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Polymerase chain reaction versus enzyme-linked immunosorbent assay in detection of Chlamydia trachomatis infection among gynaecological patients in southwestern Nigeria

T.A. Ajani, C.G. Anaedobe, T.A. Oluwasola, M.A. Ajani, S.A. Fayemiwo, R.A. Bakare

 

Abstract

Background:  Chlamydia trachomatis (C. trachomatis), is the most common bacterial Sexually Transmitted Infection, a major cause of Pelvic Inflammatory Disease and female infertility. Since C. trachomatis infections are frequently asymptomatic with higher prevalence in developing countries, highly sensitive and affordable methods are desirable for routine screening and diagnosis. This study aimed to evaluate the performance of C. trachomatis-specific IgG antibody by ELISA as a screening tool for C. trachomatis infection, by comparing the performance of ELISA with the gold standard Polymerase Chain Reaction (PCR).

Method: In this cross sectional study, we enrolled 150 women attending infertility clinic at Ibadan between January and November, 2015. ELISA for detection of IgG antibodies specific to C. trachomatis major outer membrane protein (MOMP) was performed on the blood samples using third generation indirect Enzyme Linked Immunosorbent Assay (ELISA) and endocervical samples were analyzed for presence of C. trachomatisnucleic acid using PCR. Socio-demographic bio-data and gynaecological history were obtained with questionnaire; data was analyzed using SPSS version 20.0.

Results: Overall, 58 (38.7%) were positive for C. trachomatis specific IgG antibody by ELISA and 11 (7.3%) for C. trachomatis nucleic acid by PCR. Using PCR as the gold standard, ELISA had a sensitivity of 81.8% specificity of 64.8%, positive predictive value of 15.5% negative predictive value of 97.8% and accuracy of 66%.

Conclusion: The high sensitivity of the ELISA indicates that over 80% of patients identified as being positive in the screened population are truly infected. Also, the negative predictive value approaches 100% amongst those screened out as being
negative. Thus its use as a screening tool for C. trachomatis infection is warranted particularly in developing countries where cheaper and easier to use alternatives to PCR are in dire need.

Keywords: C. trachomatis, infertility, polymerase chain reaction, ELISA, sexually transmitted infections

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Polymerase chain reaction versus enzyme-linked immunosorbent assay in detection of Chlamydia trachomatis infection among gynaecological patients in southwest

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Risk factors of cervical intraepithelial lesion in Douala-Cameroon: Implications of Herpes Simplex Virus Type 2, Chlamydia Trachomatis and Treponema Pallidum

NRR Dongang, MML Koanga, NAR Ngono, M Wankam, NG Djiakam, B Djimeli, E Fossi, EC Brulet, PH Amvam Zollo

 

Abstract

Infection with high risk oncogenic human papillomavirus (HPV) such as HPVs 16 and 18 is the main cause of cervical cancer. The objective of this study was to determine the impact of Chlamydia trachomatis, Herpes simplex virus 2 (HSV 2), Treponema pallidum and some sexual behaviour on malignant progression of cervical lesion in Douala, Cameroon. From July 2009 to January 2010, we performed routine cervical smears to 163 consenting women, who completed a questionnaire on risk factors of cervical cancer. Blood samples were obtained for each of these women and used for the detection of antibodies against Chlamydia trachomatis, HSV 2 and Treponema pallidum. Results obtained showed that 26/163 (17 LSIL and 9 HSIL) of women had abnormal cytology, 75.5% (123/163) had HSV 2 infection, 19% (31/163) infected by Chlamydia trachomatis and 4.3% (7/163) infected by Treponema pallidum. Among the LSIL-positive women 35.3% (6/17) and 94.1% (16/17) were infected with Chlamydia trachomatis and HSV 2 respectively. Among those with HSIL cytology, 22.2% (2/9), 66.7% (6/9) and 11.1% (1/9) respectively had Chlamydia trachomatis, HSV 2 and Treponema pallidum. High parity and pregnancy rate was observed among women with positive cytology. Our finding shown high rate of cervical abnormalities among women infected with HSV 2; and among those with a higher number of parities and pregnancies. These results suggest that further investigations should be made in Cameroon to access real burden of these risk factors in the progression and persistence of cervical lesion.

Key words: risk factors, cervical cancer, HSV 2, Chlamydia trachomatis, sexually transmitted infections.

Risk factors of cervical intraepithelial lesion in Douala-Cameroon Implications of Herpes Simplex Virus Type 2, Chlamydia Trachomatis and Treponema Pallidum

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Sexually transmitted infections in Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria: A decade of clinic experience

AO Oyelese, AO Onipede, AO Aboderin, AN Adedosu, O Onayemi

 

Abstract

Sexually transmitted infections (STIs) remain cosmopolitan in all societies of the world and in some cases assume epidemic proportions. These infections are common infectious diseases nowadays, with an annual incidence of more than 200 million cases a year. Venereal pathogens continue to increase in number and the spectrum of pathogens has limitless elasticity. While genital discharge and ulceration are common presenting symptoms, unusual findings on examination and investigation are not uncommon. We assessed our clinic experiences during the first ten years in an STI clinic. Salient findings are that 85% of all patients seen have an STI. The breakdown of infections revealed that Candida albicans was the most common venereal pathogen accounting for 24% while Neisseria gonorrhoeae accounted for about 18.0%. Sarcoptes scabiei and Phthirus pubis causing scabies and pediculosis accounted for 1.8% and 0.3% respectively. As commonly established, the age bracket 19 to 39 years was clearly the age group in which sexually transmitted infections were mostly diagnosed. In a control programme, this age group should be targeted, while there is the need to continue to stimulate awareness of both the general public and health workers at all levels on the problems of sexually transmitted infections, the scourge of all ages.

Key Words: Sexually transmitted infections, venereal pathogens, clinic experience, control awareness

Afr. J. Clin. Exper. Microbiol. Vol.6(1) 2005: 64-68