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Chlamydia trachomatis Infection as a Risk Factor for Infertility among Women in Ghana, West Africa

In developing countries, data about the prevalence of genital Chlamydia trachomatis infections and their sequelae, especially tubal infertility, is scarce. A prospective case-control study was performed enrolling 439 Ghanaian women. The case group included 191 patients with primary or secondary infertility. The control group consisted of 248 healthy pregnant women. First-void urine samples were investigated by PCR, and serum specimens were tested for C. trachomatis-specific IgG and IgA antibodies. Demographic and behavioral information were gathered for statistical analysis. The PCR prevalence of C. trachomatis was relatively low and did not differ significantly among both groups (2.4 versus 1.6%). In contrast, significantly higher prevalences of specific IgG (39% versus 19%) and IgA (14% versus 3%) antibodies were found among infertile women. The adjusted odds ratios were 2.1 and 2.8, respectively. Our data suggest that previous C. trachomatis infections may contribute to infertility in Ghanaian women.

Received April 17, 2007. Accepted for publication November 23, 2007.

Acknowledgments: We thank the nurses from the Outpatients Department of Obstetrics and Gynaecology of the Komfo Anokye Teaching Hospital, Kumasi, Ghana, for great support of our study. We are thankful for the help from Thomas F. Kruppa, director of the Kumasi Centre for Collaborative Research, having solved our logistical problems. The expert technical support of Mrs. Sonja Rothen-berger is greatly acknowledged.

^* Address correspondence to Jorn Siemer, University Hospital, Department of Obstetrics and Gynaecology, Universitätsstr. 21–23, 91054 Erlangen, Germany. E-mail: kaiserschnitt{at}gmx.de

Authors’ addresses: Jorn Siemer and Peter A. Fasching, University Hospital, Department of Obstetrics and Gynaecology, Universitätsstr. 21–23, 91054 Erlangen, Germany, Telephone: +49–9131–8533553, Fax: +49–9131–8533492, E-mail: kaiserschnitt{at}gmx.de. Oliver Theile and Rolf Kreienberg, University Hospital, Department of Obstetrics and Gynaecology, Ulm, Germany. Yaw Larbi and K. A. Danso, Komfo Anokye Teaching Hospital, Department of Obstetrics and Gynaecology, Kumasi, Ghana. Andreas Essig, University Hospital, Institute of Medical Microbiology and Hygiene, Ulm, Germany.

Reprint requests: Jorn Siemer, University Hospital, Department of Obstetrics and Gynaecology, Universitätsstr. 21–23, 91054 Erlangen, Germany, Telephone: +49 9131-8533553, Fax: +49 9131-8533492, E-mail: kaiserschnitt{at}gmx.de.