Sexually Transmitted Infections and Behavioral Determinants of Sexual and Reproductive Health in the Allahabad District (India) Based on Data from the ChlamIndia Study

Abstract

Background: Sexually transmitted infections (STIs), like Chlamydia trachomatis and Neisseria gonorrhoeae (CT and NG, respectively) are linked to an important sexual and reproductive health (SRH) burden worldwide. Behavior is an important predictor for SRH, as it dictates the risk for STIs. Assessing the behavior of a population helps to assess its risk profile. Methods: Study participants were recruited at a gynecology outpatient department (OPD) in the Allahabad district in Uttar Pradesh India, and a questionnaire was used to assess demographics, SRH, and obstetric history. Patients provided three samples (urine, vaginal swab, and whole blood). These samples were used to identify CT and NG using PCR/NAAT and CT IgG ELISA. Results: A total of 296 women were included for testing; mean age was 29 years. No positive cases of CT and NG were observed using PCR/NAAT. A 7% (22/296) positivity rate for CT was observed using IgG ELISA. No positive association was found between serology and symptoms (vaginal discharge, abdominal pain, dysuria, and dyspareunia) or adverse pregnancy outcomes (miscarriage and stillbirth). Positive relations with CT could be observed with consumption of alcohol, illiteracy, and tenesmus (p-value 0.02–0.03). Discussion: STI prevalence in this study was low, but a high burden of SRH morbidity was observed, with a high symptomatic load. High rates of miscarriage (31%) and stillbirth (8%) were also observed among study subjects. No associations could be found between these ailments and CT infection. These rates are high even for low- and middle-income country standards. Conclusion: This study puts forward high rates of SRH morbidity, and instances of adverse reproductive health outcomes are highlighted in this study, although no associations with CT infection could be found. This warrants more investigation into the causes leading to these complaints in the Indian scenario and potential biases to NAAT testing, such as consumption of over-the-counter antimicrobials.

Pattern and clinico-epidemiological profile of female patients of RTI/STIs attending an STI clinic in Uttarakhand, India

“…A similar pattern was seen in other studies. [ 9 16 22 24 ] This pattern is reflective of the Hindu majority population. It is suggested that the low prevalence in Muslims is due to the protective effect of the circumcision which is performed as a routine/ritual in Muslim males.…”

“…Several others[ 6 14 15 ] also consider illiteracy (lower educational status) to be a risk factor for RTI/STIs. In contrast, many studies[ 9 22 25 ] found that most patients of RTI/STIs have received at least some level of formal education, leading to the conclusion that formal education has little effect on sexual behaviour. The present study tends to agree with the latter group.…”

Use of recombinant proteins in the diagnosis of sexually transmitted infections: a systematic review and meta-analysis

“…The main microorganisms identified were HIV, T. pallidum, C. trachomatis, HSV 1 and 2, T. vaginalis, and CMV. STIs are caused by several pathogens in addition to those described in the study (Thomas et al, 2019) thereby indicating a deficit in new diagnostic tests based on recombinant proteins that address the other infectious agents. For example, M. genitalium has been associated with STIs, and the infections caused by this pathogen are most often asymptomatic, making treatment difficult and favoring transmission (Cadosch et al, 2020).…”

A Survey of Preclinical Studies Evaluating Nanoparticle-Based Vaccines Against Non-Viral Sexually Transmitted Infections

“…Sexually transmitted infections (STIs) are among the most common public health burdens worldwide (Thomas et al, 2019). They are the leading cause of severe reproductive health complications, congenital infections, and increased risk for acquiring other STIs such as human immunodeficiency virus (HIV) (Sexton et al, 2005;Barrow et al, 2020).…”