The prevalence and associated factors of Chlamydia and gonococcal infections in women attending gynaecological clinics in Mulago hospital.

Abstract

Introduction Chlamydia and Gonorrhoeae are major sexually transmitted infections in the general population and particularly in the adolescent and young adults. It is important to establish the prevalence of these infections in a sexually active Ugandan population if efforts to diagnose and treat are to be made to reduce on the burden. Objective To determine the prevalence and associated factors of Chlamydia and Gonorrhoeae in women attending Gynaecological clinics in Mulago Hospital. Study Design: Analytical Cross sectional study. Methods: From February - April 2005, 387 females aged between 15 and 49 years who were sexually active and consulted in Lower Mulago Hospital Gynaecological emergency (5A Annex) and Gynaecological outpatient clinics were recruited by consecutive sampling, interviewed to complete a demographic and sexual health questionnaire. Following an informed consent, eligible participants had a pelvic examination and an endocervical specimen was collected and transported to the laboratory at room. Specimens were tested for Chlamydia trachornatis and Neisseria Gonorrhoeae using Roche Cobas Amplicor Polymerase chain reaction. Clinical signs were also documented. Data management: Data was collected using a pre-tested interviewer administered questionnaire and analysed using Epi-info and SPSS software package. Results The prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae was 3.1% and 3.6% respectively. No education status and being single were statistically significant for the presence of C. trachomatis (p<0.05). Abdominal pain OR 2.4 (0.3-19.2), vaginal discharge OR 1.5 (0.5-4.9) and endocervical discharge OR 2.2 (0.5-10.0) were more likely for the presence of Chlamydia trachomatis. Younger age below 20 years, primary education, being single, post coital bleeding, whitish yellow vaginal discharge, use of traditional herbs, dyspareunia, vulvovaginal erythema, mucopurulent endocervical discharge and cervical excitation were statistically significant for the presence of Neisseria gonorrhoeae (p<0.05). Conclusion The prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae is 3.1 and 3.6 respectively in Mulago Hospital. Chlamydia trachomatis is associated with low education status and being single and was more prevalent in the 20-24 years age group while Neisseria gonorrhoeae is associated with age range of 15-19 years, low education status, being single, whitish yellow vaginal discharge, dyspareunia, post coital bleeding, abdominal tenderness, endocervical mucopurulent discharge and cervical excitation. 15- 19 years age group and mucopurulent endocervical discharge were independently associated with Gonococcal infection.