MOLECULAR EPIDEMIOLOGY OF ASYMPTOMATIC GENITAL CHLAMYDIA TRACHOMATIS INFECTION AMONG WOMEN PRESENTING WITH INFERTILITY IN UNIVERSITY COLLEGE HOSPITAL, IBADAN

Abstract

Chlamydia trachomatis is the most common sexually transmitted bacterial organism, worldwide. The World Health Organization (WHO) estimated 215 million new cases annually worldwide in 2010 and indicates that the incidence of the infection has continued to rise every year in both industrialized and developing countries. Chlamydia infections in females are asymptomatic and this allows the infection to go unnoticed till it results in consequences such as infertility.
The Objective of this study was to determine the prevalence of asymptomatic genital Chlamydia trachomatis infection among women presenting with infertility in University College Hospital, Ibadan with the use of Polymerase chain reaction (PCR) and Enzyme linked immunosorbitant assay (ELISA) as well as assess the risk factors among these women. It was a cross-sectional hospital based study in which endocervical swabs and blood samples were collected from 150 women presenting with infertility that had no symptoms suggestive of genital infection. Information on socio-demographic and behavioral characteristics was collected by interview-based questionnaire. The presence of Chlamydia trachomatis infection was detected by the use of conventional PCR and ELISA IgG kit. All data were analyzed statistically using SPSS version 20. Associated risk factors were assessed with logistic regression. With the use of ELISA IgG, the seroprevalence of Chlamydia trachomatis among the one hundred and fifty study participants was 38.70% while with the use of PCR, the prevalence rate was 7.30%. Nine out of the eleven study participants that were PCR positive were also ELISA positive. The Chlamydia trachomatis IgG and PCR positivity was statistically significant among the study population.(p=0.002). Using PCR as the gold standard, the sensitivity of ELISA from this present study was 81% while the specificity was 65%. The positive predictive value was 16% while the negative predictive value was 98%. Independent risk factors of Chlamydia trachomatis infection using multivariate analysis(Logistic regression) were multiple sexual partners, husbands that had other sexual partners, life time sexual partner >1and past history of Neisseria gonorrhea or other STIs. The prevalence of asymptomatic genital Chlamydia trachomatis infection among women presenting with infertility from this present study highlights the asymptomatic nature of Chlamydia trachomatis infection and the necessity for confirmation with PCR after the use of ELISA as a screening test. Understanding the risk factors will enable targeted efforts at their prevention in order to reduce the burden of infertility in Nigeria.

MOLECULAR EPIDEMIOLOGY OF ASYMPTOMATIC GENITAL CHLAMYDIA TRACHOMATIS INFECTION AMONG WOMEN PRESENTING WITH INFERTILITY IN UNIVERSITY COLLEGE HOSPITAL, IBADAN