Chlamidia trachomatis infection in an infertile population, a cross sectional study

Abstract

INTRODUCTION: Chlamydia trachomatis is sexually transmitted and causes infection of the genital tract that leads to many long term complications. Invasive procedures in infected infertile females increase the risk of ascending infection and long term consequences. Though infertile individuals are considered a high risk population prevalence data for our population is not available. Furthermore, the use of risk factor identification in diagnosis is not well established. This study was planned to determine the prevalence of Chlamydia infection and to describe the socio-economic clinical characteristics that are associated with the presence of infection among a patient population who sought treatment for infertility at a tertiary care facility. METHOD: A cross sectional study was carried out among patients who sought infertility treatment at the infertility clinic of Colombo North Teaching Hospital, Ragama. Two hundred married couples were included in the study. The socio-economic data and any symptoms suggestive of genital infections were collected and Chlamydia trachoma tis infection was diagnosed with a rapid antigen test using a commercial test kit. Intracervical swabs of the female and first void urine samples of the male were used. Data analysis was done to describe the prevalence of Chlamydia infection in each partner as well as to identify the number of couples where either partner was affected. Associations with recognized risk factors were identified. RESULTS: Presence of symptoms was low in the males while one third of female subjects had one or more symptoms. The Chlamydia test revealed 12(6%) female and 6(3%) male study participants to be positive for current disease. These study participants were from 15 couples giving a prevalence rate of either partner being positive in 7.5% of couples. Of the risk factors identified the duration of marriage or infertility, education level, household income, alcohol use and smoking by the male, and presence of symptoms did not demonstrate a significant association with the presence of the disease. Partners staying away from each other were significantly associated with a positive result. CONCLUSION: There is 7.5% disease prevalence among infertile couples seeking treatment. Risk assessment and clinical symptoms have a limited value in identification of affected couples. Couples living separately have a high risk of Chlamydia infection. The high disease prevalence warrants either screening or empirical treatment of all infertile female patients undergoing invasive procedures.