Prevalence and Immunogenetic Aspects of Chlamydia trachomatis Infection Associated with Conjugal Infertility

Abstract

Chlamydia trachomatis is a mandatory intracellular bacterium whose only natural host is humans. It is the main cause of sexually transmitted bacterial infections worldwide and is most prevalent in young women and men (14-25 years) probably due to its asymptomatic course, inadequate treatment of the partner and delayed development of protective immunity. Chlamydia trachomatis infects squamocolumnar or transition epithelial cells, causing cervicitis in women and urethritis in men. Symptoms are mild or absent. Infection by Chlamydia trachomatis exacerbates the host's inflammatory response to support its mandatory intracellular developmental cycle. Infertility is the most relevant sequel and affects 15% of couples of reproductive age. The factors responsible for infertility are dominated by Chlamydia trachomatis, which can cause serious complications, such as tubal obstructions, ectopic pregnancy, epididymitis, and total irreversible azoospermia. Infertility remains neglected or underdiagnosed in Angola and in most sub-Saharan African countries. The present study aims to estimate the prevalence of Chlamydia trachomatis and its impact on the reproductive health of couples worldwide, particularly in Sub-Saharan Africa. This review was performed by searching the relevant literature using keywords in the databases MEDLINE, PubMed and Uptodate without language or year restrictions, including Marital Infertility, Chlamydia trachomatis, and Angola. The prevalence of Chlamydia trachomatis infection is high, and the impact on human reproduction in Africa lacks screening programs and studies of greater scientific relevance. The high rates of asymptomatic infections, especially in women, suggest that diagnostic tests are available free of charge, as well as national screening programs for Chlamydia trachomatis, which already exist in other countries. This makes it possible to formulate policies to fight the disease, make diagnostic tests available free of charge, and develop clinical protocols for better guidance in clinical decisions.