Prevalence of and risk factors for curable sexually transmitted infections on Bubaque Island, Guinea Bissau

Abstract

ObjectivesComplications from sexually transmitted infections (STIs) can result in severe morbidity and mortality. To date, no STI population studies have been conducted on the Bijagos Islands, Guinea Bissau. Our objective was to estimate the prevalence of and identify risk factors for Chlamydia trachomatis (Ct), Neisseria gonorrhoea (Ng), Mycoplasma genitalium (Mg), Trichomonas vaginalis (Tv) and Treponema pallidum (Tp) on Bubaque, the most populated island.MethodsA cross-sectional survey was conducted on the island of Bubaque among people aged 16–49 years. Participants were asked to answer a questionnaire on STI risk factors, to provide urine samples (men and women) and vaginal swabs (women) for PCR testing for Ct, Ng, Mg and Tv, and to provide dry blood spots for Tp particle agglutination assays. Data were analysed to estimate the prevalence of STIs and logistic regression was used to identify risk factors.ResultsIn total, 14.9% of participants were found to have a curable STI, with the highest prevalence being observed for Tv (5.9%) followed by Ct (3.8%), Ng (3.8%), Mg (1.9%) and Tp (0.8%). Significant risk factors for having any STI included being female, younger age and concurrent partnership. Having had a previous STI that was optimally treated was a protective factor.ConclusionsThis study demonstrates that there is a considerable burden of STI on the Bijagos Islands, stressing the need for diagnostic testing to facilitate early detection and treatment of these pathogens to stop ongoing transmission. Moreover, these results indicate the need to conduct further research into the STI burden on the Bijagos Islands to help inform and develop a national STI control strategy.

Sexually transmitted infections in pregnant women from sub-Saharan Africa

“…38 Past studies have documented that there are very few population-based STI prevalence studies especially for LMICs. 39,40,41 In the developing world, the vast majority of curable STIs are reported for the African region. 27 Mycoplasma genitalium is an emerging STI and is associated with HIV acquisition, especially in SSA women, but it is not known whether women with M. genitalium transmit HIV more easily to male sexual partners.…”

“… 38 Past studies have documented that there are very few population-based STI prevalence studies especially for LMICs. 39 , 40 , 41 …”

“…There is a lack of data on the prevalence of C. trachomatis, N. gonorrhoeae, T. vaginalis and M. genitalium amongst pregnant women and their related risk factors: mainly in SSA, which bears a significant burden of HIV. 7 , 9 , 40 The infection rates are much higher amongst pregnant women than in the general population. In South Africa, sexual behaviour is not well known in pregnant women infected with HIV.…”

“… 87 , 92 Furthermore, complications from these asymptomatic STIs can result in severe morbidity and mortality. 40 Sexually transmitted infections management is a significant public health issue because of the combination of high STI prevalence, high proportion of asymptomatic infections and adverse perinatal and neonatal outcomes. 27 Joseph et al 18 reported that most pregnant women who tested positive for at least one STI were asymptomatic.…”

Acceptability and perceived utility of different diagnostic tests and sample types for trachoma surveillance in the Bijagos Islands, Guinea Bissau

“…15 The Bijagos Islands have also been the location for research involving the collection of conjunctival samples in addition to clinical examination for trachoma diagnosis 13 , 16 , 17 and blood samples for the detection of sexually transmitted infections (STIs). 18 They were therefore an ideal setting for this study.…”