The Iranian Journal of Obstetrics, Gynecology and Infertility

The Iranian Journal of Obstetrics, Gynecology and Infertility

The serosurvey study of IgG antibodies to chlamydia trachomatis among asymptomatic women, Mashhad, Iran

Document Type : Original Article

Authors
Masoud Yousefi 1
Hosein Parizad 2
Hadi Farsiani 3
Majid Khadem Rezaiyan 4
1 Associate Professor, Department of Microbiology & Virology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
2 General practitioner, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
3 Assistant Professor, Department of Microbiology & Virology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
4 Assistant Professor, Department of Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
10.22038/ijogi.2022.20047
Abstract
Introduction: Chlamydia trachomatis is the cause of chlamydial infection of the genital tract and trachoma and is the most common bacterial infection transmitted through sexual contact and the most important and costly non-viral sexually transmitted disease. This infection is a common cause of urethritis in men and cervicitis in women, and many complications such as infertility and ectopic pregnancy have been reported. This study was performed aimed to evaluate the frequency of anti-chlamydia antibodies in asymptomatic women of childbearing age referred to health centers in Mashhad.
Methods: This cross-sectional study was performed in 2016 on 93 women referring to the health care centers of Mashhad University of Medical Sciences. Anti-chlamydia IgG antibodies were tested in these samples by ELISA method. Data were analyzed using SPSS software (version 16) and Fisher Freeman Halton Exact test. P<0.05 was considered statistically significant.
Results: A total of 93 women were evaluated. The mean serum level of antibody was 0.35±0.36 ng/dl and accordingly 6.5% (n=6) had a positive result. Also, the relationship between infection and age (p=0.209) and living area (p=0.239) of ​​these people was examined, but no significant relationship was found.
Conclusion: According to the results of the present study, the frequency of anti-chlamydia antibodies was considerable in women of reproductive age referred to the health centers in Mashhad. Due to this prevalence and high complications of this infection in case of no treatment, it is recommended that the Chlamydia Trachomatis screening program be performed routinely even for asymptomatic individuals.
Keywords
Fertility
Chlamydia trachomatis
Prevalence
Women
  1. Linhares IM, Witkin SS. Immunopathogenic consequences of Chlamydia trachomatis 60 kDa heat shock protein expression in the female reproductive tract. Cell Stress and Chaperones 2010; 15(5):467-73.
  2. Alijani E, Sargolzaei N, Heidari Z, Farzaneh F. Relationship Between IgG and IgA titers of Chlamydia Trachomatis and Tubal Obstruction in Infertile Women and Comparison of Antibody Titers with Normal Women. Iran J Obstet Gynecol Infertil 2021; 23(11):9-14.
  3. Workowski KA. Centers for Disease Control and Prevention sexually transmitted diseases treatment guidelines. Clinical Infectious Diseases 2015; 61(suppl_8):S759-62.
  4. Detels R, Green AM, Klausner JD, Katzenstein D, Gaydos C, Handsfield HH, et al. The incidence and correlates of symptomatic and asymptomatic Chlamydia trachomatis and Neisseria gonorrhoeae infections in selected populations in five countries. Sexually transmitted diseases 2011; 38(6):503.
  5. Geisler WM, Wang C, Morrison SG, Black CM, Bandea CI, Hook III EW. The natural history of untreated Chlamydia trachomatis infection in the interval between screening and returning for treatment. Sexually transmitted diseases 2008; 35(2):119-23.
  6. Morré SA, Van Den Brule AJ, Rozendaal L, Boeke AJ, Voorhorst FJ, De Blok S, et al. The natural course of asymptomatic Chlamydia trachomatis infections: 45% clearance and no development of clinical PID after one-year follow-up. International journal of STD & AIDS 2002; 13(1_suppl):12-8.
  7. Haggerty CL, Gottlieb SL, Taylor BD, Low N, Xu F, Ness RB. Risk of sequelae after Chlamydia trachomatis genital infection in women. The Journal of infectious diseases 2010; 201(Supplement_2):S134-55.
  8. Peter NG, Clark LR, Jaeger JR. Fitz-Hugh-Curtis syndrome: a diagnosis to consider in women with right upper quadrant pain. Cleveland Clinic journal of medicine 2004; 71(3):233-41.
