Population Attributable Fraction of Tubal Factor Infertility Associated with Chlamydia (original) (raw)
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Journal of Health Care for the Poor and Underserved, 2011
Chlamydia trachomatis (CT), the most prevalent sexually transmitted infection in the United States, disproportionately infects women and people of color. This study aimed to identify risk factors for racial and ethnic disparities for CT infection, re-infection, and persistent infection among pregnant women. We present a secondary analysis of births from a retrospective cohort study in Syracuse, NY from January 2000 through March 2002. African American women [OR 3.35 CI (2.29, 4.92)], Latin American women [OR 4.35 CI (2.52, 7.48)], unmarried women [OR 7.57 CI (4.38, 13.10)], and teen mothers [OR 3.87 CI (2.91, 5.16)] demonstrated statistically significant increased risk for infection. In multivariate analyses that included male partner variables, father's race/ethnicity but not the mother's race/ethnicity remained statistically associated with CT. Despite near universal rates of screening pregnant women, challenges to CT control remain and reflect barriers to testing and treatment of male partners.
Sexually Transmitted Diseases, 2012
Objectives: To estimate the proportion of tubal factor infertility (TFI) caused by Chlamydia trachomatis (CT), the etiologic fraction, from a retrospective study of CT antibody prevalence in TFI cases and controls, adjusted for sensitivity and specificity. Methods: We use published data on sensitivity and specificity to estimate the performance of assays in (a) women with a previous CT infection without sequelae and (b) women with TFI caused by CT. A model was developed and applied to antibody prevalence in TFI cases and controls from 1 published case-control study to estimate the proportion of TFI caused by CT. Results: The proportion of TFI episodes that were due to CT infection was estimated to be 45% (credible intervals: 28%, 62%). Models which assume that test sensitivity is higher in women with CT-related TFI than women with previous infection and no sequelae fit the data significantly better than models that assume the same sensitivity in all those previously infected. Conclusions: Greater attention needs to be paid to methods for characterizing the performance of CT antibody tests. Serological studies could be given a greater role both in CT etiology and in monitoring the effects of prevention and control programmes.
To Compare the Frequency of Chlamydial Infection in Infertile Women Compared to Normal Women
Pakistan Journal of Medical and Health Sciences, 2021
Background: A better understanding of the role of persistent C. trachomatis infections in tubal factor subfertility may be useful in optimizing the fertility work-up by incorporating screening tests for persistent C. trachomatis infections. The aim is to accurately estimate the risk of persistence and identify those women who are at highest risk of tubal pathology. Aim: To compare the frequency of chlamydial infection in infertile women compared to normal women. Study Design: Case control study. Settings: Department of Obstetrics & Gynecology, Hospital, Bahawalpur. Study duration: 1st October 2019 to 31st March 2020. Methods: A total of 88 women (44 infertile and 44 normal), having normal semen analysis report, of age ranging from 18 to 40 years were included. Patients with polycystic ovarian disease, hyperprolactinemia, & hypothyroidism were excluded. Blood sample of all women in both groups was sent to the institutional pathology laboratory for presence or absence of chlamydial in...
Sexually Transmitted Infections, 2019
Objectives a better understanding of Chlamydia trachomatis infection (chlamydia)-related sequelae can provide a framework for effective chlamydia control strategies. the objective of this study was to estimate risks and risk factors of pelvic inflammatory disease (PiD), ectopic pregnancy and tubal factor infertility (tFi) with a follow-up time of up until 8 years in women previously tested for chlamydia in the chlamydia Screening implementation study (cSi) and participating in the netherlands chlamydia cohort Study (neccSt). Methods Women who participated in the cSi 2008-2011 (n=13 498) were invited in 2015-2016 for neccSt. chlamydia positive was defined as a positive cSi-Pcr test, positive chlamydia serology and/or selfreported infection (time dependent). Data on PiD, ectopic pregnancy and tFi were collected by self-completed questionnaires. incidence rates and Hrs were compared between chlamydia-positive and chlamydia-negative women corrected for confounders. results Of 5704 women included, 29.5% (95% ci 28.3 to 30.7) were chlamydia positive. the incidence rate of PiD was 1.8 per 1000 person-years (py) (1.6 to 2.2) overall, 4.4 per 1000 py (3.3 to 5.7) among chlamydia positives compared with 1.4 per 1000 py (1.1 to 1.7) for chlamydia negatives. For tFi, this was 0.4 per 1000 py (0.3 to 0.5) overall, 1.3 per 1000 py (0.8 to 2.1) and 0.2 per 1000 py (0.1 to 0.4) among chlamydia positives and negatives, respectively. and for ectopic pregnancy, this was 0.6 per 1000 py (0.5 to 0.8) overall, 0.8 per 1000 py (0.4 to 1.5) and 0.6 per 1000 py (0.4 to 0.8) for chlamydia negatives. among chlamydia-positive women, the strongest risk factor for PiD was symptomatic versus asymptomatic infection (adjusted Hr 2.88, 1.4 to 4.5) and for tFi age <20 versus >24 years at first infection (Hr 4.35, 1.1 to 16.8). Conclusion We found a considerably higher risk for PiD and tFi in chlamydia-positive women, but the incidence for ectopic pregnancy was comparable between chlamydia-positive and chlamydia-negative women. Overall, the incidence rates of sequelae remained low. Trial registration ntr-5597.
