title: Chlamydial infection in a population of Ethiopian women attending obstetric, gynaecological and mother and child health clinics.
abstract: The prevalence of chlamydial infection was assessed in 1,846 Ethiopian women attending clinics in Addis Ababa. Sera were tested for type-specific anti-chlamydial antibodies using purified chlamydial antigens (C. trachomatis A-C (CTA-C), C. trachomatis D-K (CTD-K), Lymphogranuloma venereum (LGVI-3), and C. pneumoniae (CPn), in a micro-immunofluorescence (micro-IF) test. Three levels of chlamydial infection were established. Sera with: 1) antibodies to CTA-C, CTD-K, LGV 1-3 and CPn singly or in combination, are considered as evidence of overall exposure to chlamydial species (OEC); 2) antibodies to CTD-K and LGV 1-3 are considered as evidence of exposure to genital chlamydial pathogens (GENCI); 3) IgM titre > or = 1/8, or Ig G titre > or = 1/64 to CTD-K and LGV 1-3 alone or at a similar level with antibodies to CTA-C and CPn is considered as being evidence of active genital chlamydial infection (AGCI). OEC was found in 84 pc, GENCI in 60 pc and AGCI in 42 pc. Infection was highest in family planning and lowest in antenatal clinic attenders. OEC increased progressively with age while GENCI and AGCI peaked at ages 35 to 49. Chlamydial infection was highest in those married and sexually active < 13 years of age (OEC 88 pc, GENCI 69 pc, AGCI 49 pc); the lowest income groups (OEC 85 pc, GENCI 65 pc, AGCI 45 pc); those with more than five sexual partners (OEC 92 pc, GENCI 78 pc and AGCI 65 pc); with highest prevalence in bargirls (OEC 97 pc, GENCI 84 pc, AGCI 75 pc). Fifty pc had clinical evidence of past or present infection in the urethra, salpinges or bartholin glands (USB). OEC, GENCI and AGCI were associated with PID. The association of seropositivity with USB was remarkably similar for both gonorrhoea and chlamydial infection: we recommend adoption of a treatment regimen effective for both infections. The micro-IF test is a useful epidemiological tool for identifying the of antibodies to chlamydial pathogens. Use of antigen pools CTA-C, CTD-K LGVI-3 and CPn enables a distinction to be made between genital and non-genital infections. The problem of symptomatic and asymptomatic chlamydial disease needs to be addressed urgently.
authors.affiliation: Department of Medical Microbiology, University of Edinburgh, Scotland, UK.
authors.forename: M E
authors.initials: ME
authors.lastname: Duncan
authors.forename: Y
authors.initials: Y
authors.lastname: Jamil
authors.forename: G
authors.initials: G
authors.lastname: Tibaux
authors.forename: A
authors.initials: A
authors.lastname: Pelzer
authors.forename: L
authors.initials: L
authors.lastname: Mehari
authors.forename: S
authors.initials: S
authors.lastname: Darougar
mesh_terms: D000293:Adolescent; D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood*; D002690:Chlamydia Infections / Q000453:epidemiology* / Q000276:immunology / Q000382:microbiology; D002692:Chlamydia trachomatis / Q000276:immunology; D016993:Chlamydophila pneumoniae / Q000276:immunology; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006801:Humans; D008430:Maternal-Child Health Centers; D008875:Middle Aged; D011159:Population Surveillance; D015995:Prevalence; D016036:Seroepidemiologic Studies
chemical_list: D000907:Antibodies, Bacterial