Chlamydia and gonorrhoea in pregnant Batswana women: time to discard the syndromic approach?

Romøren, Maria; Sundby, Johanne; Velauthapillai, Manonmany; Rahman, Mohammad Zillur; Klouman, Elise; Hjortdahl, Per

doi:10.1186/1471-2334-7-27

Cited by 77 publications

(90 citation statements)

References 20 publications

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“…This result is higher than the 3.9% observed in Jordan [29] and the 8% reported in pregnant woman in Botswana [30].In developing countries, including Sudan, diagnosis of cervical infections namely due to C. trachomatisis limited to the syndromic approach of relying on the appearance of vaginal discharge [31]. Due to the high prevalence of C. trachomatis infections in this study, routine diagnostic techniques such as the direct fluorescence test or polymerase chain reaction are needed in our hospitals.…”

Section: Discussioncontrasting

confidence: 68%

Vaginal infections among pregnant women at Omdurman Maternity Hospital in Khartoum, Sudan

Abdelaziz

Ibrahim

Bilal

et al. 2014

J Infect Dev Ctries

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Introduction: Microbial infections of the vagina in pregnant women are health problems that lead to serious medical complications and consequences. This study aimed to investigate and determine antimicrobial susceptibilities of the causative agents of vaginal infections in pregnant women. Methodology: A cross-sectional study of pregnant women (n = 200) was conducted between August and December 2008 at Omdurman Maternity Hospital, Khartoum, Sudan. Vaginal and cervical swabs were obtained from each subject and processed for isolation and identification of pathogenic microorganisms using standard methods of wet mount preparation, direct Gram smear, Nugent scoring system, direct immunofluorescence, and cultural techniques. Antimicrobial susceptibility testing of bacterial isolates was performed using standard procedures. Statistical analysis was done using SPSS program version 12.0.1. A p value < 0.05 was considered statistically significant. Results: Of the 200 pregnant women enrolled, BV was detected in 49.8%, followed by Chlamydia trachomatis (31.3%) and Candida albicans (16.6%), with low frequencies of Neisseria gonorrhoeae (1.8%) and Trichomonas vaginalis (0.5%). Higher infection rates were recorded among subjects in the third trimester (71.6%) than in the second trimester of gestation (28.4%). No significant association (p = 0.7) between history of abortions and C. trachomatis infections was found. Gentamicin was the most active agent against Gram-positive and Gram-negative bacteria. Clarythromycin was the most active against Mycoplasma species. Conclusions: Pregnant women with vaginal complaints revealed various positive microbiology results. Such cases may require specific medication. Routine culture of vaginal and cervical samples should be performed on all pregnant women during prenatal visits.

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Section: Discussioncontrasting

confidence: 68%

Vaginal infections among pregnant women at Omdurman Maternity Hospital in Khartoum, Sudan

Abdelaziz

Ibrahim

Bilal

et al. 2014

J Infect Dev Ctries

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“…Our findings and that of other recent studies, however, question the validity of this approach based on the large proportion of asymptomatic STIs prevalent in pregnant and other high-risk population groups. 15,[24][25][26][27] When extrapolating our findings to all primary health clinics using the syndromic approach to treating STIs in women, it would appear that an estimated 50% of pregnant women with 1 or more STIs and asymptomatic will go untreated if the syndromic approach is applied. Postdelivery, an estimated 80% of the women who are asymptomatic but infected with 1 or more STIs would be missed.…”

Section: Discussionmentioning

confidence: 99%

High Prevalence and Incidence of Asymptomatic Sexually Transmitted Infections During Pregnancy and Postdelivery in KwaZulu Natal, South Africa

Moodley

Sebitloane

et al. 2015

Sexually Transmitted Diseases

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“…The syndromic approach remains the main diagnostic choice in most developing countries with limited laboratory facilities. 15 …”

Section: Syndromic Approachmentioning

confidence: 99%

Are we satisfied with the tools for the diagnosis of gonococcal infection in females?

Tsou

Chen

et al. 2011

Journal of the Chinese Medical Association

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Gonorrhea (Neisseria gonorrhoeae) is a common sexually transmitted infection in women, with a heavy burden on female and neonatal health, because sequelae occur, such as female infertility, ectopic pregnancy, neonatal ophthalmitis and infection, and chronic pelvic pain. Prompt and appropriate antibiotic treatment can cure infection and avoid complications. However, adequate treatment is not easy, because early and rapid identification of gonorrhea is interfered with by many factors, including the complicated mixed microflora of the vagina and cervix, non-user-friendly culture systems, and lack of immediate availability of results, even with a combination of subjective complaint and high clinical suspicion. A PubMed search was conducted using the major headings of "gonorrhoea and diagnostic tool" and "Neisseria gonorrhoeae and diagnostic tool", before the end of 2010. Recently available methods for the diagnosis of gonorrhea infection in women were included, including traditional tools and advanced technology. Traditional tools such as microscopic examination and microbial culture have been used broadly; unfortunately, they have relatively lower specificity or sensitivity, and most importantly, "see-and-treat" is impossible for these infected women. Advances in technology, such as antigen detection by immunoassay and nucleic acid amplification tests (NAATs), have achieved major progress in the diagnosis of gonorrhea, because of their accuracy, convenience and time-saving aspects. However, NAATs are expensive, making their acceptance impossible in developing countries. Detection of pathogens including N. gonorrheae using microarray chips is viewed as a possible solution, because it is a relatively rapid, easy, inexpensive and sensitive tool, which makes an "identify-and-treat" or point-of-care policy possible. A rapid and affordable tool with high sensitivity and specificity for detection of gonorrhea in developing countries is still not available at the time of writing. To make a point-of-care policy possible, advanced technology for aiding diagnosis of gonorrhea is encouraged and appreciated.

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Chlamydia and gonorrhoea in pregnant Batswana women: time to discard the syndromic approach?

Cited by 77 publications

References 20 publications

Vaginal infections among pregnant women at Omdurman Maternity Hospital in Khartoum, Sudan

Vaginal infections among pregnant women at Omdurman Maternity Hospital in Khartoum, Sudan

High Prevalence and Incidence of Asymptomatic Sexually Transmitted Infections During Pregnancy and Postdelivery in KwaZulu Natal, South Africa

Are we satisfied with the tools for the diagnosis of gonococcal infection in females?

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