Sero-epidemiological assessment of Chlamydia trachomatis infection and sub-fertility in Samoan women

Abstract

BackgroundIn our recent village-based cross-sectional study, the prevalence of nucleic acid amplification technique (NAAT) diagnosed Chlamydia trachomatis (CT) in sexually active Samoan women was very high (36 %), and test positivity was associated with sub-fertility. We conducted a serological and epidemiological analysis in these participants to identify if serological data can provide further insight into the potential contribution of CT to sub-fertility in this population.MethodsSerological prediction of CT associated sub-fertility was conducted using a series of commercial tests. The correlation between fertility or sub-fertility, behavioral factors, and serologically predicted CT associated sub-fertility was determined.ResultsA positive antibody reaction against the Chlamydia Major Outer Membrane Protein (MOMP) was significantly associated with sub-fertility, with 50 % of infertile women being positive. Serum IgG and IgA antibodies against MOMP correlated with current infection measured by urine NAAT, suggesting longer term infections are common in this population. Chlamydia pneumoniae antibodies were frequently detected in this population (84 %), and unexpectedly, were significantly associated with sub-fertility.ConclusionsThe high prevalence of chlamydial infection and of positive chlamydial sub-fertility results suggests that CT is an important and frequent contributory factor to sub-fertility in this population.

Performance of the multitarget Mikrogen Chlamydia trachomatis IgG ELISA in the prediction of tubal factor infertility (TFI) in subfertile women: comparison with the Medac MOMP IgG ELISA plus

“…Microscopic intraluminal damage of the mucosa may also impair the ability to conceive Keltz et al 2013;Menon et al 2016).…”

Obtaining an ELISA test based on a recombinant protein of Chlamydia trachomatis

“…Several ELISA assays have been commercially developed with Chlamydia antigens; some of them are known to be C. trachomatis-specific. Menon et al (2016) reported that CT-IgG ELISA-plus MEDAC assay (uses a synthetic peptide of a variable domain from an immunodominant region of the MOMP), as a serological test of C. trachomatis, significantly associated sub-fertility, with 50% of infertile women being positive. Land et al (2003) observed a sensitivity and specificity of 55 and 83%, respectively, for the MEDAC test, while the ELISA Labsystems assay showed a sensitivity and specificity of 37 and 87%, respectively.…”

Polymerase chain reaction versus enzyme-linked immunosorbent assay in detection of <i>Chlamydia trachomatis</i> infection among gynaecological patients in southwestern Nigeria

“…ELISA for detection of chlamydial antibodies in clinical specimens using C. trachomatis MOMP has been studied extensively as a screening tool and has been reported to have good performance when compared with the gold standard [9,[26][27][29][30][31][32] . Thus, the affordability, easy application and high throughput of the immunoassay, makes it a practical screening tool in regions of high C trachomatis prevalence and a good substitution for the more sensitive and specific PCR especially low-income countries.…”