Chlamydia trachomatis and Neisseria gonorrhoeae in newborns with and without neonatal conjunctivitis: cross-sectional study in Papua New Guinea
- 1University of Bern: Universitat Bern
Abstract
Objectives Neisseria gonorrhoeae and Chlamydia trachomatis can be transmitted from an infected woman to her baby during vaginal birth to cause neonatal conjunctivitis (ophthalmia neonatorum). Little is known about how often these pathogens cause infection in babies without conjunctivitis. The objectives of this study were to investigate the frequency of C. trachomatis and N. gonorrhoeae in newborn babies with and without conjunctivitis and to estimate the prevalence of these infections and the proportion that was asymptomatic. Methods We conducted a cross-sectional study, nested in a randomised controlled trial in Papua New Guinea. At a visit scheduled 1-2-weeks after birth (visit 1), we took conjunctival swabs from babies with clinical signs of conjunctivitis and from a sample of those with no clinical signs. Babies with conjunctivitis received antibiotic treatment. Swabs were tested for N. gonorrhoeae and C. trachomatis by PCR after the end of the study. We estimated the weighted percentage (with 95% confidence intervals, CI) of babies with either organism detected and the asymptomatic proportion. Results From 21st October, 2017 to 2nd February, 2022, 1699 of 2055 newborn babies attended visit 1. Among 310 babies with clinical data and a result from any swab, 97 had signs of conjunctivitis and 213 did not. Where results were available, C. trachomatis was detected in 12/97 (12.4%) of babies with conjunctivitis and 7/211 (3.3%) without. N. gonorrhoeae was detected in 1/97 (1.0%) of babies with conjunctivitis and 6/210 (2.9%) without. The weighted estimate of C. trachomatis or N. gonorrhoeae prevalence was 6.6% (3.8-9.9%), of which an estimated 87.0% (74.8%-93.8%) was asymptomatic. Conclusions C. trachomatis and N. gonorrhoeae were detected in the absence of clinical signs of conjunctivitis in about 1 in 15 babies. This finding has implications for estimation of mother-to-child transmission and evaluation of prophylaxis and treatment interventions.
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BibTeX
@misc{low2026chlamydia,
title = {{Chlamydia trachomatis and Neisseria gonorrhoeae in newborns with and without neonatal conjunctivitis: cross-sectional study in Papua New Guinea}},
author = {N. Low and A. Mengi and L. M. Vallely and C. Descombes and L. Braunack-Mayer and M. Starr and H. Wand and B. D. Spycher and S. G. Badman and M. Laman and W. S. Pomat and A. J. Vallely and M. A. Riddell and W. T. I. Group},
howpublished = {medRxiv},
year = {2026},
month = jul,
doi = {10.64898/2026.07.09.26357364},
url = {https://www.medrxiv.org/content/10.64898/2026.07.09.26357364v3},
note = {CC BY},
}
RIS
TY - UNPB
TI - Chlamydia trachomatis and Neisseria gonorrhoeae in newborns with and without neonatal conjunctivitis: cross-sectional study in Papua New Guinea
AU - N. Low
AU - A. Mengi
AU - L. M. Vallely
AU - C. Descombes
AU - L. Braunack-Mayer
AU - M. Starr
AU - H. Wand
AU - B. D. Spycher
AU - S. G. Badman
AU - M. Laman
AU - W. S. Pomat
AU - A. J. Vallely
AU - M. A. Riddell
AU - W. T. I. Group
PY - 2026
DA - 2026/07/09
PB - medRxiv
DO - 10.64898/2026.07.09.26357364
UR - https://www.medrxiv.org/content/10.64898/2026.07.09.26357364v3
AB - Objectives Neisseria gonorrhoeae and Chlamydia trachomatis can be transmitted from an infected woman to her baby during vaginal birth to cause neonatal conjunctivitis (ophthalmia neonatorum). Little is known about how often these pathogens cause infection in babies without conjunctivitis. The objectives of this study were to investigate the frequency of C. trachomatis and N. gonorrhoeae in newborn babies with and without conjunctivitis and to estimate the prevalence of these infections and the proportion that was asymptomatic. Methods We conducted a cross-sectional study, nested in a randomised controlled trial in Papua New Guinea. At a visit scheduled 1-2-weeks after birth (visit 1), we took conjunctival swabs from babies with clinical signs of conjunctivitis and from a sample of those with no clinical signs. Babies with conjunctivitis received antibiotic treatment. Swabs were tested for N. gonorrhoeae and C. trachomatis by PCR after the end of the study. We estimated the weighted percentage (with 95% confidence intervals, CI) of babies with either organism detected and the asymptomatic proportion. Results From 21st October, 2017 to 2nd February, 2022, 1699 of 2055 newborn babies attended visit 1. Among 310 babies with clinical data and a result from any swab, 97 had signs of conjunctivitis and 213 did not. Where results were available, C. trachomatis was detected in 12/97 (12.4%) of babies with conjunctivitis and 7/211 (3.3%) without. N. gonorrhoeae was detected in 1/97 (1.0%) of babies with conjunctivitis and 6/210 (2.9%) without. The weighted estimate of C. trachomatis or N. gonorrhoeae prevalence was 6.6% (3.8-9.9%), of which an estimated 87.0% (74.8%-93.8%) was asymptomatic. Conclusions C. trachomatis and N. gonorrhoeae were detected in the absence of clinical signs of conjunctivitis in about 1 in 15 babies. This finding has implications for estimation of mother-to-child transmission and evaluation of prophylaxis and treatment interventions.
ER -