title: Association of Chlamydia trachomatis serology with tubal infertility in Nigerian women.
abstract: OBJECTIVE
  To determine the association between tubal infertility and Chlamydia trachomatis in Nigerian women.
  
  
  METHODS
  This case-control study is from the Departments of Obstetrics and Gynecology of two tertiary hospitals in Nigeria. One hundred and sixty-two infertile patients with tubal occlusion had 162 pregnant women matched for age as controls. Information on sociodemographic variables, sexual and reproductive risk factors, and history of previous pelvic infections were elicited using a study protocol. The prevalence of Chlamydia Trachomatis antibody was determined for cases and controls.
  
  
  RESULTS
  The prevalence of serum Chlamydia antibody was significantly higher in cases (65.8%) compared with controls (17.3%; P < 001). The effects of Chlamydia antibodies on infertility were strengthened in the multivariate model controlling for Chlamydia antibodies and gynecologic symptoms, compared to the univariate model. However, the association was attenuated and non-significant when the effects of gynecologic symptoms, sociodemographic characteristics, contraceptive and sexual history were controlled in the conditional logistic regression model. The strongest independent predictors of infertility in the model were vaginal discharge, education less than tertiary and more than three lifetime sexual partners (proxies of sexually transmitted infections).
  
  
  CONCLUSIONS
  There was no strong independent association between Chlamydia antibodies and the risk of being infertile in Nigerian women. By contrast, the proxies of sexually transmitted infections were significant predictors of infertility in the women. Efforts to address these factors, which are proxies of sexually transmissible infections, Chlamydia infection, and health-seeking behavior for these infections, will likely contribute to reducing the burden of infertility in Nigerian women.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Clinical Medicine, College of Medical Sciences, Delta State University, Abraka, Nigeria. eguono_2000@yahoo.com
authors.forename: Lawrence O
authors.initials: LO
authors.lastname: Omo-Aghoja
authors.forename: Friday E
authors.initials: FE
authors.lastname: Okonofua
authors.forename: Samson O
authors.initials: SO
authors.lastname: Onemu
authors.forename: Ulla
authors.initials: U
authors.lastname: Larsen
authors.forename: Staffan
authors.initials: S
authors.lastname: Bergstrom
mesh_terms: D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood; D016022:Case-Control Studies; D002690:Chlamydia Infections / Q000097:blood / Q000150:complications* / Q000382:microbiology; D002692:Chlamydia trachomatis / Q000254:growth & development*; D005184:Fallopian Tube Diseases / Q000097:blood / Q000382:microbiology*; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000097:blood / Q000382:microbiology*; D008297:Male; D009549:Nigeria; D011247:Pregnancy; D014505:Urban Population
chemical_list: D000907:Antibodies, Bacterial