Chlamydia trachomatis and Neisseria gonorrhoea Co-Infection Among Patients Attending a Teaching Hospital in Nairobi County: A Retrospective Study

Abstract

Background: Chlamydia trachomatis and Neisseria gonorrhoea are microbes that have been associated with urethritis in both male and female genders, which often may lead to complicated conditions such as pelvic inflammatory disease (PID) and infertility globally among others health complications. In Kenya and other developing countries, sexually transmitted infections associated with Chlamydia trachomatis and Neisseria gonorrhoea still pose a challenge in public health.

Methods: A retrospective study was conducted by reviewing laboratory data from Jan 2018 to Dec 2018 to estimate the prevalence of C trachomatis and N gonorrhoea coinfections in patients attending a tertiary institution and its satellite clinics spread across the country. A total of 1228 patient’s data aged 3-69 years was reviewed; with age, gender and Chlamydia trachomatis and Neisseria gonorrhoea status being analyzed.

Results: A total of 1228 patients who visited the hospital in 2018 had their urine samples being tested for Chlamydia trachomatis and Neisseria gonorrhoea by use of a PCR technique. Majority of the patients were males (63.7%). The patients who tested for Chlamydia trachomatis and Neisseria gonorrhoea had an average age of 34 years (range: 3–69 years). Of those 1.4% tested positive for both Chlamydia trachomatis and Neisseria gonorrhoea infections, and males were more infected than females (1.1% vs 0.3).

From the information gathered during the study period, the proportion of patients with Chlamydia trachomatis infection was (16.1 %) (95 % CI 9.5, 17.9), and with N. gonorrhoea infection was 5.4%. Coinfection was highest among sexually active group that is those aged between 21 years to 40 years.

Conclusion: The prevalence of C. trachomatis is significantly high among male patients. We recommend the implement a molecular screening for Chlamydia trachomatis and Neisseria gonorrhoea to identifying asymptomatic female cases. This study further provides evidence on the importance of contact tracing in the management of Chlamydia trachomatis and other STIs. There is an urgent need for studies designed to investigate the prevalence and risk factors of Chlamydia trachomatis and Neisseria gonorrhoea among female patients who are majorly asymptomatic in Kenya.