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Chlamydia Trachomatis: Wrong Target For Sexually Transmitted Diseases (STD) In Hong Kong | 17873
Epidemiology: Open Access
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(CT) is an obligate intracellular human pathogen. It is prevalent in western countries like USA and
UK and therefore the guidelines had been set to screen for it. In both sexes, the infection can result in urethritis, proctitis,
blindness, trachoma and infertility, prostatitis, epididymitis, cervicitis, pelvic inflammatory disease (PID), ectopic pregnancy
(EP), and acute or chronic pelvic pain. In neonate, it may lead to trachoma and pulmonary complications. However, it is now
realised that other organisms, e.g.
(UU) are just or more important,
as they may elicit chorioamnionitis, preterm premature ruptured membranes, preterm labour and birth. These may also lead
to pneumonia, bacteraemia, and meningitis in newborns. Therefore this study was carried out for 8 years (2005-2013) in a
private clinic in collaboration with the CUHK to find out in Hong Kong 1) if CT is the most prevalent organism; 2) the relative
prevalence of the various STD organisms and 3) the more sensitive method of collection of specimen is if semen or urine?
For Group 1 who is having subfertility and group 2 with vaginal discharges the initial screening has been conducted to test
the presence of CT & UU using Real Time PCR (Applied Biosystem 7500). If either one of the test is found to be positive, the
couples are counseled to have the complete check-up package which includes testing the presence of DNA for CT, UU, MH,
(NG); blood for VDRL for syphilis, Herpes I & II IgG. For Group 3 who are having pelvic pain and the
infected patients were asked to have the complete check-up for STD. For the screening tests, there were more UU than CT,
both in female (334/901=37.1% vs. 48/862=5.6%; p<0.001) and, male (40/289=13.8% vs. 10/177=5.7%; p=0.006). UU was
detected more in female than male (p<0.001). For those who had complete STD check-up (n=620), UU, MH, CT, NG PCR
were (+) in 35.5%, 13.7%, 7.1% & 0.8% respectively. Herpes I, II IgG & VRDL were (+) in 74.5%, 19% & 0.64%, respectively.
In the subset of 127 couples, UU, MH, CT, NG PCR were (+) in 63.4%, 18.1%, 11% & 2.4% respectively; 24.4%, 12.6%, 3.2% &
0% respectively in husbands. Herpes I, II IgG & VRDL were (+) in 78.7%, 22.8% & 0.79% respectively in wives, 67.7%, 14.2%
& 0.79% respectively in husbands. There was no significant difference in the incidence of STD detected in urine or semen
specimens. In conclusion, 1. UU & MH were both more prevalent than CT in Hong Kong 2. Detection of NG & Syphilis was
uncommon 3. Herpes I (& II) exposure was high, and 4. There did not appear any difference in the detection of STD with
semen or urine samples.
Clement Leung-kwok Chan was sent on Hong Kong Government scholarship to University of London for pre-Royal College Membership training in 1980;
Government scholarship to Monash University (Australia) as the 1st Infertility Research Fellow and Honorary Lecturer in 1984-86. All these years he has worked
from Lecturer to Associate Professor in National University of Singapore from 1986 to 2000. In 1990, he won the scholarship for RCOG accredited training in High
Risk Obstetrics at Bristol University (UK). Followed by which he was selected on Singapore MRC Fellowship to Cambridge University (UK) from 1998 to 1999. He
was also appointed as the Chairman and Professor at University of Tasmania, Australia from 2001 to 2003. Since then he has retired to private medical practice
in Hong Kong
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