AsiaLIFE

When you first hook up with a new partner that initial flush of romance may blind you from their minor foibles but it should never blind you to the possibility that they could have a sexually transmitted disease, such as Chlamydia.

Chlamydia trachomatis is a bacterial infection that can cause genital infection in both men and women. The most common sexually transmitted infection worldwide, it has an estimated 89 million new cases a year. Its prevalence varies with location. The incidence in U.K. surveys has been as high as 17 percent in some settings with an average of 5 to 10 percent in the general population.  A survey in Cambodia in 2001 (Family Health International) showed that 22 percent of Cambodian sex workers tested, and 2 to 3 percent of the general population, had Chlamydia.

Becoming Infected

You can get Chlamydia infection if you have unprotected sex with an infected person. Many men and women are unaware that they are infected, as it may not cause any symptoms. You can carry the infection for months or years without realising. An infected person with no symptoms may act as a reservoir in the community – especially if the person has many sexual partners – and may unwittingly spread Chlamydia to all such partners.

Symptoms

Watch out for bleeding in between periods or after sexual intercourse, vaginal discharge, pelvic pain, or pain and burning while passing urine (especially for men). Men may also get discharge from the penis – most often white or grey rather than the green of gonorrhea – although this isn’t totally diagnostic. If you have the infection, or think you may, it is important to get tested and treated – even if you have no symptoms. This is because the infection may spread and cause abdominal pain with fever (pelvic inflammatory disease), which can lead to scarring of the fallopian tubes and infertility. Sometimes infection in the tubes may go undetected and cause ‘silent’ scarring. This is a common cause of infertility. If you are male you may pass this infection on to a partner and cause her to have fertility problems in the future. There is some evidence that Chlamydia infection in men can cause abnormalities in male sperm counts and infertility.

Getting Tested

Testing can be done in a variety of ways. The best test is one done on urine that looks directly for the presence of the bacterium. Unfortunately, this is not yet available in Cambodia. An alternative is to take a swab from the cervix and urethra and look for the organism living inside these cells. This is pretty much the same procedure as having a Pap smear and can be done at the same time as routine screening. For a man, this test has to be done on discharge so it is difficult to do unless he has symptoms.

Treatment & Prevention

Treatment of asymptomatic infections is usually pretty straightforward and involves taking a short course of antibiotics. Your partner and any other recent partners would need to be tested and treated too. You should use condoms until both you and your partner have completed the course of treatment. You can prevent yourself from getting this infection by either both partners getting tested prior to commencing a sexual relationship or by careful, correct and consistent use of condoms. Remember to be prepared (carry a condom) and be in control (watch what you drink). If you have been at risk of Chlamydia you may also have a risk of other sexually transmitted infections and should seek advice and testing from your doctor.

Acknowledgements www.patient.co.uk and www.chlamydiae.com

Laura Watson is a general practitioner at the International SOS Medical Clinic in Phnom Penh. For more information please email: This e-mail address is being protected from spambots. You need JavaScript enabled to view it .