Prevalence of chlamydia infection using chlamydia antigen detection test and it’s predictive value in tubal disease among infertile women attending the gynaecological clinic of the Eku Baptist Hospital, Eku, Delta State, South south Nigeria

Abstract

Background and Objectives: Tubal disease is often associated with persistent chlamydia trachomatis infection. The objective detection of this infection depends on tissue culture which is time consuming and expensive. Serologic techniques for chlamydia detection have been documented. While this may be rapid, the sensitivity for detection of recent infection and prediction of tubal disease is low. This study uses chlamydia antigen to determine the prevalence of Chlamydia infection and the prediction of tubal disease amongst infertile women

Methods and Technique: This was a descriptive cross sectional study conducted from January-July 2015. A total 50 consenting patients who satisfied the inclusion criteria were examined for chlamydia infection using the chlamydia antigen detection test, a rapid test device, using rapid chromatographic immunoassay. Following  testing, the patients where werereferred for hysterosalpingogram (HSG) at the  radiology department of the hospital.

Results:Chlamydia infection was detected in 34% of the women. Majority (53%) of the affected patients were in the age range of 32-37 years.There was statistically significant relationship between parity, vaginal discharge and chlamydia infection with P-values of 0.024 and 0.0001 respectively. The test has a sensitivity of 80.5-100 and specificity of 64.5-93 for prediction of tubal obstruction. It’s positive predictive value for tubal disease is 51.5-90%.

Conclusion: There was high prevalence of Chlamydia infection in infertile women in this study, especially amongst Nullipara and those with vaginal discharge. The sensitivity of the Chlamydia antigen test in predicting tubal disease is high.

Key words: Chlamydia antigen, HSG, sensitivity, specificity, positive and negative
predictive value (PPV, NPV) tubal blockage