Prevalence of Specific Antibodies to Chlamydia Trachomatis Among Women on Routine Gynecological Visit to Jimma University Specialized Hospital, Jimma, South – West Ethiopia
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Date
2008
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Addis Ababa University
Abstract
Genital Chlamydia trachomatis infection is a key global issue facing women’s reproductive health. The worldwide prevalence of Chlamydia trachomatis genital infection (CTGI) is estimated to be 700 million, with highest prevalences in sub-Saharan Africa. To determine the prevalence of antibodies to genital Chlamydia trachomatis infection and to assess related socio-demographic and reproductive factors, 184 women routinely visiting the
gynecology out-patient department of Jimma University Specialized Hospital (JUSH) were investigated during March 2005 – February 2006. Specific IgG and IgM antibodies to Chlamydia trachomatis were detected using an Enzyme Linked Immunosorbent Assay (ELISA) system on 184 sera collected from these women. Socio-demographic information as well as gynecologic/reproductive information was collected by interviewing. Physical
examination was also done for the patients. Complete data were obtained for 184 women. The majority of the women (47.3%) were in the 20-29 year age group. The minimum age of the study participants was 12 years. The prevalence of antibodies showing exposure to genital Chlamydia trachomatis was: IgG 45.6% and IgM 5.4%. Seven women (3.8%) had positive serology for both IgG and IgM. Higher prevalence of IgG antibodies was found in women in the 20-29 year and 30-39 year age groups which was 21.7% and 12.5%, respectively, although the difference in the different age groups was not significant (p>0.05). Thirty-four percent of the study subjects had a history of one or more abortion, of whom 17.4% had positive IgG serology. The minimum and mean ages of the women at first sexual intercourse were 12 years and 16 years, respectively. Physical examination revealed no symptoms of reproductive tract infection (RTI), sexually transmitted infection (STI), urinary tract infection (UTI) or other gynecologic abnormalities in 19% of the women. Evidence of Chlamydial infection was found in half of the women who were asymptomatic. The majority of the women (81%) had either one or multiple symptoms on clinical evaluation. History of previous episodes of pelvic inflammatory disease (PID) was documented in 14 women, of whom 6 showed positive IgG serology. The most frequent complaints at presentation were: lower abdominal pain/tenderness (39%), vaginal discharge (32%) and vi vaginal bleeding (18.5%). Positive serology to Chlamydia trachomatis IgG antibodies was identified in 14.1% and 16.8% of all women with vaginal
discharge and lower abdominal pain, respectively. Thirty-five percent of the study subjects claimed to have had 2 or more sexual partners. Forty-nine percent of the women had their first sexual intercourse at an age of 12 – 16 years, of whom 23.4.8% had positive IgG serology. This study has highlighted high prevalence of antibodies to genital Chlamydia trachomatis and high frequency of behavioral and reproductive risk factors among the study
participants. Health care providers should be aware of the high prevalence of Chlamydial infection in women. Similar population-based studies of chlamydia prevalence should be conducted in different communities to elucidate the actual burden of the problem in Ethiopia and design intervention strategies.
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Keywords
Chlamydia trachomatis, Chlamydia trachomatis, IgG/IgM seroprevalence, ELISA, antibody index