GenitalChlamydia trachomatisandNeisseria gonorrhoeaeinfections among women in sub-Saharan Africa: A structured review

Abstract

Chlamydia trachomatis and Neisseria gonorrhoeae constitute major public health problems among women, but the burden of infection in sub-Saharan Africa is poorly documented. We conducted a structured review of the prevalence and incidence of genital, oral and anal C. trachomatis and N. gonorrhoeae infection in women in sub-Saharan Africa. We searched Medline, EMBASE and Web of Science over a 10-year period for studies on epidemiology of genital, oral and anal chlamydial infection and gonorrhoea in women in all countries of sub-Saharan Africa. We assessed geographic and demographic differences in prevalence and incidence of infection; weighted mean prevalence estimates were calculated with a random-effect model. A total of 102 study results were included, with data available for 24/49 of sub-Saharan countries. The weighted prevalence of chlamydial infection was lower among women in community-based studies (3.9%; 95% CI: 2.9-5.1%) than for women recruited at primary healthcare facilities (6.0%; 95% CI: 4.2-8.4%, p < 0.001); the same was observed for gonorrhoea (2.2%; 95% CI: 1.2-4.0% vs. 4.2%; 95% CI: 3.2-5.6%, p < 0.001). Prevalence of Chlamydia among sex workers was 5.5% (95% CI: 4.2-7.3%) and gonorrhoea 7.6% (95% CI: 5.4-11%). Seven studies reported on incidence which varied between 0.75-28 and 2.8-17 per 100 person-years-at-risk for chlamydial infection and gonorrhoea, respectively. Only two studies reported on anal infections and one on oral infection. This overview underscores the considerable incidence and prevalence of genital C. trachomatis and N. gonorrhoeae in women in different settings in sub-Saharan Africa. Better control strategies are warranted to reduce the burden of infection and to prevent long-term complications of these infections.

Prevalence and Risk factors of Infertility in a Mongolian Population

“…Infertility in a population in Ulaanbaatar, and four regions of Mongolian was 7.2% and this is in agreement with similar studies from around the world that had a median infertility prevalence ranging from 6.9% to 9.3% [4] (Table 6). A population-based study conducted in our neighboring country China, had a prevalence of 15.5% [13]. Some nations or regions had a high prevalence of infertility such as Iran (17.3%) [14,15], Western Siberia (16.7%) [16], and Australia (17.3%) [17].…”

Serological and PCR-based markers of ocular Chlamydia trachomatis transmission in northern Ghana after elimination of trachoma as a public health problem

“…Another difficulty in interpreting the serological data is that antibodies to Pgp3 do not distinguish between urogenital and ocular infection, and Ct exposure could have occurred at birth through ocular or respiratory infection from a mother with genital Ct [61]. This is an important consideration, however, although there is a paucity of data on the prevalence of sexually transmitted infections in Ghana, where it is documented it is reported to be relatively low [62–64] and urogenital Ct infection is not believed to be high in the Northern and Upper West regions of the country. If vertical transmission was a major driver of antibody acquisition, then it could be expected that the gradient of the age seroprevalence curve would be flat or even negative with increasing age [38].…”

Prevalence and Risk factors of Infertility in a Mongolian Population

“…Infertility in a population in Ulaanbaatar, and four regions of Mongolian was 7.2% and this is in agreement with similar studies from around the world that had a median infertility prevalence ranging from 6.9-9.3% [4] (Table 6). A population-based study conducted in our neighboring country China, had a prevalence of 15.5% [13]. Some nations or regions had a high prevalence of infertility such as Iran (17.3%) [14,15], Western Siberia (16.7%) [16], and Australia (17.3%) [17].…”