International Journal of Epidemiology, 2013
Objectives Using a statistical modelling approach, our study aim is to determine reliable age-related estimates of the risk of all-cause tubal factor infertility (TFI) following past or current chlamydial infection in women in Scotland. Method Using data from several sources, a Markov-Chain Monte Carlo model was used to estimate the age-related risk of TFI given genital chlamydia infection at any time. The analysis is based on the probability of a woman ever having chlamydial infection, ever having TFI and ever having a previous chlamydial infection given a diagnosis of TFI. The model was programmed and evaluated using WinBugs14. Results By the age 44 years, the overall risk of a woman having at least a single chlamydial infection is estimated at 42.9% (95% credible interval 30.0, 59.0%). The risk of a woman having TFI increased from 0.5% in those aged 16-19 years to 0.8% in those aged 40-44. The overall estimated probability of TFI, based on lifetime infertility, given a past or current chlamydial infection, is relatively consistent across all five age groups from 16-44 years, being 0.9% among those aged 25-29 and 1.4% in those aged 35-39; The estimates were found to be sensitive to the definition of infertility, with the estimate increasing from 1.3% in the youngest age group to 2.8% and 4.5% for 24-month primary infertility and primary or secondary infertility, respectively. Conclusions At the population level, the likelihood of all-cause TFI in those with past or current chlamydial infection is low. These findings have relevance both at the policy level, in the development of control programmes, and also at an individual level, particularly for clinicians supporting women undergoing testing or with a positive diagnosis.
Sexually Transmitted Infections, 2019
ObjectivesA better understanding of Chlamydia trachomatis infection (chlamydia)–related sequelae can provide a framework for effective chlamydia control strategies. The objective of this study was to estimate risks and risk factors of pelvic inflammatory disease (PID), ectopic pregnancy and tubal factor infertility (TFI) with a follow-up time of up until 8 years in women previously tested for chlamydia in the Chlamydia Screening Implementation study (CSI) and participating in the Netherlands Chlamydia Cohort Study (NECCST).MethodsWomen who participated in the CSI 2008–2011 (n=13 498) were invited in 2015–2016 for NECCST. Chlamydia positive was defined as a positive CSI-PCR test, positive chlamydia serology and/or self-reported infection (time dependent). Data on PID, ectopic pregnancy and TFI were collected by self-completed questionnaires. Incidence rates and HRs were compared between chlamydia-positive and chlamydia-negative women corrected for confounders.ResultsOf 5704 women inc...
Open Access Macedonian Journal of Medical Sciences, 2019
AIM: To determine the relationship between Chlamydia Trachomatis infections with patency tubal and non-patency tubal occurrence in infertile women. METHODS: This research was an observational analytic research with a cross-sectional study. This research was conducted at Haji Adam Malik General Hospital Medan, Pramita Laboratory Medan and Medical Faculty of Medicine Universitas Sumatera Utara. Laboratory on October 2017 until the number of samples was fulfilled. The samples were women who were referred to Pramita Laboratory Medan for hysterosalpingography procedure in accordance which corresponded to the inclusion criteria by using consecutive sampling technique. RESULTS: From this research, it was found that the most infertile women were aged 31-35 years, with the most infertility type was primary infertility (83,8%) with the longest infertility duration was ≥ 3 years (44%). From all samples who were infertile, 26% among them were positive to chlamydia infection. Eight from twelve p...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2017
Background: Genital Chlamydial trachomatis infection, though often asymptomatic, is an established indirect causative agent of female infertility via its activities on the tubal physiology. Many risk factors are postulated for its acquisition and the main thrust of this study was to establish the organisms’ correlates among infertile women attending gynaecologic clinic in Ibadan.Methods: A systematic sampling technique was used on each selected day to recruit women who met the inclusion criteria into the study using a sampling frame of 2. Interviewer-administered questionnaires were used to obtain attributes considered as risk factors for acquiring genital Chlamydia trachomatis infection from 150 consenting infertile women between January and November 2015. These attributes included sexual history, social status, alcohol intake and past history of sexually transmitted infections (STIs). Blood samples and endocervical swabs were subsequently taken for detection of C. trachomatis infe...
Sexually transmitted infections, 2014
To investigate the frequency and risk factors for incident and redetected Chlamydia trachomatis infection in sexually active, young, multi-ethnic women in the community. Cohort study. 20 London universities and Further Education colleges. 954 sexually experienced women, mean age 21.5 years (range 16-27), 26% from ethnic minorities, who were recruited to the Prevention of Pelvic Infection (POPI) chlamydia screening trial between 2004 and 2006, and returned repeat postal self-taken vaginal swabs 11-32 (median 16) months after recruitment. The estimated annual incidence of chlamydia infection among 907 women who tested negative at baseline was 3.4 per 100 person-years (95% CI 2.5 to 4.6 per 100 person-years), but 6.6 per 100 person-years (95% CI 4.5 to 9.3 per 100 person-years) in the 326 teenagers (<20 years). Predictors of incident chlamydia infection were age <20 years (relative risk (RR) 4.0, 95% CI 2.1 to 7.5), and (after adjusting for age) a new sexual partner during 12 mon...
Journal of reproduction & infertility, 2013
Chlamydia trachomatis is the most reported bacterial sexually transmitted disease, especially among young women worldwide. The aim of this study was comparison the prevalence of Chlamydia trachomatis infection in woman with tubal infertility by means of PCR and cell culture techniques. Fifty-one women with confirmed TFI were enrolled in this study in (avicenna infertility Clinic) between January 2010 and January 2011. Cervical swab and cytobrush specimens were collected from each patient by gynecologists and sent to laboratory in transport media. Detection of Chlamydia trachomatis in samples was performed using PCR and bacteria culture in MacCoy cell line. The data were analyzed by Fisher's exact test and independent t-test. Statistical significance was established at a p-value <0.05. A significant relation was observed between increased the age of first intercourse and chlamydial infection. Six (11.7%) samples had positive PCR result, whereas cell culture results were positi...