Chlamydia in Singapore – An Overview

According to the Ministry of Health 2018 report on Communicable Diseases Surveillance, Chlamydia in Singapore is the most common sexually transmitted infection with an incidence rate of 48.2 cases per 100,000 population. This is significantly higher than that for Gonorrhea, which is the second most prevalent at 36.4 per 100,000 population.

Chlamydia is a sexually transmitted disease that affects both genders. It is caused by the bacterium, Chlamydia trachomatis. Chlamydia is often called the silent STD because it sometimes presents no symptoms but can cause serious health issues and complications. This infection can afflict the cervix in women and the rectum and urethra in both men and women. Occasionally, other parts of the body (lining of the eyelid, throat, and rectum) can also be affected.

How is Chlamydia Transmitted?

• Intercourse without the use of a condom or other barrier method and oral sex without a barrier method are the main ways a chlamydia infection can be transmitted.
• Touching genitals together may spread the bacteria. It can also be transmitted during anal sex. Penetration does not need to occur to contract the bacteria.
• Newborn babies can also acquire chlamydia from their mothers during childbirth.
• Chlamydia eye infection can occur through oral or genital contact with the eyes, though relatively uncommon.

Symptoms of Chlamydia

Early onset Chlamydia trachomatis infections often have no signs and symptoms. Even when signs and symptoms do appear, they’re often mild, making them easy to overlook.

Chlamydia Symptoms in Women

• Bleeding between periods
• Painful periods
• Abdominal pain with fever
• Abnormal vaginal discharge that may have an odor
• Pain during sexual intercourse
• Itching or burning in or around the vagina
• Painful urination
• Inflammation of the cervix

Chlamydia Symptoms in Men

• Small amounts of clear or cloudy discharge from the tip of the penis
• Painful urination
• Burning and itching around the opening of your penis
• Pain and swelling around your testicles

Complications from Chlamydia

If left untreated, chlamydia can cause serious damage to the reproductive organs and cause other problems.

• May cause pelvic inflammatory disease (PID) in women. This may result in chronic pelvic pain, infertility and ectopic pregnancy (pregnancy outside uterus). In addition, the risk of acquiring HIV infection if exposed can be up to five times higher for women infected with chlamydia.
• Chlamydia can endanger pregnancy by causing premature delivery and stillbirth. An infected mother can also pass the infection on to her baby during vaginal delivery, resulting in pneumonia or eye infection.
• Chlamydia infection may spread to the rectum, causing inflammation, discharge and pain.
• Severe eye infection may occur if the eyes come into contact with infectious secretions.
• In rare instances, chlamydia can spread to the epididymis in men – the tube carrying sperm from the testes). This can result in fever, pain, swelling and sterility.
• In rare instances, chlamydial may cause arthritis accompanied by skin lesions and inflammation of the eye and urethra.

Diagnosis of Chlamydia

Polymerase chain reaction (PCR) or nucleic acid amplification tests (NAAT/NAT) are the most sensitive tests to diagnose Chlamydia. Samples are taken through:

Urine test. A sample of the urine is analyzed in the laboratory for the presence of the pathogen.

Swab. For women, the doctor takes a swab of the discharge from the cervix for culture or antigen testing for chlamydia. For men, the doctor inserts a slim swab into the end of the penis to get a sample from the urethra. In some cases, the doctor will swab the anus.

Treatment of Chlamydia in Singapore

Chlamydia trachomatis is curable and is treated with antibiotics. The doctor might prescribe a one-time dose, or the patient might need to take the medication daily or multiple times a day for 5 to 10 days. Azithromycin is an antibiotic usually prescribed in a single, large dose. Doxycycline is an antibiotic that is taken twice per day for about 1 week.

Part of the treatment is to abstain from any sexual activities that could cause the patient to get re-infected. It is also important to contact sexual partners of patients with Chlamydia and ask them to get tested.