Home Print this page Email this page Small font sizeDefault font sizeIncrease font size
Users Online: 975

 

Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Advertise Contacts Login 
     

  Table of Contents  
ORIGINAL ARTICLE
Year : 2014  |  Volume : 55  |  Issue : 1  |  Page : 9-13  

Genital chlamydia trachomatis infection among female undergraduate students of University of Port Harcourt, Nigeria


1 Department of Obstetrics and Gynaecology, University of Port Hartcourt Teaching Hospital, River State, Nigeria
2 Department of Obstetrics and Gynaecology, Niger Delta University, Yenagoa, Bayelsa State, Nigeria

Date of Web Publication4-Mar-2014

Correspondence Address:
A Ugboma Henry Arinze
Department of Obstetrics and Gynaecology, University of Port Harcourt Teaching Hospital, Rivers State
Nigeria
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0300-1652.128147

Rights and Permissions
   Abstract 

Background: Genital Chlamydia trachomatis infection is a common bacterial sexually transmitted infection worldwide. There is little information about this infection in Nigeria. This study determined the prevalence of genital Chlamydia trachomatis infection among female undergraduates of University of Port Harcourt and identify the various associated risk factors. Materials and Methods: A cross-sectional prospective study of 354 female students was done. Their socio-demographic characteristics and pattern of sexual behaviour was noted followed by collection of endocervical swab which was analysed with a Chlamydia Rapid Test Device. Data management was done by SPSS version 17.0 statistical package. Result: The prevalence of genital Chlamydia trachomatis infection was 30.2%. First coital exposure at14 years or less had the highest prevalence of the disease. Multiple sexual partners, tribe and inconsistent use of condom were significantly related with Chlamydia trachomatis infection. Conclusion: Genital Chlamydia trachomatis is prevalent among female undergraduates of the University of Port Harcourt.

Keywords: Genital chlamydia infections, female undergraduates, Port Harcourt, Nigeria


How to cite this article:
Arinze A U, Onyebuchi NV, Isreal J. Genital chlamydia trachomatis infection among female undergraduate students of University of Port Harcourt, Nigeria. Niger Med J 2014;55:9-13

How to cite this URL:
Arinze A U, Onyebuchi NV, Isreal J. Genital chlamydia trachomatis infection among female undergraduate students of University of Port Harcourt, Nigeria. Niger Med J [serial online] 2014 [cited 2019 Nov 13];55:9-13. Available from: http://www.nigeriamedj.com/text.asp?2014/55/1/9/128147


   Introduction Top


Chlamydia trachomatis infection is the most common bacterial sexually transmitted infection [1],[2] and is generally considered as a silent infection. [3],[4] Chlamydia is a small Gram-negative obligate intracellular bacterium that needs living host to multiply. They have a unique biphasic life cycle. The infectious metabolically inactive elementary body which infects the host, multiply and is transformed in the host to a metabolically active reticulate body. [5]

Genital Chlamydia infection is common among young sexually active people and most often asymptomatic with potential long-term consequences for female reproductive health. [3],[6]

Silent untreated infection leads to dreaded consequences like pelvic inflammatory disease, infertility, ectopic pregnancy and chronic pelvic pain. [4],[7],[8] It has been estimated that as much as 50% of salpingitis and infertility are caused by Chlamydia infection. [8]

Chlamydia has been identified as a cofactor in the transmission of HIV infection. [9],[10] It has also been proposed as an independent risk factor for development of cancer of the cervix. [11]

The prevalence of Chlamydia trachomatis varies, it depends on the characteristics of the study population and the different methods used for Chlamydia detection. [12] The United States has an overall prevalence of 5%. [13] In the United Kingdom, recent data suggest that rate of infection among young women may exceed 10%. [14]

A systematic review by Vajdic et al., [15] in Australia, reported an overall prevalence of 4.6%, with a higher prevalence of 5.6% among adolescent and young adults.

