Document Detail


Sexual violence, HSV-2 and HIV are important predictors for infertility in Rwanda.
MedLine Citation:
PMID:  20685757     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In order to formulate cost-effective health interventions aimed at preventing infertility it is necessary to identify modifiable risk factors for infertility in sub-Saharan Africa. This case-control study examined potential predictors and their population attributable fraction (PAF%) for various infertility types including lifestyle factors, sexual behaviour and reproductive tract infections (RTIs).
METHODS: Sexually active women aged 21-45 year presenting with infertility problems at the infertility clinic of the Kigali University Teaching Hospital (n = 312), and fertile controls who recently delivered (n = 283) were surveyed together with their male partners. Participants were interviewed about socio-demographic characteristics, sexual behaviours and lifestyle factors, and were tested for HIV and RTIs.
RESULTS: Variables significantly associated with tubal infertility were history of sexual violence [adjusted odds ratio (AOR) 2.41; 95% CI 1.36-4.25]; positive HIV (AOR 2.41; 95% CI 1.36-4.25), herpes simplex virus type 2 (HSV-2; AOR 1.67; 95% CI 1.03-2.71) and Chlamydia trachomatis serology (AOR 1.78; 95% CI 0.99-3.21), and current bacterial vaginosis by Amsel criteria (AOR 1.97; 95% CI 1.12-3.47). Among men, male factor infertility was associated with positive HIV (AOR 2.43; 95% CI 1.31-5.23) and HSV-2 serology (AOR 1.71; 95% CI 1.02-2.87) and current urologic abnormalities (AOR 2.38; 95% CI 1.01-5.31). Positive HSV-2 serostatus carried the greatest PAF% (26%) for tubal infertility, followed by positive HIV serostatus (20%) and history of sexual violence (17%).
CONCLUSIONS: Although temporal relationships are difficult to ascertain, history of sexual violence, HSV-2 infection and HIV infection are important predictors of infertility in Rwanda.
Authors:
N Dhont; J van de Wijgert; S Luchters; C Muvunyi; J Vyankandondera; M Temmerman
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-08-04
Journal Detail:
Title:  Human reproduction (Oxford, England)     Volume:  25     ISSN:  1460-2350     ISO Abbreviation:  Hum. Reprod.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-16     Completed Date:  2011-01-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8701199     Medline TA:  Hum Reprod     Country:  England    
Other Details:
Languages:  eng     Pagination:  2507-15     Citation Subset:  IM    
Affiliation:
International Centre for Reproductive Health, Ghent University, Ghent, Belgium. dhontnathalie@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Case-Control Studies
Chlamydia Infections / blood,  epidemiology,  microbiology
Chlamydia trachomatis / isolation & purification
Female
HIV Infections / blood,  epidemiology*,  transmission
Herpes Genitalis / blood,  epidemiology*,  transmission
Herpesvirus 2, Human*
Humans
Infertility, Female / blood,  epidemiology*,  virology
Infertility, Male / blood,  epidemiology*,  virology
Male
Middle Aged
Rwanda / epidemiology
Sex Offenses*
Sexual Behavior / statistics & numerical data
Vaginitis / epidemiology,  virology
Violence*
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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