PREVALENCE RATE OF CHLAMYDIA TRACHOMATIS INFECTION IN EGYPTIAN INFERTILE WOMEN

Chlamydia trachomatis is one of the most common curable bacterial sexually transmitted infections (STIs) worldwide, and its complications in infected women in terms of pelvic inflammatory disease (PID), infertility and ectopic pregnancy among others with this infection highlights the need of its diagnosis in women with a history of infertility and recurrent spontaneous abortion for their better management.the present study evaluates the relationship between either past or current C. trachomatis infection in asymptomatic Egyptian females with unexplained infertility. This may be needed to be highlighted to attract the attention of clinical investigators. In addition the study compares the effectiveness of the point of care (POC) chlamydia test with polymerase chain reaction (PCR) as a potential tool for rapid Chlamydia diagnosis and screening .In the present study we enrolled women attending the gynecology outpatient department (OPD) of Ain shams educational hospital in the period from January 2013 to September 2013.The case group comprised of seventy five married infertile women. control group of twenty patients who were attending the clinic for other gynecologic purposes The clinician team did a routine gynecological per speculum examination to record signs of infection and collected two cervical swabs and blood samples, The first swab was shaken on a vortex mixerThe contents of the tube were used for direct Geimsa staining and point of care testing. The second swab was shaken on a vortex mixer then it was removed after pressing against the tube wall. And the content was preserved at -70ºC until used for DNA extraction and PCR Chlamydia rapid test (CRT) wasperformed,The detection of IgG antibodies against C. trachomatis was performed by using a commercial ELISA kit  . Seventy five infertile women and twenty control females were tested for current C,trachomatis infection by PCR, C.trachomatis POC test and geimsa staining. AS well as serum samples were collected to detect C.trachomatis specific IgG by ELISA. The Participants of the infertility cases were between 20-45 years old with a mean of (34.18± 5.3) The overall prevalence of anti C trachomatis antibodies (ACTA) IgG in infertile women was 27/75 (36%) in infertile women and 2/20 (10%) in control group ,the difference was statistically significant (PC.trachomatis by PCR was (22/75)29.3% in infertile women and 1/20 (5%) in control subjects versus (18/75) 24% by C.trachomatis POCT. Sensitivity, specificity, Positive predictive value and Negative predictive value of C.trachomatis POCT was compared to PCR for the diagnosis of C.trachomatis infection and it revealed 81.8%, 98.1%, 94.7% and 92.9% respectivelyconclusion, we find a strong relationship between past and current C.trachomatis infection and infertility in a sample of Egyptian infertile women. No difference was found in the prevalence of current or past C.trachomatis infection andfertile controls. The Chlamydia rapid test achieves relatively high diagnostic sensitivity and provides results within 30 minutes. It is suitable as primary diagnostic tool for Chlamydia infection and in settings where PCR tests was limited or absent thus it could be used as a screening tool.