Screening for Chlamydia trachomatis in Egyptian women with unexplained infertility, comparing real-time PCR techniques to standard serology tests: case control study

Abdella, Rana; Abdelmoaty, Hatem I.; Elsherif, Rasha; Sayed, Ahmed El; Sherif, Nadine Alaa; Gouda, Hisham M.; Lithy, Ahmed El; Almohamady, Maged; Abdelbar, Mostafa F.; Hosni, Ahmed Naguib; Magdy, Ahmed; Ma, Yu

doi:10.1186/s12905-015-0202-5

Cited by 14 publications

(8 citation statements)

References 32 publications

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“…This finding needs to be interpreted with caution. In line with previous evidence ( Abdella et al, 2015 ), this may be due to the small numbers of patients who were adequately investigated for sexually transmitted diseases [STDs]. This revealed that the prevalence of STDs, such as genital Chlamydial infection in many developing countries lacks the reliable estimates due to limitations in diagnostic and treatment programs.…”

Section: Discussionsupporting

confidence: 77%

Evaluation of hysterosalpingographic findings among patients presenting with infertility

Toufig

Benameur

Twfieg

et al. 2020

Saudi Journal of Biological Sciences

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Background Infertility is a global health issue and hysterosalpingography (HSG) is a valuable radiological tool in infertility workup and remains a main modality for investigating female infertility. However, the HSG findings of infertility are not the same worldwide. This study aimed at evaluating the incidence of HSG findings in patients investigated for primary and secondary infertility, correlating these findings with their clinical data that reflect the infertility causes and comparing the findings with previous international studies. Methods A prospective descriptive study of 75 female patients referred, as cases of infertility, for HSG examination in Elrebat Hospital and Khartoum Advanced Diagnostic Center. HSG was performed in the first half of the cycle. The procedure and its complications, were explained to the patients and informed consents were obtained. Patients with active pelvic infection and active uterine or vaginal bleeding were excluded from the study. Using aseptic technique and with proper patient’s positioning, iodinated contrast was introduced into the cervix under fluoroscopic monitoring, to demonstrate the uterine cavity, fallopian tubes and free spillage into the peritoneal cavity. Personal data, clinical data and HSG findings were analyzed using SPSS version 23. Results The commonest age group seen was 26–36 years. Close incidences of primary and secondary infertility were detected. 52.7% had abnormal findings in HSG. Tubal pathology (42.7%) being the most common abnormality, followed by uterine and combined abnormalities. There was strong association between past medical history suggesting pelvic inflammatory disease (PID) or past history suggesting tubal blockage secondary to abdominopelvic surgery and tubal abnormalities. Conclusion HSG examinations revealed that the most common abnormality was tubal blockage possibly complicating PID and abdominopelvic surgeries. This reflects the HSG diagnostic and therapeutic role in the assessment of female infertility and the further needs for more preventive measures targeting the reduction of tubal pathologies in developing countries.

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Section: Discussionsupporting

confidence: 77%

Evaluation of hysterosalpingographic findings among patients presenting with infertility

Toufig

Benameur

Twfieg

et al. 2020

Saudi Journal of Biological Sciences

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“…The rates of C. trachomatis infection vary in different studies depending on the group of patients recruited and the study region. For example, a study using 50 infertile female patients showed a 40 % infection rate by C. trachomatis [ 18 ] whereas other studies reported only a 8 % [ 19 ] or 15 % C. trachomatis infection rate. Among patients with tubal infertility, the prevalence of C. trachomatis was reported to be 38.3 % among 120 patients [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of plasmid-bearing and plasmid-free Chlamydia trachomatis infection among women who visited obstetrics and gynecology clinics in Malaysia

et al. 2016

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BackgroundThe 7.5 kb cryptic plasmid of Chlamydia trachomatis has been shown to be a virulence factor in animal models, but its significance in humans still remains unknown. The aim of this study was to investigate the prevalence and potential involvement of the C. trachomatis cryptic plasmid in causing various clinical manifestations; including infertility, reproductive tract disintegrity, menstrual disorder, and polycystic ovarian syndrome (PCOS) among genital C. trachomatis–infected patients.ResultsA total of 180 female patients of child bearing age (mean 30.9 years old, IQR:27–35) with gynecological complications and subfertility issues, who visited Obstetrics and Gynecology clinics in Kuala Lumpur, Malaysia were recruited for the study. Prevalence of genital chlamydial infection among these patients was alarmingly high at 51.1 % (92/180). Of the 92 chlamydia-infected patients, 93.5 % (86/92) were infected with plasmid-bearing (+) C. trachomatis while the remaining 6.5 % (6/92) were caused by the plasmid-free (−) variant. Our data showed that genital C. trachomatis infection was associated with infertility issues, inflammation in the reproductive tract (mucopurulent cervicitis or endometriosis), irregular menstrual cycles and polycystic ovarian syndrome (PCOS). However, no statistical significance was detected among patients with plasmid (+) versus plasmid (−) C. trachomatis infection. Interestingly, plasmid (+) C. trachomatis was detected in all patients with PCOS, and the plasmid copy numbers were significantly higher among PCOS patients, relative to non-PCOS patients.ConclusionOur findings show a high incidence of C. trachomatis infection among women with infertility or gynecological problems in Malaysia. However, due to the low number of plasmid (−) C. trachomatis cases, a significant role of the plasmid in causing virulence in human requires further investigation of a larger cohort.

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“…Medical Education (2008) 67 Gdoura et al (2008) 178 Sadrpour et al (2013) 164 Al-Sweih et al (2012) 100 Ahmadi et al (2018) 49 Golshani et al (2007) 155 Dehghan et al (2017) 57 Moazenchi et al 2018159 Total Random effects model Heterogeneity: 93 Al-Ramahi et al (2008) 93 Joolayi et al (2017) 62 Al-Ramahi et al (2008) 93 Rashidi et al (2013) 71 Ahmed (2012) 167 Abdella et al (2015) 144 Hajikhani et al (2013) 156 Al-Ramahi et al (2008) 93 Joolayi et al (2017) 62 Mohammed et al (2017) 90 Siam and Hefzy (2012) 151 Kalantar et al (2007) 157 Gdoura et al (2001b) 177 Alfarraj et al (2015) 174 Dawood (2011) 169 Elkayal et al (2015) 146 Goshayeshi et al (2015) 58 Nada et al (2015) 45 Mousavi et al (2014) 69 Mansour Ghanaie (2014) 158 Marashi et al (2014) 66 Rashidi et al (2013) 71 Dehghan et al (2017) 57…”

Section: Prevalence (95% Ci)mentioning

confidence: 99%

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

The Lancet Global Health

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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.

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Screening for Chlamydia trachomatis in Egyptian women with unexplained infertility, comparing real-time PCR techniques to standard serology tests: case control study

Cited by 14 publications

References 32 publications

Evaluation of hysterosalpingographic findings among patients presenting with infertility

Evaluation of hysterosalpingographic findings among patients presenting with infertility

Prevalence of plasmid-bearing and plasmid-free Chlamydia trachomatis infection among women who visited obstetrics and gynecology clinics in Malaysia

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

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