Ghent University Academic Bibliography

Advanced

Chlamydia trachomatis infection in fertile and subfertile women in Rwanda: prevalence and diagnostic significance of IgG and IgA antibodies testing

Mambo-Claude Muvunyi UGent, Nathalie Dhont UGent, Rita Verhelst UGent, Marleen Temmerman UGent, Geert Claeys UGent and Elizaveta Padalko UGent (2011) HUMAN REPRODUCTION. 26(12). p.3319-3326
abstract
BACKGROUND: In many developing countries, little is known about the prevalence of genital Chlamydia trachomatis infections and complications, such as infertility, thus preventing any policy from being formulated regarding screening for C. trachomatis of patients at risk for infertility. The objective of the present study was to determine the prevalence of C. trachomatis and evaluate the diagnostic utility of serological markers namely anti-C. trachomatis IgG and IgA antibodies in women attending an infertility clinic. METHODS: Serum and vaginal swab specimens of 303 women presenting with infertility to the infertility clinic of the Kigali University Teaching Hospital and 312 fertile controls who recently delivered were investigated. Two commercial species-specific ELISA were used to determine serum IgG and IgA antibodies to C. trachomatis and vaginal swabs specimens were tested by PCR. Hysterosalpingography (HSG) was performed in subfertile women. RESULTS: The PCR prevalence of C. trachomatis infection was relatively low and did not differ significantly among subfertile and fertile women (3.3 versus 3.8%). Similarly, no significant differences in overall prevalence rates of C. trachomatis IgG and IgA among both groups were observed. The only factor associated with C. trachomatis infection in our study population was age <25 years. The seroprevalence of IgG in both assays (86.4% for ANILabsystems and 90.9% for Vircell) was significantly higher in the group of PCR C. trachomatis-positive women compared with that of PCR-negative women. Evidence of tubal pathology identified by HSG was found in 185 patients in the subfertile group (67.8%). All the serological markers measured in this study had very low sensitivities and negative predictive values in predicting tubal pathology. The specificities for ANILabsystems IgG, Vircell IgG, Anilabsystem IgA and positive C. trachomatis DNA to predict tubal pathology were 84, 86, 95 and 98%, respectively, whereas their respective positive predictive values were 73, 76, 81 and 80%. CONCLUSIONS: The prevalence of C. trachomatis in our study population in Rwanda appears to be low and women aged <25 years are more likely to have genital infection with C. trachomatis. Since serological testing for Chlamydia shows an excellent negative predictive value for lower genital tract infection, specific peptide-based serological assays may be of use for screening in low prevalence settings. Our data suggest that C. trachomatis is not the primary pathogen responsible for tubal pathology in Rwandan women.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
subfertility, PELVIC-INFLAMMATORY-DISEASE, serology, diagnostic tests, prevalence, chlamydia infection, TUBAL FACTOR INFERTILITY, SEROLOGY, PNEUMONIAE, PCR, HIV, EPIDEMIOLOGY, SPECIMENS, PROTEINS, COUPLES
journal title
HUMAN REPRODUCTION
Hum. Reprod.
volume
26
issue
12
pages
3319 - 3326
Web of Science type
Article
Web of Science id
000297058000015
JCR category
OBSTETRICS & GYNECOLOGY
JCR impact factor
4.475 (2011)
JCR rank
3/78 (2011)
JCR quartile
1 (2011)
ISSN
0268-1161
DOI
10.1093/humrep/der350
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
2075419
handle
http://hdl.handle.net/1854/LU-2075419
date created
2012-03-27 16:06:59
date last changed
2012-04-11 15:37:30
@article{2075419,
  abstract     = {BACKGROUND: In many developing countries, little is known about the prevalence of genital Chlamydia trachomatis infections and complications, such as infertility, thus preventing any policy from being formulated regarding screening for C. trachomatis of patients at risk for infertility. The objective of the present study was to determine the prevalence of C. trachomatis and evaluate the diagnostic utility of serological markers namely anti-C. trachomatis IgG and IgA antibodies in women attending an infertility clinic. 
METHODS: Serum and vaginal swab specimens of 303 women presenting with infertility to the infertility clinic of the Kigali University Teaching Hospital and 312 fertile controls who recently delivered were investigated. Two commercial species-specific ELISA were used to determine serum IgG and IgA antibodies to C. trachomatis and vaginal swabs specimens were tested by PCR. Hysterosalpingography (HSG) was performed in subfertile women. 
RESULTS: The PCR prevalence of C. trachomatis infection was relatively low and did not differ significantly among subfertile and fertile women (3.3 versus 3.8\%). Similarly, no significant differences in overall prevalence rates of C. trachomatis IgG and IgA among both groups were observed. The only factor associated with C. trachomatis infection in our study population was age {\textlangle}25 years. The seroprevalence of IgG in both assays (86.4\% for ANILabsystems and 90.9\% for Vircell) was significantly higher in the group of PCR C. trachomatis-positive women compared with that of PCR-negative women. Evidence of tubal pathology identified by HSG was found in 185 patients in the subfertile group (67.8\%). All the serological markers measured in this study had very low sensitivities and negative predictive values in predicting tubal pathology. The specificities for ANILabsystems IgG, Vircell IgG, Anilabsystem IgA and positive C. trachomatis DNA to predict tubal pathology were 84, 86, 95 and 98\%, respectively, whereas their respective positive predictive values were 73, 76, 81 and 80\%. 
CONCLUSIONS: The prevalence of C. trachomatis in our study population in Rwanda appears to be low and women aged {\textlangle}25 years are more likely to have genital infection with C. trachomatis. Since serological testing for Chlamydia shows an excellent negative predictive value for lower genital tract infection, specific peptide-based serological assays may be of use for screening in low prevalence settings. Our data suggest that C. trachomatis is not the primary pathogen responsible for tubal pathology in Rwandan women.},
  author       = {Muvunyi, Mambo-Claude and Dhont, Nathalie and Verhelst, Rita and Temmerman, Marleen and Claeys, Geert and Padalko, Elizaveta},
  issn         = {0268-1161},
  journal      = {HUMAN REPRODUCTION},
  keyword      = {subfertility,PELVIC-INFLAMMATORY-DISEASE,serology,diagnostic tests,prevalence,chlamydia infection,TUBAL FACTOR INFERTILITY,SEROLOGY,PNEUMONIAE,PCR,HIV,EPIDEMIOLOGY,SPECIMENS,PROTEINS,COUPLES},
  language     = {eng},
  number       = {12},
  pages        = {3319--3326},
  title        = {Chlamydia trachomatis infection in fertile and subfertile women in Rwanda: prevalence and diagnostic significance of IgG and IgA antibodies testing},
  url          = {http://dx.doi.org/10.1093/humrep/der350},
  volume       = {26},
  year         = {2011},
}

