Molecular prevalence of Chlamydia trachomatis infection among women attending gynaecological clinic for infertility evaluation

Abstract

BACKGROUND: Chlamydia trachomatis is one of the most prevalent sexually transmitted bacterial infections and a significant cause of infertility in women. Despite its asymptomatic nature, the bacterium can ascend the reproductive tract, leading to pelvic inflammatory disease and tubal factor infertility. OBJECTIVE: This study investigated the molecular prevalence of Chlamydia trachomatis infection (CTI) among women attending a gynaecological clinic for infertility evaluation. METHODS: This cross-sectional study involving 135 women was conducted at Edo University Teaching Hospital, Auchi, Nigeria. Endocervical swabs were collected during speculum examination and stored in DNA stabilization buffer at - 20 °C. Genomic DNA was extracted using the Qiagen DNA extraction kit, followed by PCR amplification targeting the ompA gene of C. trachomatis. Socio-demographic and clinical data were collected via structured questionnaires. Statistical significance was assessed using IBM SPSS Statistics version 25 (IBM Corp.) and the Chi-square test, with significance defined as p < 0.05. RESULTS: Out of 135 women screened, the molecular prevalence of CTI was 27.4%. The highest rate occurred among women of 18-26 years of age (31.6%), although age differences were not statistically significant (p = 0.38). Chlamydia trachomatis infection was significantly associated with a history of STIs (40.0% vs. 20.0%, p = 0.02) and PID (45.0% vs. 20.0%, p = 0.01). Women with secondary education had a higher prevalence (36.7%) than those with tertiary education (20.0%) (p = 0.05). No significant association was observed between vaginal symptoms and infection status, with malodorous discharge also failing to demonstrate statistical significance (p = 0.08). Logistic regression identified younger age (18-26 age group) (OR = 0.46, p = 0.007), STI history (OR = 0.24, p < 0.001), and PID (OR = 2.67, p = 0.005) as significant predictors of CTI. Tertiary education was protective (OR = 0.42, p = 0.028). CONCLUSION: Chlamydia trachomatis infection was prevalent among women attending a gynaecological clinic for infertility. Younger age, a history of STIs, and PID were significant predictors of infection, while tertiary education appeared protective. Targeted screening and educational interventions are essential to mitigate infection-related infertility.