  9. Mabey D, Peeling RW. Lymphogranuloma venereum. Sexually transmitted infections 2002; 78(2):90-2.
  10. Taylor HR, Burton MJ, Haddad D, West S, Wright H. Trachoma. The Lancet 2014; 384(9960):2142-52.
  11. Motamedi H, Aria M. The importance of Chlamydia trachomatis serotypes in its infection: a review. Iran J Obstet Gynecol Infertil 2017; 20(6):96-114.
  12. He W, Jin Y, Zhu H, Zheng Y, Qian J. Effect of chlamydia trachomatis on adverse pregnancy outcomes: A meta-analysis. Archives of Gynecology and Obstetrics 2020: 1-5.
  13. Pourabbas B, Rezaei Z, Mardaneh J, Shahian M, Alborzi A. Prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae infections among pregnant women and eye colonization of their neonates at birth time, Shiraz, Southern Iran. BMC infectious diseases 2018; 18(1):1-4.
  14. Numazaki K, Asanuma H, Niida Y. Chlamydia trachomatis infection in early neonatal period. BMC Infectious Diseases 2003; 3(1):1-5.
  15. Papp JR, Schachter J, Gaydos CA, Van Der Pol B. Recommendations for the laboratory-based detection of Chlamydia trachomatis and Neisseria gonorrhoeae—2014. MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports/Centers for Disease Control 2014; 63:1.
  16. Geisler WM. Duration of untreated, uncomplicated Chlamydia trachomatis genital infection and factors associated with chlamydia resolution: a review of human studies. The Journal of infectious diseases 2010; 201(Supplement_2):S104-13.
  17. Oakeshott P, Kerry S, Aghaizu A, Atherton H, Hay S, Taylor-Robinson D, et al. Randomised controlled trial of screening for Chlamydia trachomatis to prevent pelvic inflammatory disease: the POPI (prevention of pelvic infection) trial. Bmj 2010; 340.
  18. Sawhney MP, Batra RB. Chlamydia trachomatis Chlamydia trachomatis seropositivity during pregnancy seropositivity during pregnancy. Indian J Dermatol Venereol Leprol 2003; 69(6):394.
  19. Blas MM, Canchihuaman FA, Alva IE, Hawes SE. Pregnancy outcomes in women infected with Chlamydia trachomatis: a population-based cohort study in Washington State. Sexually transmitted infections 2007; 83(4):314-8.
  20. de Attayde MJ, Florêncio GL, Gabiatti JR, do Amaral RL, Júnior JE, da Silveira Goncalves AK. Perinatal morbidity and mortality associated with chlamydial infection: a meta-analysis study. The Brazilian journal of infectious diseases 2011; 15(6):533-9.
  21. Ostaszewska-Puchalska I, Wilkowska-Trojniel M, Zdrodowska-Stefanow B, Knapp P. Chlamydia trachomatis infections in women with adverse pregnancy outcome. Medycyna wieku rozwojowego 2005; 9(1):49-56.
  22. Stephens AJ, Aubuchon M, Schust DJ. Antichlamydial antibodies, human fertility, and pregnancy wastage. Infectious Diseases in Obstetrics and Gynecology 2011; 2011.
  23. Baud D, Greub G. Intracellular bacteria and adverse pregnancy outcomes. Clinical Microbiology and Infection 2011; 17(9):1312-22.
  24. Wiesenfeld HC. Screening for Chlamydia trachomatis infections in women. New England Journal of Medicine 2017; 376(8):765-73.
  25. Rowley J, Vander Hoorn S, Korenromp E, Low N, Unemo M, Abu-Raddad LJ, et al. Chlamydia, gonorrhoea, trichomoniasis and syphilis: global prevalence and incidence estimates, 2016. Bulletin of the World Health Organization 2019; 97(8):548.
  26. Newman L, Rowley J, Vander Hoorn S, Wijesooriya NS, Unemo M, Low N, et al. Global estimates of the prevalence and incidence of four curable sexually transmitted infections in 2012 based on systematic review and global reporting. PloS one 2015; 10(12):e0143304.
  27. Torrone E, Papp J, Weinstock H. Prevalence of Chlamydia trachomatis genital infection among persons aged 14–39 years—United States, 2007–2012. MMWR. Morbidity and mortality weekly report 2014; 63(38):834.
