Jacobs Journal of Community Medicine

Chlamydia Infection in children: A silent disease?

Published on: 2018-12-21


Chlamydia trachomatis infection is the most common bacterial sexually transmitted infection (STI) affecting men and women and is most asymptomatic. It can be transmitted at birth to babies if their mother has cervicitis. There is no agreed upon consensus about the natural course of the nasopharyngeal and genital tract colonisation in pre-pubertal children after vertical transmission from the mother, with or without effective anti-Chlamydia treatment. This uncertainty can pose significant clinical dilemma to professionals involved in safeguarding children, when sexual abuse is suspected. We report two cases of pre-pubertal children with Chlamydia infection to demonstrate some practical and ethical conundrums when the origin of the infection cannot be ascertained. We hypothesize that congenital Chlamydia infection may potentially persist for up to 11 years and some infections may remain resistant to several courses of effective antimicrobial treatment. While maintaining a high index of suspicion for sexual abuse, although rare, other possible confounding explanations should be carefully explored.


Sexual Abuse; Child Abuse; Gonorrhoea; Chlamydia; Treatment Failure; Cultures; Nucleic Acid Amplification Test (Naat); Sexually Transmitted Infections