Prevalence of genital Chlamydia trachomatis in parts of Africa varies considerably ranging from 3.78% in Cameroon [16] to as high as 68.25% in female sex workers in Niger Republic. [17] Data from African countries suggest that prevalence is on the rise and may exceed that reported in developed countries. [9],[17],[18]

Reports from Nigeria vary as well; Mawak et al.,[19] reported a prevalence of 56.1% among 164 women attending gynaecology clinic in Jos Plateau. A prevalence of 51% was reported by Okoror et al.,[20] among pregnant and non-pregnant women and their spouses attending prenatal and antenatal clinic of College of Medicine of University of Lagos. Nwanguma et al.,[9] in Owerri and Nsukka studied 102 Nigerians, comprising 69 volunteers of unknown HIV status, 17 HIV-seropositive subjects and 16 HIV-seronegative subjects. A prevalence of 50% in HIV-positive volunteers and 17% in the HIV-negative group was reported, with an overall prevalence of 33% reported in the asymptomatic volunteers. [9]

This study was aimed to determine the prevalence of genital Chlamydia among female undergraduate in Port Harcourt and to determine and explore the various risk factor responsible for the disease.


   Materials and Methods Top


Approval for the study was given by the Institutional Research and Ethical Committee.

Participants were female undergraduates of University of Port Harcourt aged 15-30 years.

The students were randomly selected by simple balloting.

A structured questionnaire was administered to those who gave their consent to enquire about their socio-demographic characteristic, age at first sexual exposure, sexual behaviour, use of barrier contraception and other risk factors for Chlamydia infection.

A sterile speculum was passed to visualise the cervix and endocervical swab was collected with a sterile plastic-shaft Dacron swab. The swab was processed to extract Chlamydia antigen and analysed using Chlamydia rapid test device (swab/urine). The Chlamydia rapid test device is a qualitative lateral flow immunoassay for the detection of Chlamydia antigen from female cervical swab, male urethral swab and male urine manufactured by Inter- Chemical Ltd Shenzhen China. [21] In this test antibody specific to the Chlamydia antigen was coated on the test line region of the test kit. The test procedure was conducted according to the manufacturer's instruction manual. [21]

Data were analysed using the statistical package for social science (SPSS) version 17. The data were presented as means, rates and proportion in tables. Correlations between various variables were done. Statistical test of association was carried out where applicable and the level of significance set at P < 0.05.


   Results Top


Three hundred and fifty-four participants were enrolled into this study. One hundred and seven (30.2%) of them tested positive for Chlamydia infection, while 24 (6.8%) of the test were invalid, the rest 223 (63.0%) of the participant tested negative.

[Table 1] shows the biodata of the participants, the frequencies, the percentages and the prevalence of genital Chlamydia trachomatis in relation to these variables. The age range of the participant was 15-30 years. The mean age of the participant was 20.946 ± 3.335.
Table 1: Biodata of participants


Click here to view


The prevalence of genital Chlamydia trachomatis infection was higher in the age range of 26-30 years with a prevalence of 43.8%.

Three hundred and twenty-three (91.2%) students were single while 31(8.8%) were married. Of the 323 singles, 100 (31.0%) tested positive to Chlamydia trachomatis infection while 7 (22.6%) of the 31 married students also tested positive. P value = 0.208.

Majority 332 (93.8%) were Christians, while Muslim's were 22 (6.2%) [Table1]. One hundred and six of the Christians tested positive giving a prevalence of 31.9%, while only 1 of the 22 Muslims was positive with a prevalence of 4.5% (P-value = 0.06).

Ethnicity had a significant relation with genital Chlamydia trachomatis infection [Table 1]. The Ibo's were the majority comprising 157 (44.6%) of the participants, while the Hausa's 15 (4.2%). The infection was more prevalent among the Ibibios, 16 of the 27 participants were positive with a prevalence of 59. 3% P = 0.00.

