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Molecular Diagnosis of Chlamydia trachomatis and Neisseria gonorrhoeae in Women at High Risk of Sexually Transmitted Infections

Manisha G, Anima S and Shravan Kumar M

Introduction: The genital Chlamydial and Gonococcal infections are the most common Sexually transmitted diseases (STD) among women in the developing countries and co-infection of HIV-1 with these infections represents a public health problem of growing importance among the high risk groups.
Objective: The study aims to evaluate more rapid and accurate STD diagnosis by molecular technology using Amplicor CT/NG (Chlamydia trachomatis/Neisseria gonorrhoeae) test kit for diagnosis of Chlamydia trachomatis and Neisseria gonorrhoea in HIV positive and negative women with and without symptoms and comparing the test with conventional gram staining method.
Methods: Ninety four female sex workers who were HIV (Human Immunodeficiency Virus) positive and HIV negative were included in the ratio 1:1 and endocervical specimen from them were processed at National Public Health Laboratory, Teku, over a period of 6 months, from March to end of July, 2014. Chlamydia trachomatis and Neisseria gonorrhoeae were detected by Nucleic Acid Amplification test (NAATs) and gram staining using standard protocols.
Results: This study observes that among ninety four participants twenty five patients showed positive result by Amplicor test. The rate of Chlamydia trachomatis and Neisseria gonorrhoeae test results in the clinical study among HIV positive and negative were 38.2% and 14.8%, respectively. The total illiterate and literate cases showed 65.9% and 34.04%, respectively. The measures of accuracy of Amplicor test showed sensitivity of 27.03% as compared to Gram staining to detect CT and NG from endocervical swab which was 9.46%. In this study, relationship of the STD was found statistically significant (p<0.005) with education, HIV status, symptoms and sex. Whereas, it was not significant (p>0.005) with age, case type, contraceptive method, Chlamydia trachomatis infection status and Neisseria gonorrhoeae infection status, respectively.
Conclusion: It can be concluded that nucleic acid amplification test as compared to gram staining maintains high sensitivity for diagnosing C. trachomatis and N. gonorrhoeae in a low prevalence population.