Chicago
Muvunyi, Mambo-Claude, Nathalie Dhont, Rita Verhelst, Marleen Temmerman, Geert Claeys, and ELIZAVETA PADALKO. 2011. “Chlamydia Trachomatis Infection in Fertile and Subfertile Women in Rwanda: Prevalence and Diagnostic Significance of IgG and IgA Antibodies Testing.” Human Reproduction 26 (12): 3319–3326.
APA
Muvunyi, M.-C., Dhont, N., Verhelst, R., Temmerman, M., Claeys, G., & PADALKO, E. (2011). Chlamydia trachomatis infection in fertile and subfertile women in Rwanda: prevalence and diagnostic significance of IgG and IgA antibodies testing. HUMAN REPRODUCTION, 26(12), 3319–3326.
Vancouver
1.
Muvunyi M-C, Dhont N, Verhelst R, Temmerman M, Claeys G, PADALKO E. Chlamydia trachomatis infection in fertile and subfertile women in Rwanda: prevalence and diagnostic significance of IgG and IgA antibodies testing. HUMAN REPRODUCTION. 2011;26(12):3319–26.
MLA
Muvunyi, Mambo-Claude, Nathalie Dhont, Rita Verhelst, et al. “Chlamydia Trachomatis Infection in Fertile and Subfertile Women in Rwanda: Prevalence and Diagnostic Significance of IgG and IgA Antibodies Testing.” HUMAN REPRODUCTION 26.12 (2011): 3319–3326. Print.