{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T22:58:25Z","timestamp":1778281105054,"version":"3.51.4"},"reference-count":28,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2020,8,28]],"date-time":"2020-08-28T00:00:00Z","timestamp":1598572800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Programa Nacional de ITS\/VIH\/Hepatitis Viral"},{"name":"Ministerio de Economia y Finanzas de Panama","award":["009044.049"],"award-info":[{"award-number":["009044.049"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2020,7,9]]},"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To determine the prevalence and risk factors of genital<jats:italic>Chlamydia trachomatis<\/jats:italic>(CT) among school-going sexually experienced male and female adolescents in Panama.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted two multisite cross-sectional studies using two-stage cluster sampling to select adolescents aged 14\u201319\u2009years attending urban public high schools (URB) in Panama City, San Miguelito, Col\u00f3n and Panama Oeste from 2015 to 2018, and in the rural Indigenous Comarca Ng\u00e4be-Bugl\u00e9 (CNB) from July\u2013November 2018. CT testing was performed by real-time PCR on urine samples. Random-effects logistic regression accounting for sample clustering was used to identify risk factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We enrolled 3166 participants (54.3% females), median age 17 years (IQR: 15.9\u201318.1), with no difference by sex. Sexual experience was reported by 1954 (61.7%) participants. Combined CT prevalence was 15.8% (95% CI: 14.2 to 17.4), with no significant differences by region (URB=16.5%, 95%\u2009CI: 14.7% to 18.6%; CNB=13.6%, 95%\u2009CI: 10.9% to 16.8%; p=0.12). In an age-and-region-adjusted analysis, CT prevalence was higher among female participants compared with males (21.6% vs 9.1%, adjusted OR (AOR)=2.87, 95%\u2009CI: 1.62 to 5.10). Among sexually experienced females, CT prevalence was higher among those who reported \u22653 lifetime sex partners compared with one partner (33.5% vs 15.3%, AOR=2.20, 95%\u2009CI: 1.09 to 4.07); and among those reporting at least one pregnancy compared with nulligravidae participants (30.9% vs 13.8%, AOR=1.89, 95% CI: 1.05 to 3.43). In unadjusted analyses among males, CT was associated with older age (11.5% among those aged 18\u201319\u2009years vs 3.4% among those aged 14\u201315\u2009years, OR=3.69, 95%\u2009CI: 1.10 to 12.33).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We report high CT prevalence among sexually experienced, school-going adolescents in Panama. Female adolescents, particularly those with multiple sex partners and a history of pregnancy, were at highest risk. Adolescent-targeted CT screening should be implemented in Panama. Additionally, evidence-based comprehensive sexuality education will be imperative.<\/jats:p><\/jats:sec>","DOI":"10.1136\/sextrans-2019-054395","type":"journal-article","created":{"date-parts":[[2020,8,28]],"date-time":"2020-08-28T21:24:29Z","timestamp":1598649869000},"page":"304-311","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Prevalence and determinants of genital<i>Chlamydia trachomatis<\/i>among school-going, sexually experienced adolescents in urban and rural Indigenous regions of Panama"],"prefix":"10.1136","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7712-0444","authenticated-orcid":false,"given":"Amanda","family":"Gabster","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5730-947X","authenticated-orcid":false,"given":"Philippe","family":"Mayaud","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alma","family":"Ortiz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorge","family":"Castillo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omar","family":"Castillero","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7816-3040","authenticated-orcid":false,"given":"Alexander","family":"Mart\u00ednez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anyelini","family":"L\u00f3pez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Betsy","family":"Aizpr\u00faa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sherly","family":"Pitano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anet","family":"Murillo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3258-1359","authenticated-orcid":false,"given":"Juan Miguel","family":"Pascale","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,8,28]]},"reference":[{"key":"2024092104001712000_97.4.304.1","unstructured":"World Health Organization . Who guidelines for the treatment of Chlamydia trachomatis, 2016. Available: https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/246165\/9789241549 714-eng.pdf?sequence=1 [Accessed Jul 2019]."},{"key":"2024092104001712000_97.4.304.2","unstructured":"Holmes KK , Sparling PF , Stamm WE , et al . Adolescents and STDs including HIV infection. Sexually transmitted diseases: McGraw HIll Medical, 2008: 165\u201386."},{"key":"2024092104001712000_97.4.304.3","doi-asserted-by":"crossref","unstructured":"Singh SK . Diagnostics to Pathogenomics of sexually transmitted infections. John Wiley & Sons Ltd, 2019: 135\u201366.","DOI":"10.1002\/9781119380924"},{"key":"2024092104001712000_97.4.304.4","first-page":"834","article-title":"Prevalence of Chlamydia trachomatis genital infection among persons aged 14-39 years--United States, 2007-2012","volume":"63","author":"Torrone","year":"2014","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2024092104001712000_97.4.304.5","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyn222"},{"key":"2024092104001712000_97.4.304.6","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0163391","article-title":"Correlates of sexually transmitted infections among adolescents attending public high schools, Panama, 2015","volume":"11","author":"Gabster","year":"2016","journal-title":"PLoS One"},{"key":"2024092104001712000_97.4.304.7","unstructured":"Ministerio de Salud, Caja de Seguro Social, Instituto Conmemorativo Gorgas de Estudios de Salud . 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