Comparison of direct immunofluorescence [DIF] and enzyme immunoassay [ELISA] for detection of chlamydia trachomatis infection in cases of abortion and premature rupture of membrane

ABSTRACT

Genital Chlamydia trachomatis [C. trachomatis] in the endocervix was investigated among 90 pregnant women [60 women applying for spontaneous abortion and 30 women with premature rupture of membrane [PROM]; The incidence of infection with this sexual transmitted pathogen was 1.67% among asymptomatic low risk group and 23.33% among the group presenting with symptomatic endocervitis [high risk group] with a total incidence among the 90 pregnant women of 8.89%. C. trachomatis was found more associated with greater sexual activity so it's incidence was high among younger age group and early marriage. The diagnosis of genital C. trachomatis was done by non culture immunological detection of Chlamydial antigens. We applied tuo different methods for diagnosis, direct immunofluorescence and enzyme immunoassay. The sensitivity and specificity of DIF in our study was 88.89% and 100% respectively while the sensitivity of ELISA was more than DIF [100%] and the specificity was slightly lower [98.7%]. The percentage of over all agreement between the two antigen detection assays were 98.8%. Neither test is ideal for diagnosis of Chlamydial infection but still they can provide an alternative to the cost, time consuming and technique dependent cell culture. The effect of C. trachomatis on the outcome of pregnancy is still speculative. There is a significant [P<0.05] association between spontaneous abortion and endocervical carriage of Chlamydia. Other adverse pregnancy outcomes as PROM were not associated with Chlamydia positive women