Occupational Determinants of Azoospermia among Patients Attending Ebenezer Clinical Laboratory - Kampala Capital City, Uganda

Background: Azoospermia is one of the social problems affecting families/countries today in the whole world, which has resulted in an involuntary declining birth rate (Sengoku, 2012) [34]. Worldwide, more than 70 million couples suffer from infertility, and it is estimated that azoospermia is found in up to 10 to 20 per cent of the men who present to an infertility clinic (Kumar, 2015) [30]. Uganda is among the countries where male infertility is assumed to be a big challenge, with an estimated 5,000,000 people facing infertility, where 10 to 15% of the couples are unable to have children. Hence the current study aimed at establishing the occupational-related factors associated with azoospermia among patients attending Ebenezer Clinical Laboratory, Kampala, Uganda.

Methods: A retrospective case-control study design was conducted on men who had visited the Microbiology Department for semen analysis from 1st January to 31st December 2015. Cases were azoospermic participants in the ECL database with no sperm cells in the ejaculate whereas controls were normozoospermic participants in the ECL database with normal sperm cells in the ejaculate. Systematic sampling was employed in the selection of respondents using their clinical records. The sample size was 204 (102 cases and 102 controls) clients, determined using a formula from the OpenEpi software package for Kelsey. The sample involved 102 cases and 102 with a ratio of cases to controls being 1:1. The study used a data abstraction semi-structured questionnaire for data collection. Data was analyzed using descriptive statistics to generate frequencies, percentages, means, standard deviations, and ranges. The chi-square test and binary logistic regression analyses were used to determine whether there was a significant association between risk factors and azoospermia at 0.05 statistical significance.

Results: The study found that exposure to phones [AOR = 0.110, (CI 95% = 0.001- 0.171), p=0.001], noise exposure [AOR = 0.041, (CI 95% = 0.009 - 0.189), p=0.000], and having ever had an accident [AOR = 0.041, (CI 95% = 0.002 - 0.923), p=0.000] were statistically significant factors associated with azoospermia among patients (p < 0.05) (p < 0.05).

Conclusions: Interventions should be focused on improving these factors, such as sensitizing the males on dangers of getting exposed to mobile phones, as well as strengthening policy guidelines on noise pollution and road safety measures.