The prevalence and outcome of asymptomatic chlamydial infection screening among infertile women attending gynecological clinic in ibadan, South west Nigeria.
BACKGROUND
Chlamydial trachomatis infection is the most common cause of tubal infertility among women world-wide. Serological diagnosis of Chlamydial infection that may suggest previous, persistent or on-going infection is now incorporated into routine pre-treatment evaluation of infertile women including assisted conception.


OBJECTIVE
The aim of this study is to determine the prevalence and predictors of asymptomatic Chlamydial infection screening among infertile women and also to compare the screening outcome with findings on hysterosalpingogram (HSG).


METHODS
This was an observational study conducted among 132 infertile women that were attending Adeoyo Maternity Hospital Ibadan. A total volume of 2-3 ml of venous blood was collected for Chlamydia serology using ImmunoComb Bivalent immunoglobulin G kit (Code 50416002) and the results were compared with their HSG. Other information collected was socio-demographics and clinical parameters. Descriptive, bivariate and multivariate tests were performed using Statistical Package for the Social Sciences 15.0 (Chicago, IL USA) and statistical significance was set at (P < 0.05).


RESULTS
A total of 130 women were studied with a mean age of 31.6 years (standard deviation = 4.7). Majority - 72.0% (95/132) - had been infertile for 5 years or less. The prevalence of Chlamydial trachomatis was 20.5% (27/132). Bivariate analysis between the biosocial variables and serology result showed a significant association with education (P < 0.01) and religion (P < 0.01). Logistic regression analysis revealed that Muslim women were 3.6 times more likely than Christians to have positive Chlamydial serology result (95% confidence interval odds ratio = 1.18-11.11). Of those with HSG result (64), the accuracy of the test kit showed low sensitivity - 44.2% (19/43) and negative predictive value 40.0% (16/40) (but, high specificity - 76.2%(16/21), and positive predictive value - 79.2% (19/24).


CONCLUSIONS
Asymptomatic Chlamydial infection is common among infertile women and it positively predict HSG blockage. The serological test may prove invaluable in predicting the presence of tubal blockage; therefore, prophylactic antibiotics may be justified to be included in their care.
Department of Obstetrics and Gynecology, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria.
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Morhason-Bello
Department of Obstetrics and Gynecology, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria ; Center for Population and Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria.
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Ojengbede
Department of Obstetrics and Gynecology, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria.
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Oladokun
Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria.
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Adedokun
Nordica Fertility Centre, Lagos State, Nigeria.
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Ajayi
Adeoyo Maternity Hospital, Yemetu, Ibadan, Oyo State, Nigeria.
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Adeyanju
Nordica Fertility Centre, Lagos State, Nigeria.
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Ogundepo
Department of Nuclear Medicine, University College Hospital, University of Ibadan, Ibadan, Oyo State, Nigeria.
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Kareem
Africa; Chlamydial infection; Infertile women