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Previous issue date: 2013-08-08 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / Genital infection with Chlamydia trachomatis is now recognized as one of the most prevalent sexually transmitted infections (STDs). Despite major advances in laboratory diagnosis techniques, primarily the character of asymptomatic chlamydial infection in both men and in women constitutes the basis for the formation of reservoirs that perpetuate transmission and acquisition of this and other STDs. The asymptomatic in women favors the rise of infection to the upper genital tract, causing injuries that can result in infertility. An examination of population screening for early detection and treatment of asymptomatic infections is the key step in combating this major public health problem. The present study aimed to evaluate the prevalence of infection by C. trachomatis in sexually active women attended the screening program for cervical cancer of the uterus in health facilities in municipalities in different regions of the State of Rio Grande do Norte, and identify factors that may contribute to the spread of this pathogen and its relationship with the lesions of the uterine cervix. It is a cross-sectional study aimed at detecting the presence of genital tract infection by C. trachomatis either in isolated form or in association with human papilloma virus (HPV) infection in asymptomatic women. Were included in this study, a total sample of 1,134 women aged 13-76, mean 34.4 years, from March 2008 to September 2012. Specimens containing exfoliated cells of the epithelium of the uterine cervix were analyzed by examining Pap cytology for the detection of possible injuries, and the polymerase chain reaction (PCR) for detection of plasmid DNA from C. trachomatis and HPV. Infection with C. trachomatis was detected with overall prevalence rate of 8.1% in the isolated form and 2.8% in co-infection with HPV. The infection was detected in 7.4% of women with normal cytology 11.5% of those with atypical cells of undetermined significance (ASC-US) and 16.7% of those with low-grade squamous intraepithelial lesion (LSIL). We observed an association between C. trachomatis and incidence of low-grade squamous intraepithelial lesion (LSIL). The genital tract infection by C. trachomatis alone was associated with education level, ethnicity and parity, revealing that women with higher education, those of non-white ethnicity and those who had three or more pregnancies were more likely to acquire infection. Levels very close to statistical significance were observed for chronological age, age at first sexual intercourse and first pregnancy. There was no association with marital status, number of sexual partners. Co-infection with C. trachomatis and HPV was detected in 2.3% of women with normal cytology, who had 5.1% in ASC-US and 10.4% in those with LSIL. No association was found between infection C. trachomatis and increased risk of HPV infection, but women with simultaneous infection by both pathogens showed greater risk for LSIL. Co-infection was more prevalent among single women, who had in the first sexual intercourse under 18 years and those who had two or more sexual partners over a lifetime / A infec??o genital por Chlamydia trachomatis ? reconhecida atualmente como uma das mais prevalentes infec??es sexualmente transmiss?veis (IST). Apesar dos grandes avan?os das t?cnicas de diagn?stico laboratorial, o car?ter primariamente assintom?tico da infec??o clamidial tanto em homens, quanto em mulheres constitui-se na base para forma??o de reservat?rios que perpetuam a transmiss?o e a aquisi??o desta e de outras IST. A forma assintom?tica em mulheres favorece a ascens?o da infec??o para o trato genital superior, ocasionando agravos que podem resultar em infertilidade. O exame de triagem populacional para a detec??o precoce e o tratamento das infec??es assintom?ticas ? o procedimento chave no combate a este importante problema de sa?de p?blica. O presente estudo teve como objetivo avaliar a preval?ncia da infec??o por C. trachomatis em mulheres sexualmente ativas atendidas pelo programa de rastreamento do c?ncer de colo do ?tero em unidades de sa?de de munic?pios das diferentes regi?es do Estado do Rio Grande do Norte, bem como identificar fatores que podem contribuir para a dissemina??o desse pat?geno e sua rela??o com as les?es da c?rvice uterina. Trata-se de um estudo transversal que visa detectar a presen?a de infec??o do trato genital por C. trachomatis seja na forma isolada, ou em associa??o com o v?rus do papiloma humano (HPV) em mulheres assintom?ticas. Foram estudadas 1.134 mulheres com idade variando de 13 a 76, m?dia de 34,4 anos, no per?odo de mar?o de 2008 a setembro de 2012. Esp?cimes contendo c?lulas descamadas do epit?lio da c?rvice uterina foram analisados por meio do exame citol?gico de Papanicolau para a detec??o de poss?veis les?es, e pela rea??o em cadeia da polimerase (PCR) para detec??o do DNA plasmidial da C. trachomatis e do HPV. A infec??o por C. trachomatis foi detectada com taxa de preval?ncia global de 8,1%, na forma isolada e de 2,8% em co-infec??o com HPV. A infec??o foi detectada em 7,4% das mulheres com citologia normal, 11,3% daquelas com c?lulas at?picas de significado indeterminado (ASC-US) e 16,7% das que tinham les?o intraepitelial de baixo grau (LSIL). Observou-se associa??o entre C. trachomatis e ocorr?ncia de les?o intraepitelial de baixo grau (LSIL). A infec??o do trato genital por C. trachomatis sozinha mostrou-se associada com escolaridade, etnia e n?mero de gesta??es, revelando que as mulheres com maior escolaridade, as de etnia n?o branca e aquelas que tiveram tr?s ou mais gesta??es apresentaram maiores chances de adquirir infec??o. N?veis muito pr?ximos da signific?ncia estat?stica foram observados, para idade cronol?gica, idade do primeiro intercurso sexual e da primeira gesta??o. N?o se observou associa??o com situa??o conjugal e n?mero de parceiros sexuais. A co-infec??o por C. trachomatis e HPV foi detectada em 2,3% das mulheres com citologia normal, 5,1% nas que tinham ASC-US e 10,4% naquelas com LSIL. N?o se observou associa??o entre a infec??o C. trachomatis e aumento de risco de infec??o pelo HPV, mas as mulheres com infec??o simult?nea pelos dois pat?genos apresentaram maior risco de ter LSIL. A co-infec??o foi mais prevalente nas mulheres solteiras, nas que tiveram o primeiro intercurso sexual com menos de 18 anos e nas que tiveram dois ou mais parceiros sexuais ao longo da vida
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/13097 |
| Date | 08 August 2013 |
| Creators | Magalh?es, Paulo Andr? Freire |
| Contributors | CPF:09457135415, http://lattes.cnpq.br/7078820975978056, Cornetta, Maria da Concei??o Mesquita, CPF:35303646491, http://lattes.cnpq.br/7465090403635260, Ara?jo, Joselio Maria Galv?o de, CPF:01016476469, http://lattes.cnpq.br/6430774978643765, Fernandes, Jos? Ver?ssimo |
| Publisher | Universidade Federal do Rio Grande do Norte, Programa de P?s-Gradua??o em Ci?ncias Biol?gicas, UFRN, BR, Biodiversidade; Biologia Estrutural e Funcional. |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Format | application/pdf |
| Source | reponame:Repositório Institucional da UFRN, instname:Universidade Federal do Rio Grande do Norte, instacron:UFRN |
| Rights | info:eu-repo/semantics/openAccess |
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