How chlamydia fuels infertility
When 36-year-old Maria suffered an ectopic pregnancy, she went for medical checkups and was in all instances given clean bill of health, including for Sexually Transmitted Infections (STIs). After the clean bill of health, Maria who had been married for six years without a child, continued to experience stomachache. EXPLAINER: What you need to know […]
When 36-year-old Maria suffered an ectopic pregnancy, she went for medical checkups and was in all instances given clean bill of health, including for Sexually Transmitted Infections (STIs).
After the clean bill of health, Maria who had been married for six years without a child, continued to experience stomachache.
Therefore, she was shocked when she travelled to Europe and was diagnosed as having chlamydia.
She was also told that chlamydia infection was responsible for the ectopic pregnancy and had blocked one of her fallopian tubes.
She said, “The chlamydia was not seen in any of my previous tests in Nigeria, but I got to know that it had been with me for a long time and had been responsible for my inability to conceive.”
Azeezat on her part had been married for eight years and suffered the stigma that comes with infertility. She was diagnosed with bilateral tubal occlusion (blocked fallopian tubes) as a result of chlamydia.
She never had any symptom or heard about chlamydia. After tests for STIs, she was only told she had staphylococcus.
She said, “I did hepatitis test too, and never knew I had such a disease that could cause me immense damage.”
Jonah (28) was diagnosed with chlamydia when he had no symptoms. He was glad it was diagnosed early when his friend who is a physician asked him to do some tests.
Experts say chlamydia is often asymptomatic, and if undetected and untreated, leads to infertility and chronic pelvic pain, ectopic pregnancy and can also facilitate HIV acquisition and transmission.
According to the Centre for Disease Control (CDC), chlamydia is a common Sexually Transmitted Disease (STD) that can infect both men and women.
CDC notes that: “It can cause serious, permanent damage to a woman’s reproductive system. This can make it difficult or impossible for her to get pregnant later on. Chlamydia can also cause a potentially fatal ectopic pregnancy (pregnancy that occurs outside the womb).”
The centre explained that one can get chlamydia by having vaginal, anal or oral sex with someone who has the disease.
CDC further notes that: “If your sex partner is male you can still get chlamydia even if he does not ejaculate (cum).If you’ve had chlamydia and were treated in the past, you can still get infected again. This can happen if you have unprotected sex with someone who has chlamydia. If you are pregnant, you can give chlamydia to your baby during childbirth.
“This could cause eye infection or pneumonia in your newborn. Having chlamydia may also make it more likely to deliver your baby too early.
“If you are pregnant, you should get tested for chlamydia at your first prenatal visit. Testing and treatment are the best ways to prevent health problems.”
According to CDC, most people who have chlamydia have no symptoms, and that if they have symptoms, they may not appear until several weeks after they have sex with an infected partner.
Women with symptoms may notice abnormal vaginal discharge and a burning sensation when urinating, while men may notice a discharge from their penis and a burning sensation when urinating.
Medical experts say chlamydia can be cured with the right treatment.
CDC noted that repeated infection with chlamydia is common, and therefore advised that one should be tested again about three months after treatment, even if their sex partner was also treated.
Challenges with chlamydia diagnosis in Nigeria
Laboratory tests can diagnose chlamydia. However, diagnosis of this disease seems a problem in Nigeria.
Dr Casmir Ifeanyi Casmir, a public health expert, said his findings on the prevalence of chlamydia among female university students showed that it was quite high.
Dr Casmir said, “Unfortunately, most public and private health institutions in Nigeria; close to 99.9 per cent, lack capacity and competency and do not have the supportive infrastructure and resources for the routine detection of chlamydia infection in men and women.”
He said that was why chlamydia was causing primary and secondary infertility in both men and women in the country.
He explained that, “Most times many of what are considered or labeled as staphylococcus infection are actually undetected complicated STIs that may be due to chlamydia.”
According to Dr Casmir, who is also a medical laboratory scientist, the cultivation of organisms like chlamydia are largely performed via cell culture and Polymerase Chain Reaction (PCR) which are not commonly available in Nigeria.
However, he said diagnosis of chlamydia could be made “using the eliza platform and the chemelusense RTD-based test that detected antigen-based test from clinical specimen.
He said, “There are a few rapid diagnosis kits out there for the detection of chlamydia in blood and other clinical specimens such as urethra swab and endo-cervical swab. So whenever you have a case of non-gonococal urethritis, you will need to screen chlamydia.
“What do I mean by non-gonococcal urethritis? A man has urethra discharge and you do all the screenings and all you find it is staphylococcus. Besides, before your screening, you do not find discharge or you find colourless discharge, you will need to screen for chlamydia
“Once you have signs of urinal tract infection, pelvic inflammatory disease, part of the work up differential diagnosis should include a test for chlamydia, and that can be done using the eliza protocol, and using also some of the chemelusense RTD-based test that detects each antigen-based test from clinical specimen”
He said his recommendations as a medical microbiologist was that for every patient presenting STD or other infections, “You should in your work up differential cocktail include a test for chlamydia, particularly an antigen -based test for chlamydia.”
He added that another challenge was the lack of awareness among clinicians, caregivers and even health-seeking members of the public.
Therefore, he advised that, “It is not as if we have a total lack of capacity for its detection. The major challenge is that the awareness is low. Clinicians are also largely not informed. They gloss over it. They think that it is out of reach. It is within reach. So we need to begin to hype information around the preponderance of chlamydia as a leading cause of STIs and their sequel, which are issues about primary and secondary infertility.”