Epidemiological Aspects of Acute Pelvic Inflammatory Disease in Uganda

Sexually transmitted diseases among randomly selected attenders at an antenatal clinic in The Gambia.

“…Westrom et al have shown that in Sweden the incidence of ectopic pregnancy is increased sevenfold following an attack of PID.3' Figures for the incidence of ectopic pregnancy in Africa are scarce, but several workers have drawn attention to the high incidence of PID in Africa,32 33 and most have linked it with gonococcal infection.33-35 C trachomatis is the major cause of PID in certain industrialised countries. 36 The results of this study and those from Nairobi and Johannesburg suggest that C trachomatis may be at least as important as N gonorrhoeae in causing PID in Africa.…”

“…Many workers have drawn attention to the high rate of infertility in certain parts of Africa. [32][33][34][35][36][37][38][39][40] The Gambia, a careful longitudinal study of births and deaths over 25 years in two rural villages has shown that 3%o to 5% of women suffer from primary infertility, and 13% to 19% from secondary infertility (defined as failure to bear children after the age of 30).4' Exact figures are not available for other areas, but over 50% of gynaecological consultations in the government hospital in Banjul are for infertility, and most women investigated by hysterosalpingography or at operation have bilateral tubal occlusions (G Ogbaselassie, unpublished observation). Ballard et al have shown appreciably higher titres of circulating chlamydial antibody in women in Johannesburg with tubal infertility than in controls with normal fallopian tubes, suggesting that chlamydial salpinigitis is an important cause of-infertility in that community.23 Similar studies are needed elsewhere in Africa if a rational policy is to be suggested for the control of PID and its sequelae.…”

Sexually transmitted diseases in tropical Africa. A review of the present situation.

“…In Uganda, it has been reported that between 22%o and 30%o of gynaecological admissions were for acute PID. 8 The evidence available suggests that in tropical Africa there is a strong association between gonorrhoea and reproductive failure in both sexes.…”