Chlamydia causing infertility among young women

An increase in infertility attributed to chlamydia, causing blockage of fallopian tubes in Kenya, is raising eyebrows among fertility experts who singled out university students and young women of reproductive age as the most affected.

Prof Koigi Kamau of the department of Obstetrics and Gynecology, University of Nairobi, said chlamydia is a sexually transmitted infection caused by a specific strain of bacteria known as Chlamydia trachomatis.

Dr Ruth Masha, the CEO National Syndemic Diseases Control Council (NSDCC) said increase in cases of Chlamydia is mainly due to unsafe sex.

“If you go to fertility clinics today, and look at the queues, most of the girls have chlamydia, a worrying trend because this means more infertility in the future,” said Dr Masha.

Prof Kamau explained that chlamydia is dangerous because its growth is insidious (slow) and not easily (imperceptible) detected.

Most patients are diagnosed at an adverse stage “unlike gonorrhoea when the pain comes it is severe and therefore easy to look for attention.”

Though immunological tests can detect the antigens (components of chlamydia), they do not necessarily detect active disease.

“Chlamydia has been marked by mystery, yet it is extremely common,” said Prof Koigi. “It blows in the society without announcing its presence.”

Word Bank data shows that Kenya’s fertility rates have declined in the recent past, from 7.3 children per woman in 1960 to 5.1 in 2000. In 2020, it dipped to 3.3 children per woman.

The current fertility rate stands at 3.311 births per woman, a 1.55 percent decline from 2021.

Chlamydia is an infection by the bacteria Chlamydia trachomatis.[iStockphoto]
Take 37-year-old Brenda from Gilgil in Nakuru. The mother of a 17-year-old daughter has unsuccessfully tried to conceive since 2013

Doctors diagnosed her with blocked fallopian tubes, and neither modern nor herbal medicine have helped treat the condition.

“I did not present any symptoms of blocked tubes, a condition I learnt about as I tried to conceive unsuccessfully,” said Brenda adding that she can hardly afford IVF which requires the upwards of Sh400, 000.

Though her medical records do not specify the cause of the blockage, experts observe it might be due to chlamydia.

According to the fertility expert, infertility due to tubal damage is the most common, with nearly 80 percent, chlamydia being the leading cause of gonorrhea and infections as a result of unsafe abortions, endometriosis, and adenomyosis.

Dr Fredrick Kareithia, a gynecologist in Nairobi pegs cases of tubal blockage at 40 percent of patients though the blockage is not specifically due to chlamydia.

Dr Kareithia said at least 40 percent of infertility is attributed to males and 40 percent to females with 20 percent due to unknown factors.

The gynaecologist said the cases of chlamydia he has reviewed reported damaged and blocked fallopian tubes with majority of patients being from low social economic status.

“I have treated infections, among them, those caused by chlamydia, but there is no credible data,” added Kareithia adding that  the best way of preventing chlamydia is to have a monogamous relationship as “multiple partners risk contraction of chlamydia.”

He adds that any pain or abnormal discharge after sexual intercourse needs check-up and treatment as “ chlamydia can be treated easily, but if someone does not show up on time, it becomes complicated.”

He also advised on use condoms during sex.

Chlamydia is an infection by the bacteria Chlamydia trachomatis.[iStockphoto]
However, Kenya is currently facing an acute shortage of condoms, with the Ministry of Health yet to allocate a budget for them.

But even with the shortage, Dr Masha said people should embrace protected sex, especially college students.

Prof Koigi observed that lack of condoms risks infections of more sexually transmitted diseases besides antimicrobial Resistance also contributing to STIs and UTIs.

According to him, infection strains emerge because of poor, wrong use of antibiotics, wrong diagnosis, and lack of information and misinformation.

According to a study in Thika last year, at least one in eight adolescents tested positive for gonorrhea, chlamydia trachomatis, trichomonas vaginalis (TV) and vaginal gram stains.

Data by the Kenya Health Information System this March  also revealed an increase in syphilis among pregnant women: out of 128,767 pregnant women who attended Antenatal clinic this January, more than 4,000 tested positive for syphilis.

To prevent STIs, Prof Koigi observed the need to have public education besides including sex education into the curriculum.

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