Prevalence and Risk Factors of Chlamydia trachomatis among Female University Students in Port Harcourt, Nigeria: A Pilot Screening Study Using Rapid Antigen Testing

Abstract

Chlamydia trachomatis infection is among the most common bacterial sexually transmitted infections globally, with young women disproportionately affected due to biological susceptibility and the often-asymptomatic nature of infection. In Nigeria, routine screening among university students is limited, largely due to diagnostic and resource constraints. This pilot study assessed the prevalence of C. trachomatis among female undergraduate students at Rivers State University, Port Harcourt, Nigeria, using a urine-based lateral flow assay (LFA), and examined associated socio-demographic characteristics, sexual behaviors, knowledge, and testing practices. A cross-sectional study was conducted among 150 consenting female undergraduates. Structured questionnaires captured socio-demographic data, sexual behavior, contraceptive use, and awareness of C. trachomatis. Urine samples were tested for C. trachomatis antigens using the ROSTEC Chlamydia Rapid Test Cassette. Data were analyzed descriptively using SPSS. Participants had a mean age of 20.0 ± 1.82 years; 60% were single, and 65.3% resided on campus. While 92.7% had received sexual education, only 12.7% reported prior awareness of C. trachomatis. Sexual activity was reported by 45.3%, with 26.0% engaging in unprotected intercourse. Contraceptive use was reported by 36%, and 41.3% attended routine STI check-ups. All urine samples tested negative for C. trachomatis, resulting in a prevalence of 0.0%. The zero prevalence observed likely reflects limitations of urine-based LFAs in asymptomatic populations rather than true absence of infection. These findings highlight both the feasibility and limitations of rapid screening approaches in university settings and underscore the need for confirmatory molecular testing and improved infection-specific sexual health education.