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What chlamydia is

Chlamydia is an infection caused by the bacterium Chlamydia trachomatis. It is the most commonly reported bacterial sexually transmitted infection in the world, and in South Africa it is consistently among the most detected organisms on sexual health panels.

It is also, for most people, completely silent. The commonly cited figures are that around 70% of women and around 50% of men with chlamydia have no symptoms at all. That is the whole problem with it: there is usually nothing to notice, so there is usually no reason to test, so it is usually found late or not at all.

How it spreads

Through vaginal, anal and oral sex, and through sharing sex toys. It can also pass from a mother to her baby during birth. It does not spread through toilet seats, towels, swimming pools or sharing a cup.

Because it transmits during oral and anal sex as well, it can live in the throat or the rectum. A genital swab will not find it there. This matters more than most people realise, and it is why we add a throat or anal swab to any panel at no extra charge.

Symptoms, if there are any

Most people have none. Where symptoms do appear, they usually show up 1 to 3 weeks after exposure.

• Unusual discharge from the vagina or penis
• Burning or pain when urinating
• Bleeding between periods or after sex
• Pelvic pain or pain during sex
• Pain or swelling in one or both testicles
• Rectal pain, discharge or bleeding, where the infection is rectal

None of these are specific to chlamydia. Gonorrhoea, Mycoplasma genitalium, ureaplasma, trichomoniasis and a urinary tract infection can all produce the same list, which is why a panel that tests for several at once answers the question better than a single test does.

What happens if it is left

Chlamydia is straightforward to treat, and the reason it is worth finding is what it does when nobody finds it.

• Pelvic inflammatory disease. The infection travels upwards from the cervix into the uterus and fallopian tubes. It is a leading preventable cause of infertility.
• Ectopic pregnancy. Scarring in the fallopian tubes raises the risk of a pregnancy implanting outside the uterus.
• Chronic pelvic pain, which can persist long after the infection itself is gone.
• Epididymitis in men: painful inflammation of the tube at the back of the testicle.
• Reactive arthritis, an uncommon complication affecting joints, eyes and the urethra.
• Higher HIV risk. An active STI makes both acquiring and transmitting HIV more likely.

Treated early, none of this happens. That is the entire argument for testing when you feel fine.

How chlamydia is tested at Epicentre

By PCR, which looks for the bacterium's genetic material directly rather than for your body's response to it. It is the most accurate method available, and it works on a self-collected swab or a urine sample. No blood draw, no examination, no speculum.

Chlamydia is included in every one of our PCR sexual health panels, so the question is not whether a panel covers it but how much else you want covered at the same time.

When to test after exposure

PCR is most accurate from around 1 to 2 weeks after the exposure you are worried about. Testing the next morning is usually too early for the bacterium to be present in detectable numbers, and a negative result at that point tells you very little.

If you have symptoms, test now rather than waiting, and see a doctor at the same time if the symptoms are severe or if there is pelvic or testicular pain. A result takes 5 to 7 working days; a doctor can examine you today.

There is one other kind of chlamydia test worth knowing about, so that you do not buy the wrong one. The blood-based Sexual Health Express at R1,078 includes a Chlamydia IgM antibody test. An antibody test looks for your immune response, not the organism, and it answers a different question from a PCR swab. For "do I have chlamydia now", PCR on a swab or urine sample is the test you want.

Your result, and what happens next

You get one report, emailed to you and to nobody else. It is the YourGenes patient report: colour coded, in plain language, with a line for every organism on your panel saying whether it was detected. There is no second document, and no separate practitioner version. This report is what your doctor reads too.

If chlamydia is detected, Epicentre does not treat it. We are a diagnostic laboratory. We collect samples, run tests and report results. We do not diagnose, prescribe medication or provide treatment, anywhere, including on WhatsApp. You have two equally good routes from here:

• Your own doctor, clinic or pharmacy clinic. Take the report. It names the organism, which is exactly what they need.
• An independent doctor we work with, who consults online or in person on sexual health results. She prescribes on her own responsibility, not as an Epicentre service.

Where to test

Walk in during those hours, no appointment and no doctor's referral. All three branches are closed on South African public holidays. If you would rather not come in, a home kit is couriered to you in discreet packaging and a free courier collects the sample.

Common questions