ELFA and IFAT Techniques to Detect Chlamydial Infections in Baghdad Women and Its Effect on the Immunoglobulins Level.

Background: Chlamydia trachomatis is one of the most common human pathogens and considered as one of the causative agents of STDs. This organism cause acute and recurrent pelvic infections and infertility. Patients and Methods: Two hundred and seventy three females were included in the present study, attending infertility department, AL-Elwiya hospital, AL-Jarah private hospital, central public health laboratory and STDs clinic to whom IFAT, ELAF and immunoglobulins concentration were done. Results: Females were divided into three age groups <20; 20-39 and ≥40 years. Single and repeated abortions were 44.9%, 55.1% respectively. Primary and secondary infertility were 55.6% and 44.4%. Higher abortions rate were in the age group 20-39 years which represents 31.5% and 41.6% in single and repeated abortions. Primary and secondary infertility were high in the same age group which represents 42.6% and 33.3% of the total investigated females, also the multipartners within the same age group constitutes 56.7%.Chlamydial infections detected by IFAT technique constitute 12.8% which were represented as 14.6%, 11.1%, 36.7% and 5% in abortions, infertility, multipartners and fertility with no abortion groups respectively. While by ELFA technique the percentages were 12.4%, 9.3%, 30% and 4% in the same mentioned groups.Immunoglobulins mean value in females with chlamydial infections wee as follows IgG = 2102.1 mg/dl; IgA = 317.9 mg/dl and IgM = 272.5 mg/dl. Which were more than the normal values of the immunoglobulins. Conclusions: Chlamydial infections were distributed largely among multipartners than other aborted females. High abortions were noted in age group 20-39 years. IFAT technique was more reliable than ELFA technique to detect chlamydial infections. IgG and IgM concentrations were higher than normal concentrations, while IgA remains normal

Epidemiology of Chlamydia trachomatis in the Middle East and north Africa: a systematic review, meta-analysis, and meta-regression.

BACKGROUND: The epidemiology of Chlamydia trachomatis in the Middle East and north Africa is poorly understood. We aimed to provide a comprehensive epidemiological assessment of C trachomatis infection in the Middle East and north Africa. METHODS: We did a systematic review of C trachomatis infection as well as a meta-analysis and meta-regression of C trachomatis prevalence. We searched PubMed and Embase, as well as regional and national databases up to March 13, 2019, using broad search terms with no language or year restrictions. Any document or report including biological measures for C trachomatis prevalence or incidence was eligible for inclusion. We extracted all measures of current (genital or rectal), recent, and ever infection with C trachomatis. We estimated pooled average prevalence in different populations using random-effects meta-analysis. Factors associated with prevalence and sources of between-study heterogeneity were determined using meta-regression. FINDINGS: We identified a total of 1531 citations, of which 255 reports contributed to 552 C trachomatis prevalence measures from 20 countries. No incidence measures were identified. Pooled prevalence of current genital infection was 3·0% (95% CI 2·3-3·8) in general populations, 2·8% (1·0-5·2) in intermediate-risk populations, 13·2% (7·2-20·7) in female sex workers, 11·3% (9·0-13·7) in infertility clinic attendees, 12·4% (7·9-17·7) in women with miscarriage, 12·4% (9·4-15·7) in symptomatic women, and 17·4% (12·5-22·8) in symptomatic men. Pooled prevalence of current rectal infection was 7·7% (4·2-12·0) in men who have sex with men. Substantial between-study heterogeneity was found. Multivariable meta-regression explained 29·0% of variation. Population type was most strongly associated with prevalence. Additional associations were found with assay type, sample size, country, and sex, but not with sampling methodology or response rate (about 90% of studies used convenience sampling and >75% had unclear response rate). There was no evidence for temporal variation in prevalence between 1982 and 2018. INTERPRETATION: C trachomatis prevalence in the Middle East and north Africa is similar to other regions, but higher than expected given its sexually conservative norms. High prevalence in infertility clinic attendees and in women with miscarriage suggests a potential role for C trachomatis in poor reproductive health outcomes in this region. FUNDING: National Priorities Research Program from the Qatar National Research Fund (a member of Qatar Foundation)