Bhardwaj Davinder, Chawla Sushil, Seth Atul, Gill J S, Saraswat Monica
Associate Professor (Obst & Gynae), 167 Military Hospital C/o 56 APO, India.
Professor, INHS Asvini, Colaba, Mumbai, India.
Med J Armed Forces India. 2024 Dec;80(Suppl 1):S73-S77. doi: 10.1016/j.mjafi.2022.09.007. Epub 2022 Nov 28.
In India, the prevalence of Chlamydia Trachomatis (CT) studies in different groups are focused on high-risk populations - HIV-positive women and female sex workers - and have shown a variable prevalence rate ranging from 1.1 to 45%. One concern about comparing these studies is that the enzyme-linked immunosorbent assay (ELISA) test is estimated to be only 65-70% sensitive. The data of CT prevalence among women undergoing treatment for infertility, using more sensitive methods, such as Nucleic Acid Amplification Test (NAAT), are sparse. The disease is easily treatable, and knowledge of prevalence will provide the burden of disease on fertility.
A cross-sectional hospital-based observational study was carried out on 169 patients attending an infertility clinic at assisted reproductive technology (ART) center or gynecology outpatient department (OPD) of a tertiary care hospital.
The overall prevalence was 8.87% with the highest prevalence (53.84%) among the women having vaginal discharge. The prevalence in patients with secondary infertility (10.81%) was higher than in those with primary infertility (7.36%).
It is recommended that patients attending gynecological OPD in low resource setting to be treated for Chlamydia empirically and if facilities permit then they should undergo NAAT for CT detection. Screening programs are warranted among Indian women of child bearing age to prevent complications of Chlamydia infection like tubal blockage and dyspareunia.
在印度,针对不同人群的沙眼衣原体(CT)感染率研究主要集中在高危人群——艾滋病毒阳性女性和女性性工作者——研究显示感染率在1.1%至45%之间不等。比较这些研究时存在的一个问题是,酶联免疫吸附测定(ELISA)检测的灵敏度估计仅为65% - 70%。使用更灵敏方法(如核酸扩增检测(NAAT))对接受不孕症治疗的女性进行CT感染率检测的数据较少。该疾病易于治疗,了解感染率将有助于明确其对生育能力的影响。
在一家三级医院的辅助生殖技术(ART)中心或妇科门诊(OPD)就诊的169例不孕症患者中开展了一项基于医院的横断面观察性研究。
总体感染率为8.87%,其中有阴道分泌物的女性感染率最高(53.84%)。继发性不孕症患者的感染率(10.81%)高于原发性不孕症患者(7.36%)。
建议在资源匮乏地区妇科门诊就诊的患者经验性地接受衣原体治疗,如果条件允许,应进行NAAT检测以检测CT。有必要在印度育龄妇女中开展筛查项目,以预防衣原体感染的并发症,如输卵管堵塞和性交困难。