Prevalence, Pathogenic Profile, and Risk Factors of Pelvic Inflammatory Disease at a Referral Hospital in Sub-Saharan Africa: A Case-Control Study

Background: Pelvic Inflammatory Disease (PID) remains a significant public health issue in low-resource settings due to its adverse effects on female reproductive health. This study aimed to determine the prevalence, microbial profile, and associated risk factors of PID at the Douala General Hospital in Cameroon. Methods: A retrospective case-control study was conducted over a 10-year period (January 2013-December 2023) at the Douala General Hospital. Sexually active women aged 15 - 50 diagnosed with PID were included as cases, and healthy pregnant women served as controls (1:2 ratio). Data were analyzed using SPSS version 24.0. Logistic regression was used to identify risk factors, and adjusted odds ratios (AORs) with 95% confidence intervals (CI) were calculated. Statistical significance was set at p Results: A total of 257 PID cases and 514 controls were analyzed. The mean age was 31.6 ± 7.7 years, with the 25 - 30 age group most affected. The prevalence of PID was 11.93%. The leading pathogens were Chlamydia trachomatis (33.9%), Ureaplasma urealyticum (24%), and Mycoplasma hominis (22.88%), with all cases showing polymicrobial infections. Significant risk factors included age 35 - 40 years (AOR = 1.74), being single (AOR = 2.62), secondary education (AOR = 1.84), being a housewife (AOR = 2.46), history of intrauterine procedures (AOR = 2.68), history of STDs (AOR = 18.87), having ≥2 sexual partners (AOR = 8.67), early sexual debut (Conclusion: PID prevalence was 11.93%, with polymicrobial infections dominated by C. trachomatis, U. urealyticum, and M. hominis. Identified behavioral and reproductive risk factors highlight the need for targeted prevention strategies and the use of multiplex PCR testing for early diagnosis and management.