Original Research
Chlamydia trachomatis, Neisseria gonorrhoeae and human papillomavirus infections of lower genital tract of Indigenous women from Xingu Indigenous Park
AUTHORS
Claudia Regina Cinti Correa Porto1 PhD, Postdoctoral Fellow
Adhemar Longatto-Filho2 PhD, Associate Professor 
Bruna Cristine De Almeida3 PhD, Postdoctoral Fellow
Tatiana CS Bonetti4 PhD, Affiliated Researcher Professor
Sula Fernanda A Kamaiurá5 Vice-President of the Yamurikumã Association
Ricardo Sobhie Diaz6 MD, PhD, Associate Professor
Thais Heinke7 MD, PhD, Adjunct Professor
Fernanda de Paula Cury8 MSc, Laboratory Technician
Iara Viana Vidigal Santana9 MD, Pathologist
Mariana M Queiroz10 Nurse, Coordinator of Women's Health at the Xingu Project
Douglas Antonio Rodrigues11 MD, PhD, Coordinator of the Indigenous Clinic
Neila Maria De Gois Speck12 MD, PhD, Adjunct Professor *
AFFILIATIONS
1, 12 Gynecological Disease Prevention Nucleus (NUPREV), Department of Gynecology, Paulista Medical School (UNIFESP/EPM), Federal University of São Paulo, 821 Botucatu Street, São Paulo, SP 04023-062, Brazil
2 Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, São Paulo, Brazil; School of Medicine, Life and Health Sciences Research Institute, ICVS/3B’s - PT Government Associate Laboratory, Campus de Gualtar, University of Minho, Braga 4710-057, Portugal; and Laboratory of Medical Investigation (LIM) 14, Hospital das Clinicas da Faculdade de Medicina, Universidade de Sao Paulo, HCFMUSP, 455 Dr. Arnaldo Avenue, São Paulo, SP 05403-010, Brazil
3 Structural and Molecular Gynecology Laboratory (LIM 58), Discipline of Gynecology, Department of Obstetrics and Gynecology, Hospital das Clinicas, Faculty of Medicine, University of São Paulo, HCFMUSP, 455 Dr. Arnaldo Avenue, São Paulo, SP 05403-010, Brazil
4 Molecular Gynecology Laboratory, Department of Gynecology, Paulista Medical School (UNIFESP/EPM), Federal University of São Paulo, 781 Pedro de Toledo Street, São Paulo, SP 04039-032, Brazil; and Professor Geraldo Rodrigues de Lima Neuroscience Center and Women's Health, Department of Gynecology, Federal University of São Paulo – Paulista Medical School (UNIFESP/EPM), São Paulo, SP, Brazil
5 Yamurikumã Association, 733 Paraná Avenue, Nova Canarana, Canarana, Mato Grosso, 78640-000, Brazil
6 Department of Infectious Diseases, Paulista Medical School (UNIFESP/EPM), Federal University of São Paulo, 669 Pedro de Toledo Street, São Paulo, SP 04039-032, Brazil
7 Department of Pathology, Paulista Medical School (UNIFESP/EPM), Federal University of São Paulo, 740 Botucatu Street, São Paulo, SP 04023-062, Brazil
8, 9 Pathology Department of Fundação Pio XII / Barretos Cancer Hospital, 1331 Antenor Duarte Vilela Street, Pavilhão João Paulo e Daniel, Barretos, SP 14784-400, Brazil
10, 11 Department of Preventive Medicine, Paulista Medical School (UNIFESP/EPM), Federal University of São Paulo, 740 Botucatu Street, São Paulo, SP 04023-062, Brazil
ACCEPTED: 4 March 2023
early abstract:
Introduction: Xingu Indigenous Park (XIP) currently protects 16 ethnic Indigenous groups and is located in the central area of Brazil. XIP is the first and the largest Indigenous land to be recognized in the country. Community access is limited and restricted to the non-Indigenous population, and the Indigenous women are constantly dealing with shortages of medical care. High-risk human papillomavirus (HR-HPV) is the most common cause of cervical cancer and is detected in 99% of cervical precancers. HPV infections may be associated with bacterial agents such as Chlamydia trachomatis and Neisseria gonorrhoeae, which are also important causative agents of sexually transmitted infections and are responsible for the most frequent bacterial infections in the world. The present study evaluated the frequency and potential impact of Chlamydia trachomatis, Neisseria gonorrhoeae, and HR-HPV in the Indigenous women of XIP.
Methods: In this cross-sectional study, 992 cervical–vaginal samples were collected from Indigenous women using a Cervex-Brush and were immediately placed in a SurePath medium. All samples were submitted to the cobas® 4800 detection system for the identification of 14 different types of HR-HPV, and the multiplex Abbott RealTime CT/NG assay for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae.
Results: HR-HPV was detected in 18.2% of women; 6% were positive for HPV16, 5% for HPV18, and 81% for other types of HR-HPV. Co-infections of HPV16 and other types was observed in 5% of women, and 3% had co-infections of HPV18 and other types. Moreover, 1.8% of women were positive for Chlamydia trachomatis, while Neisseria gonorrhoeae was not detected. In women with HR-HPV, 33% had Chlamydia trachomatis infections; 28% were positive for HR-HPV other than HPV16 or HPV18, and 5% had co-infections of HPV16 and the other types of HPV. Younger women were found to be more susceptible to HPV infections.
Conclusion: The findings indicate a high frequency of HR-HPV and a considerable frequency of Chlamydia trachomatis in the Indigenous women of XIP. The detection of Chlamydia trachomatis, Neisseria gonorrhoeae, and/or HR-HPV does not present evidence of a potential interrelationship for a combined pathogenic action in these women.