DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20150097

Acute pelvic inflammatory disease in a sub-Saharan country: a cross sectional descriptive study

Elie Nkwabong, Madye Ange Ngo Dingom

Abstract


Background: Acute Pelvic Inflammatory Disease (PID) can lead to tubal damage resulting in tubal infertility, ectopic pregnancy and chronic pelvic pain. This study aimed at identifying the sociodemographic profile and clinical presentation of women diagnosed with acute PID, as well as the microorganisms isolated.

Methods: This cross-sectional descriptive study was carried out between October 1st, 2013 and March 31st, 2014 in the University Teaching Hospital and the Central Hospital, both of Yaoundé (Cameroon). Seventy women diagnosed with acute PID were recruited. The main variables recorded were: maternal age, occupation, marital status, number of current sexual partners, the clinical presentation at admission and the microorganisms identified. Data were analyzed using SPSS 20.0.

Results: Mean maternal age was 29.0 ± 7.7 years. Students were more represented (37.1%), 58.6% were single, 64.3% had ≥2 sexual partners. The most frequent signs and symptoms were abnormal vaginal discharge (100%), adnexal tenderness (97.1%), cervical motion tenderness (94.3%) and fever ≥38.3°C (82.9%). No microorganism was isolated in 20% of cases, especially among women who underwent intra-uterine procedures. Among the cases where microorganisms were isolated, the most frequent germs were genital tract mycoplasmas (54.3%) and Chlamydia trachomatis (37.1%).

Conclusions: Acute PID is common among young, single women with multiple sexual partners, who should be regularly screened for the various sexually transmissible infections. The micro-organisms frequently responsible for acute PID were genital tract mycoplasmas, whose identification should be included among the routine tests done to women with acute PID. Cases of acute PID due to intra-uterine procedures reminds us that adequate asepsis should be observed during these procedures.


Keywords


Acute pelvic inflammatory disease, Patients’ sociodemographic profile, Clinical presentation, Microorganisms isolated

Full Text:

PDF

References


Rohrbeck P. Pelvic inflammatory disease among female recruit trainees, active component, U.S. Armed Forces, 2002-2012. MSMR. 2013;20(9):15-8.

Spencer TH, Umeh PO, Irokanulo E, Baba MM, Spencer BB, Umar AI, et al. Bacterial isolates associated with pelvic inflammatory disease among female patients attending some hospitals in Abuja, Nigeria. Afr J Infect Dis. 2014;8(1):9-13.

Wiesenfeld HC, Hillier SL, Meyn LA, Amortegui AJ, Sweet RL. Subclinical pelvic inflammatory disease and infertility. Obstet Gynecol. 2012;120(1):37-43.

French CE, Hughes G, Nicholson A, Yung M, Ross JD, Williams T, et al. Estimation of the rate of pelvic inflammatory disease diagnoses: trends in England, 2000-2008. Sex Transm Dis. 2011;38:158-62.

Reekie J, Donovan B, Guy R, Hocking JS, Jorm L, Kaldor JM, et al. Hospitalisations for pelvic inflammatory disease temporally related to a diagnosis of chlamydia or gonorrhoea: a retrospective cohort study. PLoS One. 2014;9(4):e94361.

Oroz C, Bailey H, Hollows K, Lee J, Mullan H, Theobald N. A national audit on the management of pelvic inflammatory disease in UK genitourinary medicine clinics. Int J STD AIDS. 2012;23(1):53-4.

Davies B, Turner K, Ward H. Risk of pelvic inflammatory disease after Chlamydia infection in a prospective cohort of sex workers. Sex Transm Dis. 2013;40(3):230-4.

Herzog SA, Althaus CL, Heijne JC, Oakeshott P, Kerry S, Hay P, et al. Timing of progression from Chlamydia trachomatis infection to pelvic inflammatory disease: a mathematical modelling study. BMC Infect Dis. 2012;12:187.

Schindlbeck C, Dziura D, Mylonas I. Diagnosis of pelvic inflammatory disease (PID): intra-operative findings and comparison of vaginal and intra-abdominal cultures. Arch Gynecol Obstet. 2014;289(6):1263-9.

Sweet RL. Pelvic inflammatory disease: current concepts of diagnosis and management. Curr Infect Dis Rep. 2012;14(2):194-203.

McGowin CL, Anderson-Smits C. Mycoplasma genitalium: an emerging cause of sexually transmitted disease in women. PLoS Pathog. 2011;7(5):e1001324.

Maget V, Gromez A, Roman H, Verspyck E, Marpeau L. Pelvic inflammatory disease and intrauterine contraceptive device. Monocentric continuous study of 70 cases over 5 years. [French]. Gynecol Obstet Fertil. 2013;41(7-8):437-8.

Kielly M, Jamieson MA. Pelvic inflammatory disease in virginal adolescent females without tubo-ovarian abscess. J Pediatr Adolesc Gynecol. 2014;27(1):e5-7.

Zhao WH, Hao M. Pelvic inflammatory disease: a retrospective clinical analysis of 1922 cases in North China. Gynecol Obstet Invest. 2014;77(3):169-75.

Abrao MS, Muzii L, Marana R. Anatomical causes of female infertility and their management. Int J Gynaecol Obstet. 2013;123(Suppl 2):S18-24.

Armed Forces Health Surveillance Center. Acute pelvic inflammatory disease, active component, U.S. Armed Forces, 2002-2011. MSMR. 2012;19(7):11-3.

Xholli A, Cannoletta M, Cagnacci A. Seasonal trend of acute pelvic inflammatory disease. Arch Gynecol Obstet. 2014;289(5):1017-22.

Goyal M, Hersh A, Luan X, Localio R, Trent M, Zaoutis T. National trends in pelvic inflammatory disease among adolescents in the emergency department. J Adolesc Health. 2013;53(2):249-52.

Sufrin CB, Postlethwaite D, Armstrong MA, Merchant M, Wendt JM, Steinauer JE. Neisseria gonorrhea and Chlamydia trachomatis screening at intrauterine device insertion and pelvic inflammatory disease. Obstet Gynecol. 2012;120(6):1314-21.

Crittle KN, Peipert JF. Diagnosis and treatment of pelvic inflammatory disease: a quality assessment study. Obstet Gynecol. 2014;123(Suppl 1):26S.

Woods JL, Scurlock AM, Hensel DJ. Pelvic inflammatory disease in the adolescent: understanding diagnosis and treatment as a health care provider. Pediatr Emerg Care. 2013;29(6):720-5.

Taylor BD, Darville T, Haggerty CL. Does bacterial vaginosis cause pelvic inflammatory disease? Sex Transm Dis. 2013;40(2):117-22.