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Title: Determinants of infertility in Africa. Author: Meheus A, Reniers J, Colletet M. Journal: Afr J Sex Transmi Dis; 1986 Oct; 2(2):31-5. PubMed ID: 12281123. Abstract: Infertility is very common in some areas of Africa, and accounts for a significant proportion of the demand for health services in some countries. Infertility has profound social implications, as blame is often assigned to the woman and she is frequently divorced. Infertility must be distinguished from pregnancy wastage as they have different etiologies, necessitating different control strategies. Primary infertility is common in some countries, with considerable differences between countries. In Zaire, 22.1% of women aged 25-29 are childless, with rates up to 46.2% in some areas, as opposed to rates of 17% in the Congo, 26% in Mali, and 7.2% in Upper Volta. Worldwide, there is a "core" infertility rate of 5% due to chromosomal, congenital and endocrinologic factors. Rates above this are indicative of acquired infertility, of which the most common cause in women is infectious salpingitis. In the World Fertility Study, all 4 African countries studied had 2ndary infertility rates above the mean. Infectious salpingitis can also cause 1st degree infertility if acquired at a young age. Data from developing countries implicate tubal factors as the main cause of infertility. A WHO study found that bilateral tubal occlusion is 3x as frequent in Africa as in other developing areas (49% vs. 11%) as a cause of infertility. 85% of African women had an infectious etiology (vs. 36%). Pelvic inflammatory disease (PID), the main cause of tubal blockage, causes infertility in 15% of women after 1 bout. Various studies have shown that PID in Africa is caused mainly by N. gonorrhoea (38 to 46%) and C. trachomatis (21 to 23%). PID in Africa occurs commonly after childbirth and abortion, with the same pathogens. STDs may also cause male infertility by blockage of the sperm ducts or decreased sperm count. Thus, STD is responsible for a large proportion of infertility in Africa and preventing STD is a major part of reducing infertility.[Abstract] [Full Text] [Related] [New Search]