[Table 2] shows the sexual characteristic of the participants, the frequences and the various relationship with chlamydia infection.
Table 2: Sexual behaviour of participants


Click here to view


The mean age at coitarche among the participants was 16.39 ± 2.32. Two hundred and twenty-five (72.0%) of the students had their first coital exposure between the ages of 15 and 19years. Seventy of the students had their first coital exposure at 14 years of age or less, amongst these students 45 (64.3%) of them were positive for chlamydia infection. Age at first coital expure was significantly related to chlamydia infection in this study P = 0.00

More of the participants had 1-2 sexual partners and life-time sexual partners. Thirty-six students (10.2%) had 5 or more life time sexual partners, out of which 30 tested positive for Chlamydia trachomatis infetion with a prevalence of 83.3%. Number of sexual partners was also significant P = 0.00.


   Discussion Top


The prevalence of genital Chlamydia trachomatis infection in this study was 30.2%. This is similar to a prevalence of 29.4% reported by Ikeme et al., in Enugu [22] and 33% reported in asymptomatic volunteers by Nwanguma et al. [9] The result from this study is at variance with higher values reported by other researchers, Mawak et al., reported prevalence of 56.1% in Jos Plateau, [19] while Okoror et al., reported a prevalence of 51% among pregnant women attending antenatal clinic in Lagos state. [20] The prevalence of Chlamydia infection has been known to vary depending on the population studied and laboratory method of analysis used. [12]

The prevalence of Chlamydia infection in this study and others found in different parts of Nigeria is high when compared to those in developed countries. In Europe, the prevalence ranged from 1.7 to 17% depending on the setting, context and country, [23] while the USA has an overall prevalence of 5%. [13] These marked difference could be as a result of organised screening for Chlamydia infection that exist in developed countries, increased awareness of Chlamydia trachomatis infection, easy access to laboratory diagnosis and treatment, the reverse of which is the case in developing countries like Nigeria.

The risk factors for the transmission of Chlamydia trachomatis infection includes history of co-existing or previous sexual transmitted infection, early age at coitarche, multiple sexual partners, non-use of barrier contraception, HIV seropositivity, being unmarried, black race and involvement with new partners. [4],[9],[10],[19],[24],[25] Age less than 25 has continued to be an important risk factor for Chlamydia trachomatis infection. [4],[25] The finding from this study differed from this fact. The highest prevalence of genital Chlamydia trachomatis in this study was among age group of 26-30 years with a prevalence of 43.8%. This is similar to the findings of Mawak et al., [19] who noted the highest prevalence in age group 25-29 years. This age group fall within sexually active adolescents and young adult in whom the disease is commoner and this could be the reason for the higher prevalence of the infection in this age group. [17] The infection was more in singles (31.0%) than married students (22.6%). This differed from other studies that noted the infection to be more in married than single ladies. [19] This is not unexpected because of the population studied.

Ethnicity was found to be statistically significant in this study with the highest prevalence (59.3%) of the infection occurring in the Ibibio's. This may be related to their majority in this environment so the results may be skewed in their favour. The sexual characteristics assessed in this study were statistically significant with Chlamydia trachomatis infection. Early coitarche was associated with Chlamydia infection. This study is similar to other studies that have linked  Chlamydia trachomatis Scientific Name Search  infection with early coitarche. [10],[19],[26]

Multiple sexual partners was also significantly associated with, of the 110 participant with 3-4 sexual partners, 58 (52.7%) tested positive while 30 (83.8%) of 36 with 5 or more sexual partners tested positive. This is in keeping with results of other studies that have identified number of sexual partners to be significantly related to Chlamydia infection. [10],[19],[24],[25],[26]

This study is in agreement with several other studies which has found that inconsistent use of condom has been associated with chlamydia trachomatis infection. [10],[24],[25],[26]

In conclusion, Chlamydia trachomatis infection is prevalent amongst female undergraduates of University of Port Harcourt.

Early coitarche, multiple number of sexual partners and inconsistent use of condoms are significantly related to genital Chlamydia trachomatis. Recommendation since Chlamydia trachomatis infection is prevalent amongst these students and is mainly silent with no available vaccine against it, there should be community health education on the need to avoid risky sexual practices by inclusion of sex and health education in the school curriculum at the secondary level. Heath talks and programs should be organised by the health units at the tertiary level also there is the need to involve the religious organizations as well as the various youth organisations and groups. There is also the need for the government to develop and implement Chlamydia control strategies by putting in place a screening programmes that will identity those at risk, those infected and treat the infected person so as to safeguard their future reproductive health.

