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High prevalence of Chlamydia trachomatis infection among infertile women in Mwanza city, Tanzania: a need to introduce screening and treatment programme
  1. Mansour Y Ramadhani1,
  2. Mariam M Mirambo2,
  3. Happiness Mbena1,
  4. Albert Kihunrwa1,
  5. Stephen E Mshana2
  1. 1 Department of Obstetrics and Gynaecology, Weill Bugando School of Medicine, Mwanza, Tanzania
  2. 2 Department of Microbiology and Immunology, Weill Bugando School of Medicine, Mwanza, Tanzania
  1. Correspondence to Dr Mariam M Mirambo, Department of Microbiology and Immunology Department, Weill Bugando School of Medicine, P. O. Box 1464, Mwanza, Tanzania; mmmirambo{at}

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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.



  • Contributors MMM, AK and SEM participated in the design of the study. MYR, AK and HM enrolled participants, collected specimens and clinical data and performed the tests. MMM and SEM analysed and interpreted the data. MMM and SEM wrote the first draft of the manuscript. All authors read and approved the final version of the manuscript.

  • Competing interests None.

  • Ethics approval The Joint Catholic University of Health and Allied Sciences/Bugando Medical Centre (CUHAS/BMC) research ethics and review committee (CREC number CREC/096B/2015).

  • Provenance and peer review Not commissioned; internally peer reviewed.