  28. Parish WL, Laumann EO, Cohen MS, Pan S, Zheng H, Hoffman I, et al. Population-based study of chlamydial infection in China: a hidden epidemic. Jama 2003; 289(10):1265-73.
  29. Götz HM, Van Bergen JE, Veldhuijzen IK, Broer J, Hoebe CJ, Richardus JH. A prediction rule for selective screening of Chlamydia trachomatis infection. Sexually transmitted infections 2005; 81(1):24-30.
  30. Brunham RC, Pourbohloul B, Mak S, White R, Rekart ML. The unexpected impact of a Chlamydia trachomatis infection control program on susceptibility to reinfection. The Journal of infectious diseases 2005; 192(10):1836-44.
  31. Niccolai LM, Livingston KA, Laufer AS, Pettigrew MM. Behavioural sources of repeat Chlamydia trachomatis infections: importance of different sex partners. Sexually transmitted infections 2011; 87(3):248-53.
  32. Cohen CR, Gichui J, Rukaria R, Sinei SS, Gaur LK, Brunham RC. Immunogenetic correlates for Chlamydia trachomatis–associated tubal infertility. Obstetrics & Gynecology 2003; 101(3):438-44.
  33. Sonmez S, Sonmez E, Yasar L, Aydin F, Coskun A, Sut N. Can screening Chlamydia trachomatis by serological tests predict tubal damage in infertile patients?. Microbiologica-Quarterly Journal of Microbiological Sciences 2008; 31(1):75-80.
  34. Land JA, Hartog JD. Chlamydia antibody testing in subfertile women. Drugs of Today 2006; 42:35-42.
  35. Baud D, Regan L, Greub G. Emerging role of Chlamydia and Chlamydia-like organisms in adverse pregnancy outcomes. Current opinion in infectious diseases 2008; 21(1):70-6.
  36. Khezerdoust S, Haghollahi F, Roostaie S, Badami N, Naghizadeh MM, Jafarabadi M. Chlamydia trachomatis infection in pregnant women. Journal of Reproduction & Infertility 2009; 10(2):121-9.
  37. Naserpour-Farivar T, Taheri M. Prevalence of Chlamydia Trachomatis in urine sample of patients with UTI in Zahedan. Journal of Gorgan University of Medical Sciences 2003; 5(2):66-70.
  38. Ahmadi MH, Mirsalehian A, Bahador A. Prevalence of genital Chlamydia trachomatis in Iran: a systematic review and meta-analysis. Pathogens and global health 2015; 109(6):290-9.
  39. Roshani D, Ramazanzadeh R, Farhadifar F, Ahmadi A, Derakhshan S, Rouhi S, et al. A PRISMA systematic review and meta-analysis on Chlamydia trachomatis infections in Iranian women (1986–2015). Medicine 2018; 97(16).
  40. Khajehkarramedini M, Hashemi SA, Naderinasab M, Meshkat Z, Amel Jamehdar S. Frequency of Chlamydia trachomatis infection in cervical and urethral samples referred to Ghaem Hospital of Mashhad. Iran J Obstet Gynecol Infertil 2011; 13(6):17-21.
  41. Safdari H, Yari A, Ghazvini K. Prevalence of Chlamydia trachomatis among women with genital infection in northeast of Iran in 2013. Iran J Obstet Gynecol Infertil 2015; 18(147):1-6.
  42. Goshayeshi L, Vahid Roudsari F, Ghazvini K, Nomani H, Amel Jamehdar S. Pilot prevalence evaluation of Chlamydia trachomatis by PCR in female infertile referred to study center of infertility in Mashhad. ISMJ 2015; 18(1):92-9.
  43. Besharati R, Lashkardoost H, Hamedi A, Mehrabi M, Gholami S. Prevalence of Chlamydia trachomatis infection with ELISA method and its related factors in women with a history of abortion referred to Bental-Hoda Hospital; 2020.
  44. Naderinasab M, Genaat J, Rashed T, Ghazvini K. The level of antibody against Chlamydia trachomatisamong patients with genital infections in Mashhad. Iranian Journal of Medical Microbiology 2007; 1(2):35-41.
  45. MJ T. A molecular survey of Chlamydia trachomatis infection in married women: a cross sectional study on 991 women. Tehran University Medical Journal TUMS Publications 2008; 66(7):485-91.
The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 24, Issue 13
February 2022
Pages 90-99