Chlamydia trachomatis prevalence in the Greater Accra region and the Western region of Ghana

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Chlamydia trachomatis is one of the most prevalent Sexually Transmitted infections (STIs) worldwide due to its frequent asymptomatic nature and is normally tested alongside Niesseria gonorrhoeae which is also a bacterial pathogen. It is known to cause infections which can lead to ectopic pregnancy and neonatal conjunctivitis among pregnant women and Pelvic Inflammatory diseases (PID) in women when left untreated. C. trachomatis can also lead to infertility among males. Five sites in two regions were selected for the study. These included the 37 Military hospital and Adabraka STI clinic, Accra (Greater Accra region) and the three clinics at Sekondi/Takoradi (2 Medical Reception Station (2MRS), the Naval Health Center and the Air Force Medical Center) in the Western region. Patients who met the eligibility criteria provided consent, filled out a questionnaire and were made to provide urine samples which were transported to the Noguchi Memorial Institute for Medical Research (NMIMR) at 4˚C for Nucleic Acid Amplification Testing (NAAT).A total of 35 C. trachomatis positives out of 340 (151 males and 189 females) patients were detected during the study, giving a prevalence of 10.3%. The prevalence of chlamydia was higher (19.8%, 14/73) among the Takoradi clinics than the Greater Accra clinics (7.9%, 21/267). The males showed higher percentages in all the risk factors analyzed than the females. The risk factors included burning during urination, discharge and bleeding from penis/vagina, foul smell from urine, pain in penis/vagina, pain when having sex, ulcers and warts on genital parts. Burning during urination showed a relationship of a patient testing positive for the disease in both males and females. Most of the symptoms presented did not have any association in testing positive for C. trachomatis. It is recommended that more innovative ways be found to test sexually active young people, since the disease remain subclinical in many people. Health authorities and Clinicians should be encouraged to use NAATs as a diagnostic tool and in the absence of laboratory testing, syndromic approach could be used for diagnosis.
A thesis submitted to Department of Clinical Microbiology, School of Medical Sciences, Kwame Nkrumah University of Science and Technology (KNUST) in partial fulfillment of the requirement for the award of Master of Philosophy Clinical Microbiology degree, 2015