Risk of having a sexually transmitted infection in women presenting at a termination of pregnancy clinic in Pretoria, South Africa

Jongh, M. De; Lekalakala, Ruth; Roux, M. Le; Hoosen, Anwar A.

doi:10.3109/01443611003797687

Cited by 13 publications

(7 citation statements)

References 12 publications

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“…Swygard et al [ 17 ] reported coinfection rates between CT and TV to be 15–28% in the USA. In South Africa, coinfection rates for CT and TV have only been reported in men with urethritis [ 18 ] and pregnant women [ 19 ], thereby limiting the comparison of our study data with other reports from South Africa. To the best of our knowledge, our data is novel in nonpregnant women and suggests that younger women whether pregnant or not have a higher prevalence of STIs.…”

Section: Discussionmentioning

confidence: 81%

Sexually Transmitted Infections in Women Participating in a Biomedical Intervention Trial in Durban: Prevalence, Coinfections, and Risk Factors

Abbai

Wand

Ramjee

2013

Journal of Sexually Transmitted Diseases

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Background. Sexually transmitted infections (STIs) continue to be a significant public health problem especially among women of reproductive age in Africa. Methods. A total of 2236 women that had enrolled in the MDP301 vaginal microbicide trial were tested for the presence of Chlamydia trachomatis (CT), Neisseria gonorrhea (NG), Treponema pallidum, and Trichomonas vaginalis (TV). Results. CT was identified as the most prevalent STI (11%) followed by TV (10%), NG, and Syphilis (3%). The highest prevalence of coinfection was reported between T. pallidum and TV (19.67%, P = 0.004), followed by CT and TV (13.52%, P ≤ 0.001). Risk factors that were significantly associated with STI acquisition were women of 23 years of age or younger (HR: 1.50, 95% CI 1.17, 1.93), baseline STI with CT (HR: 1.77, 95% CI 1.32, 2.35), TV (HR: 1.58, 95% CI, 1.20, 2.10), and T. pallidum (HR: 5.13, 95% CI 3.65, 7.22), and a low education level (HR: 1.30, 95% CI 1.02, 1.66). Conclusion. Young women with lower education and a history of STIs are at high risk of multiple STIs. Prevention programs should consider target approach to STI prevention among young women. This trial is registered with ISRCTN64716212.

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Section: Discussionmentioning

confidence: 81%

Sexually Transmitted Infections in Women Participating in a Biomedical Intervention Trial in Durban: Prevalence, Coinfections, and Risk Factors

Abbai

Wand

Ramjee

2013

Journal of Sexually Transmitted Diseases

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“…Consistent with findings from other studies, the majority of women in our study with STIs were asymptomatic. 21,22 Self-reported symptoms only identified a quarter of women with STIs, while clinician-observed symptoms could only identify about a third. Though the sensitivity of symptom screening seemed enhanced when self-reported and clinician-observed symptoms were combined, less than half of women with STI infections would have been correctly identified using this combined screening method.…”

Section: Discussionmentioning

confidence: 99%

High prevalence of asymptomatic sexually transmitted infections among human immunodeficiency virus-infected pregnant women in a low-income South African community

et al. 2017

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There is a lack of evidence on the burden of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Trichomonas vaginalis (TV) among HIV-infected pregnant women in South Africa. We conducted a cross-sectional analysis of HIV-infected pregnant women in two healthcare facilities in a South African township to determine the prevalence of CT, NG and TV. HIV-infected pregnant women were recruited during the first antenatal care visit for their current pregnancy and requested to self-collect vulvovaginal swab specimens. Specimens were tested for CT, NG and TV using the Xpert® assay (Cepheid, Sunnyvale, CA). Of 247 tested for CT, NG and TV, 47.8% tested positive for at least one organism; CT = 36.8%, TV = 23.9%, NG = 6.9%. Forty three (17.4%) had multiple infections, of which 42 included CT as one of the infecting organisms. Of the 118 participants who tested positive for at least one sexually transmitted infection (STI), 23.7% reported STI-like symptoms. Among women who tested positive for CT, 29.7% reported symptoms while 47.1 and 27.1% of those who tested positive for NG and TV, respectively, reported symptoms. The high STI prevalence coupled with the low symptom prevalence among infected individuals justifies the use of diagnostic screening approaches rather than syndromic management of STIs in this setting.

