Association between serum chlamydial antibody levels and tubal infertility in tertiary health facility in South-East Nigeria: a case-control study.

Augustine D Onyeabochukwu,Chukwunonyerem P Duke-Onyeabo,Chiemeka C Onumajuru,Uchenna T Ejelonu,Emmanuel O Izuka,Chinelo E Obiora-Izuka,Onyema A Onyegbule,Uchenna I Nwagha

doi:10.4314/gmj.v55i3.2

Abstract

This study evaluates the association between genital Chlamydial infection and tubal factor infertility in a tertiary health facility in South-East Nigeria. This was a case-control analytical study. Gynaecology Clinic and Maternity Unit of the Department of Obstetrics and Gynaecology of the Federal Medical Centre (FMC), Owerri, Imo State, Nigeria. Ninety-six (96) women with confirmed tubal factor infertility served as the cases, and 96 women with normal intra-uterine pregnancy matched in age served as the control. A structured questionnaire was used to extract information on the sociodemographic data and the sexual history of the participants. About 2mls of blood was collected, the blood was allowed to clot, and the sera were used for the test. Pearson Chi-square, Fisher's exact test, likelihood ratio and multivariate logistic regression were used to determine risk associations and identify factors independently related to tubal factor infertility. P-value < 0.05 was considered significant. The sociodemographic characteristics of both cases and control did not differ (P = 0.975). The Chlamydial antibody seropositivity was significantly higher in the cases than the control 78(81.2%) versus 13(13.5%) respectively {(P < 0.001; OR (95% CI) = 27.7(12.7-60.2)}. Only lower abdominal pain {(P = 0.011); OR (95% CI) = 4.3(1.4-13.3)}; was independently associated with tubal factor infertility. Tubal factor infertility is strongly associated with chlamydial IgG antibodies, and a history of lower abdominal pain significantly predicted tubal factor infertility. The authors paid the cost of procuring the anti-chlamydial ELIZA test kits, plain sample bottles, syringes, gloves and other consumables and stationaries.

Highlights

Despite the high fertility rates and “high rates of pregnancy wastages” in sub-Saharan Africa, infertility was recently described as rampant
This finding agrees with the report of other studies which showed that women with tubal factor infertility are more likely to have chlamydial immunoglobin G antibodies when compared with pregnant women without tubal blockage,[10,19,20,21] emphasizing the role of past genital Chlamydia trachomatis infection on tubal damage
Olaleye O et al found that 65.7% of those with tubal infertility were positive while only 10.8% of those without tubal damage were positive for chlamydial immunoglobulin G (IgG) antibody.[21]

Summary

Introduction

Despite the high fertility rates and “high rates of pregnancy wastages” in sub-Saharan Africa, infertility was recently described as rampant. It constituted a severe social problem in this part of the world.[1] This may not be unconnected because a high premium is placed on childbearing, and any childless woman is seen as not being a real woman on the African continent. In Sub-Saharan Africa, infertility is the commonest reason for a consultation in a Gynaecological clinic, and tubal factor is the commonest cause of infertility in this sub-region.[2,5,6] www.ghanamedj.org Volume 55 Number 3 September 2021. Chlamydia trachomatis infection is the most common bacterial sexually transmitted infection.[7,8] Tubal disease from Chlamydia trachomatis infection occurs because of repeated infections of the upper genital tract, usually subclinical[6,9] and asymptomatic

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Methods

Conclusion