 
   References Top

1.Manavi K. A Review on infection with Chlamydia trachomatis. Best Pract Res Clin Obstet Gynaecol 2006;20:941-51.  Back to cited text no. 1
[PUBMED]    
2.Bebear C, De Barbeyrac B. Genital Chlamydial infections. Clin Microbiol Infect 2009;151:4-10.  Back to cited text no. 2
    
3.Fenton KA, Lowndes CM. Recent trend in the epidemiology of sexually transmitted infection in the European Union. Sex Transm Infect 2004;80:255-63.  Back to cited text no. 3
    
4.Pelpert JF. Genital Chlamydia infection. N Engl J Med 2003;349:2424-30.  Back to cited text no. 4
    
5.Beatty WL, Morrison RP, Byme GI. Persistent Chlamydia; from cell culture to a paradigm for Chlamydia pathogenesis. Microbiol Rev 1994;58:686-99.  Back to cited text no. 5
    
6.Centre for Disease Control and Prevention. Sexually transmitted Disease Surveillance, 2004. Atlanta, GA, US Department of Health and Human services, 2005.  Back to cited text no. 6
    
7.Westrom L, Joesoef R, Reynolds G, Hagdu A, Thompson SE. Pelvic inflammatory disease and fertility: A cohort study of 1,844 women with laparoscopically verified disease and 657 control women with normal laparoscopic results. Sex Transm Dis 1992;19:185-92.  Back to cited text no. 7
    
8.Zenilman JM. Chlamydia and Cervical cancer. A Real Association? JAMA 2001;285:81-3.  Back to cited text no. 8
[PUBMED]    
9.Nwanguma B, Kalu I, Ezeanyika L . Seroprevalence of anti-chlamydia trachomatis IgA antibody in a Nigeria population: Diagnostic significance and implication for the heterosexual transmission of HIV. The Internet Journal of Infectious Disease 2009;7:2.  Back to cited text no. 9
    
10.Joyee AC, Thyagarajan SP, Riddy EV, Venkatesan C, Genapathy M. Genital Chlamydia infection in patients; its relation to HIV infection. Indian J Med Microbiol 2005;23:37-40.  Back to cited text no. 10
[PUBMED]  Medknow Journal  
11.Anttila T, Saikku P, Koskela P, Bloigu A, Diller J, Ikaheimo I. Serotypes of Chlamydia trachomatis and risk development of squamous cell carcinoma. JAMA 2001;285:47-51.  Back to cited text no. 11
    
12.Buve A, Weiss HA, Lega M, Van Dyck E, Musonda R, Zekeng L. The epidemiology of gonorrhoea, Chlamydia infection and syphilis in four African countries. AID 2001;15:578-88.  Back to cited text no. 12
    
13.Centre for Disease Control and Prevention. Chlamydia screening among sexually active young female enrollees of health plans-united states 2000-2007. MMWR Morb Mortal Wkly Rep 2009;58:362-5.  Back to cited text no. 13
    
14.Tobin JM. Chlamydia screening in primary care: Is it useful, affordable and universal? Curr Opin Infect Dis 2002;15:31-6.  Back to cited text no. 14
[PUBMED]    
15.Vajdic CM, Middleton M, Bowden FJ, Fairley CK, Kaldor JM. The prevalence of genital Chlamydia trachomatis in Australia 1997-2004: A systematic review. Sex Health 2005;2:169-83.  Back to cited text no. 15
    
16.Ngandjio A, Clerc M, Fonkoua MC, Thonno J, Njock F, Pouillot R, et al. Screening of volunteer students in Yaoundé (Cameroon, Central Africa) for Chlamydia trachomatis infection and genotyping of isolated Chlamydia trachomatis strains. J Clin Microbiol 2003;41:4404-7.  Back to cited text no. 16
    
