Sero-epidemiological assessment of Chlamydia trachomatis infection and sub-fertility in Samoan women.
BACKGROUND
In our recent village-based cross-sectional study, the prevalence of nucleic acid amplification technique (NAAT) diagnosed Chlamydia trachomatis (CT) in sexually active Samoan women was very high (36 %), and test positivity was associated with sub-fertility. We conducted a serological and epidemiological analysis in these participants to identify if serological data can provide further insight into the potential contribution of CT to sub-fertility in this population.


METHODS
Serological prediction of CT associated sub-fertility was conducted using a series of commercial tests. The correlation between fertility or sub-fertility, behavioral factors, and serologically predicted CT associated sub-fertility was determined.


RESULTS
A positive antibody reaction against the Chlamydia Major Outer Membrane Protein (MOMP) was significantly associated with sub-fertility, with 50 % of infertile women being positive. Serum IgG and IgA antibodies against MOMP correlated with current infection measured by urine NAAT, suggesting longer term infections are common in this population. Chlamydia pneumoniae antibodies were frequently detected in this population (84 %), and unexpectedly, were significantly associated with sub-fertility.


CONCLUSIONS
The high prevalence of chlamydial infection and of positive chlamydial sub-fertility results suggests that CT is an important and frequent contributory factor to sub-fertility in this population.
Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.
S
S
Menon
Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.
S H
SH
Stansfield
Centre for International Health, University of Otago, Dunedin, New Zealand.
M
M
Walsh
National University of Samoa, Apia, Samoa.
E
E
Hope
National Health Service Laboratory Division, Apia, Samoa.
L
L
Isaia
Centre for International Health, University of Otago, Dunedin, New Zealand.
A A
AA
Righarts
Samoa Family Health Association, Apia, Samoa.
T
T
Niupulusu
Centre for Samoan Studies, National University of Samoa, Apia, Samoa.
S V A
SV
Temese
Samoa National Council of Churches, Apia, Samoa.
L
L
Iosefa-Siitia
National University of Samoa, Apia, Samoa.
L
L
Auvaa
Samoa AIDS Foundation, Apia, Samoa.
S A
SA
Tapelu
Samoa National Council of Churches, Apia, Samoa.
M F
MF
Motu
Victoria University of Wellington, Wellington, New Zealand.
T
T
Suaalii-Sauni
Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Maroochydore, Australia.
P
P
Timms
Centre for International Health, University of Otago, Dunedin, New Zealand.
P C
PC
Hill
Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia. Wilhelmina.Huston@uts.edu.au.|School of Life Sciences, Faculty of Science, University of Technology Sydney, Broadway, Sydney, NSW, Australia. Wilhelmina.Huston@uts.edu.au.|School of Life Sciences, University of Technology Sydney, PO BOX 123, Broadway, Sydney, NSW, 2007, Australia. Wilhelmina.Huston@uts.edu.au.
W M
WM
Huston
D000293:Adolescent; D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood; D001425:Bacterial Outer Membrane Proteins / Q000276:immunology; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology; D002692:Chlamydia trachomatis / Q000235:genetics / Q000276:immunology / Q000378:metabolism; D003430:Cross-Sectional Studies; D004269:DNA, Bacterial / Q000235:genetics / Q000378:metabolism; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D007247:Infertility, Female / Q000175:diagnosis*; D016133:Polymerase Chain Reaction; D018947:Samoa / Q000453:epidemiology; D014930:Women; D055815:Young Adult
D000907:Antibodies, Bacterial; D001425:Bacterial Outer Membrane Proteins; D004269:DNA, Bacterial; D007070:Immunoglobulin A; D007074:Immunoglobulin G
Chlamydia; Pacific islands; diagnosis; female sub-fertility; samoa; serology