Relationship between serum Chlamydia trachomatis antibody titer and tubal block in infertile Egyptian women

Oppong

Intl J Gynecology & Obste

2019

Objective To determine the prevalence of Chlamydia trachomatis infection and the correlates of tubal pathology among Ghanaian women undergoing hysterosalpingography for suspected tubal factor infertility. Methods A cross‐sectional study was conducted among 189 women with infertility who underwent hysterosalpingography at Korle Bu Teaching Hospital, Ghana, from September 1 to November 30, 2016. Demographic data; obstetric and gynecologic history; and hysterosalpingography findings were collected using a structured questionnaire. Endocervical swabs were tested for the presence of Chlamydia trachomatis using a rapid antigen‐based diagnostic kit. Associations between the variables were assessed using bivariate analysis. Results Positive test results for Chlamydia trachomatis were recorded among 15 participants, giving an overall prevalence of 7.9% (95% confidence interval [CI] 4.1%–11.7%). In all, 67 (35.4%) participants had abnormal findings on hysterosalpingography, with 40 (21.2%) displaying bilateral tubal occlusion. The remaining 122 (64.6%) women had normal findings on hysterosalpingography. Eight participants with normal tubal appearance tested positive for Chlamydia trachomatis (prevalence 6.6%, 95% CI 2.2%–11.0%), whereas seven participants with abnormal tubal appearance tested positive (prevalence 10.4%, 95% CI 3.1%–17.7%; P=0.402). No associations were found between participant characteristics and tubal pathology. Conclusion The prevalence of Chlamydia trachomatis did not differ by hysterosalpingography findings.

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Chlamydia trachomatisinfection among Ghanaian women undergoing hysterosalpingography for suspected tubal factor infertility

Oppong

Intl J Gynecology & Obste

2019

The Lancet Global Health

Epidemiology of Chlamydia trachomatis in the Middle East and north Africa: a systematic review, meta-analysis, and meta-regression

Smolak

Chemaitelly

Hermez

et al. 2019

Background The epidemiology of Chlamydia trachomatis in the Middle East and north Africa is poorly understood. We aimed to provide a comprehensive epidemiological assessment of C trachomatis infection in the Middle East and north Africa. Methods We did a systematic review of C trachomatis infection as well as a meta-analysis and meta-regression of C trachomatis prevalence. We searched PubMed and Embase, as well as regional and national databases up to March 13, 2019, using broad search terms with no language or year restrictions. Any document or report including biological measures for C trachomatis prevalence or incidence was eligible for inclusion. We extracted all measures of current (genital or rectal), recent, and ever infection with C trachomatis. We estimated pooled average prevalence in different populations using random-effects meta-analysis. Factors associated with prevalence and sources of betweenstudy heterogeneity were determined using meta-regression. Findings We identified a total of 1531 citations, of which 255 reports contributed to 552 C trachomatis prevalence measures from 20 countries. No incidence measures were identified. Pooled prevalence of current genital infection was 3•0% (95% CI 2•3-3•8) in general populations, 2•8% (1•0-5•2) in intermediate-risk populations, 13•2% (7•2-20•7) in female sex workers, 11•3% (9•0-13•7) in infertility clinic attendees, 12•4% (7•9-17•7) in women with miscarriage, 12•4% (9•4-15•7) in symptomatic women, and 17•4% (12•5-22•8) in symptomatic men. Pooled prevalence of current rectal infection was 7•7% (4•2-12•0) in men who have sex with men. Substantial between-study heterogeneity was found. Multivariable meta-regression explained 29•0% of variation. Population type was most strongly associated with prevalence. Additional associations were found with assay type, sample size, country, and sex, but not with sampling methodology or response rate (about 90% of studies used convenience sampling and >75% had unclear response rate). There was no evidence for temporal variation in prevalence between 1982 and 2018. Interpretation C trachomatis prevalence in the Middle East and north Africa is similar to other regions, but higher than expected given its sexually conservative norms. High prevalence in infertility clinic attendees and in women with miscarriage suggests a potential role for C trachomatis in poor reproductive health outcomes in this region.

Chlamydia trachomatis seropositivity among women with tubal factor infertility and fertile controls: a comparative study

Odelola¹,

Akadri²

2023

Pan Afr Med J

Introduction Chlamydia trachomatis is the most reported bacterial sexually transmitted infection and if not properly treated may lead to tubal blockage. Tubal factor infertility is the most common form of infertility in Nigeria. This study was designed to determine the usefulness of chlamydia antibody testing in diagnosis of tubal factor infertility. Methods this was a comparative cross-sectional study conducted in Olabisi Onabanjo University Teaching Hospital Sagamu. One hundred and forty-seven women with tubal blockage on hysterosalpingography and confirmed with laparoscopy, and pregnant control were recruited using convenience sampling method. Information obtained and chlamydia assay results were entered into a computer and analyzed using SPSS version 21. Chi-square was used to determine association between categorical variables. Logistic regression analysis was used to determine the risk factors associated with chlamydia infection. Results ninety-four (63.9%) of the women with tubal factor infertility were positive for chlamydia IgG antibodies while 37(25.2%) women in the control group had positive results for IgG antibody. This was statistically significant (P=0.001). Analysis using multivariate logistic regression shows early age of coitarche, presence of multiple sexual partners and previous sexually transmitted infection were significantly associated with chlamydia infection (P=0.001). Conclusion there was a strong association between chlamydia seropositivity and tubal blockage. Early age at coitarche, previous sexually transmitted infection and multiple sexual partners are significant risk factors for chlamydial infection. Chlamydia trachomatis antibody testing could be used as marker for tubal blockage when evaluating infertile patient.