EPIDEMIOLOGY OF CHLAMYDIA TRACHOMATIS IN LATIN AMERICA AND THE CARIBBEAN: SYSTEMATIC REVIEW, META-ANALYSES, AND META-REGRESSIONS

Abstract

Background: Chlamydia trachomatis (CT) is a Sexually Transmitted Disease (STD); it leads to health complications and infertility if not treated. Aim: To provide a comprehensive epidemiological assessment of CT in Latin America and the Caribbean (LAC). Methods: This study followed Cochran and PRISMA guidelines. We conducted the search in PubMed, Embase, and LILACS databases. We estimated the pooled-mean CT prevalence using random-effects meta-analyses. We conducted random-effects meta-regressions to identify sources of heterogeneity and possible predictors of high prevalence. Results: The pooled-mean urogenital CT prevalence was 8.2% (95% CI: 7.5-9.1) for general populations, 14.0% (95%CI: 12.7-15.4) for female sex workers, 10.8% (95% CI: 8.4-13.4) for men who have sex with men, male sex workers, and transgenders, 16.1% (95% CI: 12.6-19.8) for symptomatic women, 25.4 (95% CI: 18.6-38.5) for symptomatic men, 9.7% (95%CI: 6.1-14) for HIV-positive individuals and individuals in HIV-discordant couples, and 11.9% (95 CI: 8.5-15.8) for STI clinic attendees. Urogenital CT prevalence appears to decrease with age, to be higher in women compared to men, and to increase by 1% yearly. Anorectal CT appears to be higher in men compared to women but shows no temporal trend. Discussion: Urogenital CT prevalence among general populations is higher than that in other world regions. Conclusion: LAC is burdened by CT infection. Public health response in LAC region is required to effectively tackle CT infection.