Chronic Chlamydia pneumoniae infection and stroke in Cameroon: a case-control study.
OBJECTIVE
To determine the relationship between chronic Chlamydia pneumoniae infection and stroke in Cameroon.


METHODS
Sixty-four consecutive stroke patients 26 to 80 years of age were enrolled at 2 tertiary hospitals in Yaoundé, Cameroon, between March 2000 and December 2001 and matched for age and sex to 64 controls. We measured IgG (1/64) and IgA (1/16) titers against C pneumoniae in both patients and controls using a validated microimmunofluorescence technique.


RESULTS
There was no significant difference between cases and controls with respect to hypertension (P=0.2), smoking (P=0.53), alcohol intake (P=0.8), body mass index (P=0.49), waist-to-hip ratio (P=0.14), and diabetes (P=0.76). IgA antibodies were detected in 50 (78.1%) patients and 27 (42.2%) controls (odds ratio [OR] 4.29; 95% CI, 1.84 to 11.56; P=0.0002), and IgG antibodies in 41 (64.1%) patients and 35 (54.7%) controls (OR, 1.46; 95% CI, 0.68 to 3.22; P=0.29). For confirmed thrombotic stroke, the association with IgA antibodies became stronger (OR, 21.0; 95% CI, 3.38 to 868.45; P<0.0001), but there was still no association with IgG antibodies (OR, 1.86; 95% CI, 0.69 to 5.50; P=0.18).


CONCLUSIONS
Our study shows a strong statistical association between (IgA, and not IgG, as a serological marker of) chronic C pneumoniae infection and stroke for the first time in a resident indigenous African population. These findings, if confirmed, may have important policy implications (in terms of antibiotic use in stroke prevention) in sub-Saharan Africa.
Njamnshi
Alfred K
AK
Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Cameroon.
Blackett
Kathleen Ngu
KN
Mbuagbaw
Josephine N
JN
Gumedze
Freedom
F
Gupta
Sandeep
S
Wiysonge
Charles S
CS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000378:metabolism; D015992:Body Mass Index; D001921:Brain / Q000473:pathology; D002163:Cameroon; D016022:Case-Control Studies; D023521:Chlamydophila Infections / Q000150:complications*; D016993:Chlamydophila pneumoniae / Q000378:metabolism*; D006801:Humans; D007070:Immunoglobulin A / Q000378:metabolism; D007074:Immunoglobulin G / Q000378:metabolism; D008856:Microscopy, Fluorescence; D008875:Middle Aged; D015233:Models, Statistical; D016017:Odds Ratio; D012307:Risk Factors; D020521:Stroke / Q000097:blood* / Q000150:complications* / Q000473:pathology / Q000628:therapy; D013927:Thrombosis
D000907:Antibodies, Bacterial; D007070:Immunoglobulin A; D007074:Immunoglobulin G