Rapid Diagnosis of Chlamydial Infection in Young Women at Reproductive Age

Abstract

Aim: To determine the seroprevalence of Chlamydia trachomatis in a group of randomly selected pregnant women, using the ELISA IgG and IgM assays. The study included 88 married women whose age range was 19-38 years. This study was conducted in the Microbiology lab at Azadi Teaching Hospital from February 2009 to Dec 2009 in Duhok city. Two endocervical swabs were taken from each woman, the first to be examined as wet preparation stain to find bacteria, RBCs, epithelial cells, monilia, Trichomonas vaginalis, the second swab was used to examine for the presence of Chlamydia trachomatis antibodies by ELISA anti Chlamydia specific IgM, and anti Chlamydia specific IgG. The wet preparation examination of the swabs revealed Trichomonas vaginalis in 4 patients. Gram's stain revealed the presence of Gram positive Streptococci in 10 patients, Gram negative bacilli in 6 patients, and no bacteria was found in 45 patients. ELISA test to detect anti Chlamydia Antibodies (IgM), all the 88 examined women were negative. ELISA test to measure the anti Chlamydial antibodies (IgG) detect chronic infections and the results showed ten positive cases, 10/88 (11.3%). The age group of eight out of ten IgG positive cases is between 21-30 years old, for the remaining two cases is between 31-40 years old. Five of the IgG positive cases had history of ectopic pregnancies; another two had history of acute conjunctivitis in their newborn babies, while the remaining three had chronic infection and discharge. The results of this study revealed that the commercially available rapid test is of no value in detection of Chlamydia in endocervical swabs. The trend should be toward the substitution of this test by the direct immunoflourescence test. The nucleic acid amplification test which is highly sensitive should be used in future studies to detect the prevalence of Chlamydia infection.