CHLAMYDIA-TRACHOMATIS, INFERTILITY, AND POPULATION-GROWTH IN SUB-SAHARAN AFRICA

In sub-Saharan Africa, Neisseria gonorrhoeae and ChlamYdia trachomatis are common infections. These pathogens are also the major causes of p ost-salpingitis tubal infertility, and infertility is a frequent probl em in this region. A mathematical model, recently devised to estimate the effect of gonococcal infection on population growth, was used to e stimate the potential effect of chlamydial infection on population gro wth. The model predictions for chlamydial infection were compared with those previously reported for gonococcal infection. The model predict s that both infections may be exerting severe effects on population gr owth at realistic prevalence rates of infection. The model also predic ts that N. gonorrhoeae produces a steeper reduction in population grow th than does C. trachomatis because its transmission dynamics result i n a higher force of infection (incidence rate) at any given prevalence of infection. Large scale changes in the epidemiology of these infect ions can be expected to occur in sub-Saharan Africa because of improve d sexually transmitted disease (STD) diagnosis and treatment services as a component of AIDS prevention. Changes in the epidemiology of gono coccal and chlamydial infection are predicted to result in accelerated population growth unless STD control programs are linked to effective contraception programs.