Global mapping of sexually transmitted Chlamydia trachomatis disease: a systematic review and meta-analysis

BACKGROUND: Chlamydia trachomatis (C. trachomatis) is known as a leading cause of one of the most prominent sexually transmitted diseases (STD) worldwide. A meta-analysis was performed in this study to comprehensively determine the prevalence of C. trachomatis in the STD population. METHOD: PubMed/Medline, Embase, and Web of Science databases were used to conduct an extensive literature search on relevant papers published from 2000 to 2023. After that, statistical analysis was performed utilizing comprehensive meta-analysis (CMA) software (version 2.0, Biostat, USA) to report the global prevalence of C. trachomatis in the STD population. RESULT: In prevalence studies involving an overall number of 40,159 STD individuals, 17,289 C. trachomatis isolates were collected in 86 countries worldwide, either by culture or by indirect DNA testing. The pooled prevalence of C. trachomatis within the global STD population was 41.6% (95% CI,40.1–43%), while a higher rate was recorded for males (12807 vs. 18871). The prevalence of C. trachomatis infection was highest in Oceania, followed by Europe, America, Asia, and Africa (49.9%, 46.3%, 41.3%, 41.1%, and 36.1%, respectively). According to data from case reports and case series, lymphogranuloma venereum (LGV) and human immunodeficiency virus (HIV) infection were the most common concurrent diseases and co-infections. CONCLUSION: The elevated prevalence of C. trachomatis in 86 countries suggests that innovative screening and infection-prevention programs are required to reduce the burden of this clinically very significant bacterial infection. Our results support the demand for further fundamental investigations in this area especially among HIV-positive patients.