:14Z No. of bitstreams: 1 2012_dis_rasteles.pdf: 651513 bytes, checksum: c0f30c61f8be5d8505c06dd8ea0784c5 (MD5) / Approved for entry into archive by Erika Fernandes(erikaleitefernandes@gmail.com) on 2013-05-16T13:40:10Z (GMT) No. of bitstreams: 1 2012_dis_rasteles.pdf: 651513 bytes, checksum: c0f30c61f8be5d8505c06dd8ea0784c5 (MD5) / Made available in DSpace on 2013-05-16T13:40:10Z (GMT). No. of bitstreams: 1 2012_dis_rasteles.pdf: 651513 bytes, checksum: c0f30c61f8be5d8505c06dd8ea0784c5 (MD5) Previous issue date: 2012 / Chlamydia trachomatis (Ct) is the most common bacterial sexually transmitted infection worldwide, but there are few published dates about it in Brazil. The aim of this study was to determinate the prevalence of Chlamydia trachomatis infection and to assess the socialdemographic behavioral, clinical and cytopathological factors associated with this infection among adolescents and young women in a low-income area of Fortaleza - Brazil. A cross-sectional study was conducted in 200 sexually active women aged 12 to 25 years, from august 2011 to august 2012, in gynecology outpatient clinic of the General Hospital District Gonzaga Mota - Barra do Ceará. Personal information and date of gynecogical examination were recorded in a questionnaire and the patients underwent collection of material from the endocervix to hybrid capture test for C. trachomatis and Pap test, followed by colposcopy. Data were analyzed using Graphpad Prism 5.0 software, proceeding to descriptive and analytical analysis using the Student t test for nominal variables and the Fisher exact test for quantitative variables. No association was found between infection and studied the socio-demographic characteristics, sexual habits, signs and symptoms questioned, cylindrical ectropion and colposcopic changes.Among the abnormal cytological atypia, ASC-US was presented in 20,7% of cases and 4,5% of controls (p=0,0067, RR=3,452, IC=1,72-6,89), with a positive association with the infection. G. vaginalis morphotype was identified in 54,8% of infected women and 30,7% of negative patients (p=0,0133, RR=2,305. IC=1,21-4,39), showing a relationship with the infection. It was concluded that infection with C. trachomatis had a high prevalence in the population studied, no association was observed with socio-demographic, biological and clinical findings and colposcopic changes. There was association of ASC-US and G. vaginalis in cytology with the infection studied. / A Chlamydia trachomatis (Ct) é a bactéria de transmissão sexual mais comum em todo o mundo, apesar de existirem poucos dados sobre este agravo na população brasileira. O objetivo da pesquisa foi determinar a prevalência da infecção por Ct, avaliando os fatores sóciodemográficos e achados clínicos, colposcópicos e citopatológicos associados à ocorrência desta infecção em mulheres jovens na periferia de Fortaleza. Foi realizado um estudo de corte transversal em 200 mulheres sexualmente ativas, com idade entre 12 e 25 anos, atendidas no período de agosto de 2011 a agosto de 2012, no ambulatório de ginecologia geral do Hospital Distrital Gonzaga Mota – Barra do Ceará. Informações pessoais e dados do exame ginecológico foram anotados em um questionário e as pacientes submeteram-se à coleta de material da endocérvice para teste de captura híbrida II para Chlamydia trachomatis e para citologia oncótica convencional, seguido de colposcopia. Os dados foram analisados utilizando o software Graphpad Prism 5.0, procedendo-se a análise descritiva e analítica utilizando o teste t de Student para as variáveis nominais e o teste exato de Fisher para as variáveis quantitativas. A prevalência da infecção por Chlamydia trachomatis foi 15,5% (31/200) em mulheres adolescentes e adultas jovens. Não foi encontrada associação entre a infecção estudada e as características sóciodemográficas, hábitos sexuais, sinais e sintomas questionados, ectopia cilíndrica e alterações colposcópicas. Dentre as atipias citológicas, o ASC-US esteve presente em 20,7% dos casos e 4,5% dos controles (p=0,0067, RR=3,452, IC=1,72-6,89), mostrando uma associação positiva com a infecção clamidiana. A G. vaginalis foi encontrada em 54.8% das pacientes infectadas e em 30,7% das pacientes negativas (p=0,0133, RR=2,305. IC=1,21-4,39), mostrando uma relação com a infecção estudada. Concluiu-se que a infecção por C. trachomatis teve uma prevalência alta na população estudada, que não houve associação com fatores de risco sócio-demográfico, biológico, com achados clínicos e/ou colposcópicos. Houve associação de ASC-US e G. vaginalis na citologia oncótica com a infecção estudada.

Made available in DSpace on 2014-06-12T23:03:29Z (GMT). No. of bitstreams: 2 arquivo8806_1.pdf: 602566 bytes, checksum: 4d7bc38669878a55e825fd9e78020363 (MD5) license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) Previous issue date: 2006 / A citologia oncótica cérvico-vaginal, além de ser útil na triagem de câncer cervical, também pode ser utilizada na detecção de características sugestivas de infecção pela Chlamydia trachomatis (C. trachomatis).O objetivo deste estudo foi comparar a citologia com a técnica de imunofluorescência direta (IFD) para Chlamydia trachomatis, utilizando 171 esfregaços cérvico-vaginais de mulheres atendidas no setor de coleta preventiva de câncer de colo uterino, no Centro Integrado de Saúde Amaury de Medeiros-CISAM, no Recife-PE. Seis casos (3,5%) foram positivos para C. trachomatis pela IFD. A citologia mostrou inclusões eosinofílicas em células metaplásicas, sendo consideradas sugestivas de infecção por C. trachomatis em apenas um caso (0,6%), confirmado pela IFD. A citologia pode contribuir na detecção da infecção por Chlamydia, desde que sejam levadas em consideração coletas adequadas, com presença de células glandulares endocervicais e/ou metaplásicas, além de se considerar também o conhecimento dos critérios citológicos característicos da infecção, visto que, quando comparada a IFD, mostrou baixa sensibilidade. A IFD deve continuar sendo utilizada na detecção de casos de infecção por Chlamydia, com critério e, se possível, com maior abrangência em serviços públicos de saúde