Study on the etiology of acute pelvic inflammatory disease in women within the ages 16 - 40 years as seen at the special treatment clinic (stc), Nairobi city commission

Abstract

Acute Pelvic Inflammatory disease is a common gynecological problem in many parts of Africa. It is one of the major problems seen at the Sexually Transmitted Disease Clinic at Nairobi City Commission. In this study, 100 women within the ages 16-40 years with clinical signs and symptoms of acute pelvic inflammatory disease and another 100 women within the same age group but without clinical signs and symptoms of acute PID were enrolled for the study. The main objective of the study was to study the prevalence of Neisseria gonorrlweae, Chlamydia trachomatis and Group B Streptococcus (Streptococcus agalactiae) in women with clinical signs and symptoms of acute pelvic inflammatory disease. Also to study the relation of acute PID in terms of age, parity, marital status and contraception method used by the patient. These findings were then to be compared to those seen in the control women. These women were screened for N. gonorrlweae, C. trachomatis, Group B. Streptococcus using endocervical cultures on Thayer Martin, blood agar and irradiated McCoy cell lines, and also by Gramstain of endocervical smears. They were also screened for Treponema pallidum antibodies using rapid plasma reagin card test. Acute pelvic inflammatory disease was found to be more prevalent in the younger age group below 25 years of age with a peak at 16-20 years. Oral contraceptive use was correlated with a significantly decreased risk of acute PID (odds ratio 0.78, p-value<0.05) and IUCD use correlated with a significantly increased risk of acute PID (odds ratio 1.27, p-value<0.05). Gonococcal acute PID was found to be commoner in a younger age group than non-gonococcal acute PID. Risk of gonococcal acute PID was also found to be significantly increased in the single, separated (odds ratio 3.12; pvalue- cu.Ob) and the divorced women (odds ratio 1.67; p-value-cu.Ob). Chlamydial acute PID was found to be commoner in a younger age group as compared to non-chlamydtal acute PID. Group B streptococcus was isolated from only 1% of acute PID cases