Prevalence of syphilis and chlamydia in married females of Quetta

The objective of the research was to study the prevalence of syphilis and chlamydia in married females who visited Gynecology OPD of Bolan Medical College Hospital Pakistan for different gynecological problems during the months of January to April 2016. Total number of female patients studied was 100. Out of which 86 were local females and 14 were immigrant/non-local immigrant female patients. Blood samples were collected and serum was separated for detection of antibodies against Syphilis and for the detection of chlamydia vaginal swabs were taken and tested using Immuno-chromatography Kits. Out of 100 females tested 2% were found positive for Syphilis and 15% were found positive for chlamydia. Syphilis was detected in age group 28 to 37. Out of 15 chlamydia positive cases, 5 were detected in age group 18 to 27, 6 were detected in age group 28 to 37; one each was detected in age groups 38 to 47, 48 to 57, 58 to 67 and 68 to 77 respectively. Out of 86 local females tested, 12.79% were found positive for chlamydia and 2.32% were found positive for syphilis. Out of 14 non-local/immigrant females tested, 28.57% were positive for chlamydia and none was positive for syphilis. All females found positive either for syphilis or chlamydia were uneducated and had no knowledge of Sexually Transmitted Diseases (STD). Syphilis and chlamydia are important STDs which cause infertility and other health problems. Community based knowledge is important to prevent these diseases in married females of Quetta. A considerable %age of females were found positive for syphilis and chlamydia in this study.

In this study we preferred to do antibody/antigen detection as this method is easy and quick.In addition antibodies can be detected from the blood for longer periods.Area wise Balochistan is the largest province but the population is less than other provinces.
People do not have much awareness about these diseases in the province, on the other diagnostic facilities regarding the infection are scarce.If syphilis and chlymidia are diagnosed at proper time they can be treated.The aim of this work was rapid detection of antibodies/antigen against Treponema pallidum and chlamydia with the help of one-step rapid diagnostic kit in married females of Quetta which was achieved.

Materials and methods
Approval from the concerned ethical committee of Bolan Medical College and CASVAB, UOB was obtained before collection of the samples.Samples were collected from patients of Gynecology Department of Bolan Medical Collage Hospital, Quetta.
For detection of syphilis, blood samples were taken from patients in sterilized blood collections tubes while for chlamydia, Cervical swabs were taken from patients by the trained hospital staff.Samples were brought to the bacteriology Lab of CASVAB, University of Balochistan Quetta and were analyzed on same day.For detection of Antibodies against syphilis blood samples were centrifuged at 6000 rmp for 3 min and serum was separated, Acon (Korea) Immunochromatograpic test kit/ Cassetts (ICT) were used.Using sterilized dropper provided with the kit, 2 to 3 drops were added to the kit well and waited for 15 minutes to read the results.For detection of chlamydia from cervical swab samples, 5 drops of reagent A (approximately 250 ul-colorless reagent) were added to the extraction tube.The swab was immediately inserted in the tube and six drops of reagent B (approximately 300 ul-pale yellow) were added to the extraction tube.The swabs were rotated until the solution turned clear or slightly green or blue tint.The swab was squeezed against the side of tube and removed.Now six drops (approximately 300 ul) were taken and added to the cassette well of the chlamydia test kit and waited for 15 minutes to interpret the results.The results were interpreted according to the findings given below Positive: Control and Test regions show red lines.Negative: Only control shows red line.Invalid: Control line does not appear Results Age wise prevalence Syphilis and chlamydia both were found more prevalent in 28-37 year age group; in addition, it was also found that chlamydia was more prevalent as compared to syphilis in the females of Quetta as shown in Table 1.

Socioeconomic wise prevalence
It was seen in the study that illiterate patients were more infected with syphilis and chlamydia than literate.While in case of socioeconomic status syphilis and chlamydia infections were seen to be more frequent in lower middle class and lower class, as shown in Table 3.
According to the history taken from the patients, most the patients were found with the complaint of previous illness and infertility.Watery discharge from the nose was observed in only one syphilis positive case out of hundred while vaginal discharge was observed in 30% cases of chlamydia positive cases as shown in Table 4.

12, 13].
Treponema palladium is grouped into four subspecies such as T. palladium, T. pendemicium, T. pcarateum, and T. ppertenue [1].Sexual and vertical Chlamydia is a bacterium but it resembles virus as it is unable to replicate outside a cell and it has both the RNA and DNA unlike a virus.It is not dependent like viruses and has its own enzymes.They are specifically adapted for extracellular survival [7].C.psittaci is very prevalent in birds and in human infection occurs due the contracting the organism from dried droppings of infected birds.Chlamydiae trachomatis and Chlamydiae psittaci are the two important species.About 56 countries have reported trachoma as endemic [8].It has been reported that 16-24 year age are more vulnerable to this disease [9].Syphilis can be very dangerous when it accompanies HIV.Seropositive cases have been reported in pregnant women [