Chlamydia trachomatis direct isolation, antibody prevalence and clinical symptoms in women attending outpatient clinics.

Two hundred and ninety-seven women with complaints of vaginal or urethral discharge and 100 women attending outpatient clinics for contraceptive or other advice (enrolled as controls) were studied and compared. A meticulous sampling for Chlamydia trachomatis was taken from one hundred and seventy-seven women enrolled in the study group (A1). Technical difficulties were encountered with the remaining 120 cases--study group (A2). It was found that ninety-three out of the 177 women (of group A1) were infected with either Chlamydia trachomatis or Neisseria gonorrhoeae (52.5%) compared to four out of 120 (3.4%) in the A2 subgroup. The overall prevalence of C. trachomatis antibodies was found to be 171/397 (43.1%) when all three groups studied were tested by immunoperoxidase (IPA). In comparison, by direct culture alone 92/397 (23.2%) were positive. The most significant clinical symptoms for chlamydial infection were purulent or mucoid discharge, bleeding and vaginitis (p = 0.005). This study demonstrates that immunoperoxidase (IPA) and ELISA techniques for C. trachomatis serology are helpful for the identification of infection by this agent. The possibility of using these serological methods in screening tests for vaginal infections in addition to C. trachomatis direct culture and clinical symptoms in outpatient clinics should be considered.