Prevalence of chlamydia infection among patients with ectopic pregnancy and incomplete abortion at the Kenyatta National Hospital
Abstract
Background: Ectopic pregnancy is the leading acute gynaecological
emergency in Kenya. There has been an association between Chlamydia
infection and ectopic pregnancy.
Objective: To describe and compare the prevalence of Chlamydia infection
in patients with ectopic and incomplete abortion at the Kenyatta National
Hospital
Design: A case control study. The cases were patients with ectopic
pregnancy while the controls were those with incomplete abortion.
Setting: Acute gynaecological ward at the Kenyatta National Hospital.
Subjects: Patients with ectopic pregnancy and incomplete abortion. - Methods: A cervical swab was taken from a patient with an ectopic
pregnancy post-operatively. Another swab was taken from an age matched
client presenting at the acute gyna~cological ward with an incomplete
abortion. Detection of Chlamydia ,antig. ens in the samples was done through
rapid immunoassay using Diaspot! Chlamydia Rapid Test Device. Social
demographic profiles of the participants were also extracted using a
structured questionnaire.
Data management: Data was collected using a structured questionnaire by
the principal investigator. Data entry was done using Access database while
data analysis was done using the SPSS 12 for Windows programme.
Results: 40 participants were recruited wit'f, ectopic pregnancies and 40 with
incomplete abortions. The prevalence of Chlamydia was 8% (3/40) among
those with ectopic pregnancy and 3% (1/40) in those with incomplete
abortion. The difference was not statistically significant.
Discussion: Prevalence of Chlamydia infection was found to be lower than
expected in both cases and controls.
Conclusions and recommendations: Although not statistically significant,
prevalence of Chlamydia was 3 times greater among patients with ectopic
pregnancy than among those with incomplete abortion. Studies on other
causes of tubal damage leading to ectopic pregnancy should be done.
INTRODUCTION
Chlamydia trachomatis is an obligate intracellular bacterium that commonly
- attaches to columnar or transiti.ofl~1 epithelium. C. trachomatis infections are
an enormous public health problem throughout the world, accounting for
most bacterial sexually transmitted diseases. WHO estimated that there were
sixteen million new cases of chlamydia in sub-Saharan Africa in 1999.1 , . .
Although there are no recent global Chlamydia prevalence estimates country
data from US and UK suggest that the preva lence may have increased."
A study in women undergoing tubal ligation found chlamydia prevalence to be
14.9%,3 while 9 % of women aged 18 - 40 years attending an STD clinic in
Nairobi, were found to have Chlarnydia." Lagarde, et al in a multicenter study
in Kisumu, reported the prevalence of chlamydia to be 4.5% in women
selected from the general population.
Most pregnant women have asymptomatic infection but some present with
urethral syndrome, urethritis or Bartholins gland infection." Chlamydia
Citation
Master of Medicine degree in Obstetrics and GynaecologyPublisher
Department of Obstetrics and Gynaecology, University of Nairobi, Kenya