Comparative Serological and PCR-based Detection of Chlamydia Trachomatis Infection Among Women Attending a Tertiary Hospital in Sokoto

Background: Chlamydia trachomatis infections are the most prevalent bacterial sexually transmitted infections recognized globally. Infection is associated with increased risk of sequelae in women, such as pelvic inflammatory disease (PID), ectopic pregnancy and tubal subfertility. Molecular methods such as Polymerase Chain Reaction (PCR) are considered as gold standard and highly specific diagnostic test for its detection. This study aimed at comparing both C. trachomatis specific IgM and IgG antibody detection by ELISA with Polymerase Chain Reaction (PCR) to see the practicability of using only serological methods for routine screening and diagnosis especially in low and middle income countries. Method: Three hundred and twenty-five women of reproductive age group who were attending gynecological clinic of Usmanu Danfodiyo university Teaching Hospital Sokoto were enrolled in the study. Patients were administered questionnaires requesting information on biomedical and sociodemographic data. Endocervical specimens were collected, subjected to DNA extraction and polymerase chain reaction (PCR) using primers from Inqaba Biotechnical industries, South Africa. Blood samples were also collected for indirect Enzyme Linked Immunosorbent Assay (ELISA) for detection of IgG and IgM antibodies specific to C. trachomatis major outer membrane protein (MOMP). Data collected were subjected to descriptive and inferential statistical analysis using IBM Corp. Released 2015. IBM SPSS Statistics for Windows, Version 23.0 (Armonk, NY: IBM Corp.). Results: The overall results showed that C. trachomatis specific IgM antibody was detected in 7 (7/325) 2.2%, C. trachomatis specific IgG antibody was also detected in 5 (5/325) 1.5% using ELISA, while the rate of C. trachomatis infection confirmed by PCR was 12 (12/325) 3.7%. Using PCR as the gold standard, the sensitivity and specificity of ELISA were 73.3% and 100% respectively. While the positive predictive value, negative predictive value was 100% and 1.3% respectively. Conclusion: C. trachomatis specific IgM and IgG antibody detection by ELISA gave comparable results in more than 70% of true positive samples detected by PCR. Thus, it suggests that they are practicable and cheaper alternatives to the molecular techniques for routine screening and diagnosis especially in low and middle income countries.