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“…Data on the prevalence of NG infection in the general population do not seem to exist. Studies based on females undergoing TOP in a hospital setting mentioned infection rates as follows: CT 2.8% to 15.74%; MG 0.98% to 8.7%; NG 0.67% to 3% (12,(15)(16)(17)(18). Reasons for these wide ranges are multifarious, e.g.…”

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confidence: 99%

Prevalence and Determinants of Sexually Transmitted Infections in Women at Risk Undergoing Abortion in a Swiss Primary Care Setting

Wesbonk

Chmiel

Rosemann

et al. 2014

Praxis

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Background: Specific prevalence data are needed to assess the burden of sexually transmitted infections (STIs) in specific settings where data are scant, such as women seeking early termination of pregnancy (TOP). We aimed to investigate the prevalence of STIs and its determinants in women at risk (e.g. pathological cervical swab) undergoing TOP in a primary care setting in Switzerland.Methods: Cross-sectional study of 620 women seeking abortion counselling at a general practice in Zurich, Switzerland.. Patients' characteristics were assessed and in case of pathological cervical swab a PCR-based screening for Chlamydia trachomatis (CT), Mycoplasma genitalium (MG) and Neisseria gonorrhoeae (NG) was initiated to estimate STI prevalence. Bi-and multivariable analysis were used to investigate STI determinants.Results: 585 out of the 620 women presenting for counselling resulted in TOP. 581 (93.7%) cervical specimens were available with 272 having pathological signs (46.8%), thus were considered at risk for STIs. In 192 screened samples 28 STIs (14.6%) (95% CI: 10.3-20.3%) were detected, predominantly CT (17 cases) followed by MG (9 cases) and NG (2 cases).Compared to non-immigrants, immigrants were more likely to have a STI (adjusted OR 2.63; p=0.037) Non-screened women were significantly more often self-payers (31.3%) compared to screened women (8.3%) (p<0.001). Conclusion:We found a high STI prevalence in women presenting for TOP in a Swiss primary care setting. Women with a migration background seemed to be a vulnerable subgroup. Public health efforts are needed to implement cost-effective screening and case management programs in this population at risk for STIs. 2 Ü1 Abbreviations Ü1 IntroductionSexually transmitted infections (STI) are among the most common causes of illness in the world and have far-reaching health, social and economic consequences for many countries.Chlamydia trachomatis (CT), Mycoplasma genitalium (MG) and Neisseria gonorrhoeae (NG) are considered being common sexually transmitted pathogens and can cause genitourinary infections with a wide range of symptoms; in women MG and NG can cause cervicitis, urethritis and endometritis (1-5). The causal connection of MG with salpingitis as well as potentially resulting infertility remains controversial, whereas CT and NG are known to cause salpingitis and have an impact on infertility (1, 4,(6)(7)(8)(9)(10)). An untreated CT infection can also lead to peritonitis, perihepatitis, pelvic inflammatory disease (PID) and ectopic pregnancy (EP) (4, 6, 7). Genital CT and NG infections are asymptomatic or just show mild symptoms in up to 70% and 50% of cases, respectively (4, 11). As a consequence, these infections often remain undetected thus abetting further transmission. Similarly, asymptomatic MG infections have also been described, raising the question whether also asymptomatic subgroups, such as women presenting for early termination of pregnancy (TOP), should be screened for MG (12, 13).International prevalence rates of STIs vary, depe...

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Risk of having a sexually transmitted infection in women presenting at a termination of pregnancy clinic in Pretoria, South Africa

Cited by 13 publications

References 12 publications

Sexually Transmitted Infections in Women Participating in a Biomedical Intervention Trial in Durban: Prevalence, Coinfections, and Risk Factors

Sexually Transmitted Infections in Women Participating in a Biomedical Intervention Trial in Durban: Prevalence, Coinfections, and Risk Factors

High prevalence of asymptomatic sexually transmitted infections among human immunodeficiency virus-infected pregnant women in a low-income South African community

Prevalence and Determinants of Sexually Transmitted Infections in Women at Risk Undergoing Abortion in a Swiss Primary Care Setting

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