17.Mamodou S, Laouel Kader A, Rabiou S, Aboubacar A, Soumana O, Garba A, et al. Prevalence of HIV infection and five other sexually transmitted infections among sex workers in Niamey, Niger. Bull Soc Pathol Exot 2006;99:19-22.  Back to cited text no. 17
    
18.Okoror LE, Agbonlahor DE, Esumeh FI, Umolu PI. Prevalence of Chlamydia in patients attending gynaecology clinic in south eastern Nigeria. Afr Health Sci 2007;7:18-24.  Back to cited text no. 18
    
19.Mawak JD, Dashe N, Agabi YA, Panshak BW. Prevalence of Genital Chlamydia Trachomatis Infection among Gynaecology Clinic Attendees in Jos, Nigeria. Shiraz E-Medical J 2011;12:2.  Back to cited text no. 19
    
20.Okoror LE, Omilabu SA, Fadojutimi J, Nsongkhai V. Seroepidemiological survey of Chlamydia in patients attending pre and post natal clinic at the College of Medicine of the University of Lagos, Nigeria. In: Book of Abstract of the 24 th Annual Conference of The Nigerian Society for Microbiology. 2000.  Back to cited text no. 20
    
21.Chlamydia Antigen Rapid Test interchemical (Shenzhen) Ltd). Available from: http://www. interchemicallab.en.eclaplaza.net/9.asp. [Last accessed on 2012, Mar 5].  Back to cited text no. 21
    
22.Ikeme AC, Ezegwui HU, Ikeako LC, Agbata I, Agbata E. Seroprevalence of Chlamydia trachomatis in Enugu, Nigeria. Niger J Clin Pract 2011;14:176-80.  Back to cited text no. 22
[PUBMED]  Medknow Journal  
23.Wilson JS, Honey E, Templeton A, Paavonen J, Mardh PA, Stary-Pedersen B; EU Biomed Concerted Action Group. A systematic review of the prevalence of Chlamydia trachomatis among European women. Hum Reprod Update 2002;8:385-94.  Back to cited text no. 23
    
24.Norman J. Epidemiology of female genital Chlamydia trachomatis infection. Best Pract Res Clin Obstet Gynaecol 2002;16:775-87.  Back to cited text no. 24
[PUBMED]    
25.Nelson HD, Heifand M. Screening for Chlamydia infection. Am J Prev Med 2001;20:95-107.  Back to cited text no. 25
    
26.Kimani J, Macleean I, Bwayo J. Risk factors for Chlamydia trachomatis pelvic inflammatory disease among sex workers in Nairobi, Kenya. J Infect Dis 1996;173:1437-44.  Back to cited text no. 26
    



 
 
    Tables

  [Table 1], [Table 2]


This article has been cited by
1 Predominance of cervicitis agents with minimal testing rate within the student population in Benin city, Nigeria
Chinyere Charity Ezeanya,Nneka Regina Agbakoba,Ifeoma Bessie Enweani,Charlotte Oguejiofor
Journal of Obstetrics and Gynaecology. 2019; : 1
[Pubmed] | [DOI]
2 Prevalence of chlamydia trachomatis infection among reproductive age women in sub Saharan Africa: a systematic review and meta-analysis
Siraj Hussen,Demelash Wachamo,Zemenu Yohannes,Endale Tadesse
BMC Infectious Diseases. 2018; 18(1)
[Pubmed] | [DOI]
3 Molecular characterization of lower vaginal swabs for Human papilloma virus in association with Chlamydia trachomatis infection in Cameroonian Women
Pythagore Fogue,Geraldo Djeudong,George Bouting,Elom Aglago,Gustave Simo,Smiths Lueong
Journal of Infection and Public Health. 2017;
[Pubmed] | [DOI]



 

Top
  
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
    Abstract
   Introduction
    Materials and Me...
   Results
   Discussion
    References
    Article Tables

 Article Access Statistics
    Viewed4207    
    Printed51    
    Emailed3    
    PDF Downloaded187    
    Comments [Add]    
    Cited by others 3    

Recommend this journal