• CHLAMYDIA TRACHOMATIS
• REPRODUCTIVE HEALTH
• WOMEN
• INFERTILITY

Chlamydia trachomatis infections are recognised to be one of the causes of infertility in women; moreover, it is a cause that health services are able to do something about. So, in contexts of high infertility, establishing chlamydia (CT) prevalence can be a powerful argument in favour of prioritising interventions such as routine screening and treatment of high-risk women.

In view of this, a team of researchers from Bugando Weill School of Medicine in Mwanza, Tanzania, conducted a cross-sectional hospital-based study of infertile women in Mwanza between November 2015 and April 2016 to determine the importance of CT. Endocervical swabs were taken from 290 infertile women (mean age: 32±6.6 years), and testing was performed using chlamydia rapid antigen test (Innovation Biotech, Beijing, China), with a sensitivity and specificity against PCR of 87.5% and 96.5%, respectively.

The prevalence of CT was 105/290 (36.21%, 95% CI 30.6 to 41.7). This was significantly higher than prevalence among adolescent girls (p<0.001) in the same setting detected in a previous study.1 Moreover, CT was more strongly associated with primary (45/104, 43.3%) than with secondary (60/186, 32.2%) infertility. The difference of prevalence between the two studies suggests that CT is an important factor in infertility, while the association with primary infertility indicates that it is affecting women at a relatively young age. Other factors found to predict CT when adjusted for age, residence and education were the following: sexual partners (adjusted OR (AOR): 1.2, 95% CI 1.019 to 1.415, p=0.028); history of STI (AOR: 6.39, 95% CI 3.244 to 12.596, p<0.001); positive HIV status (AOR: 2.08, 95% CI 1.286 to 3.373, p=0.003).

We conclude that the prevalence of CT among infertile women in Mwanza is high. In our view, we have a strong case for introducing a policy of routine screening and treatment for high-risk women to alleviate the consequences of the infection.