de Lima Soares Valquíria, de Mesquita Ana Maria Torres S, Cavalcante Fábia Gazzaneo T, Silva Zenaldo Porfírio, Hora Valéria, Diedrich Thomas, de Carvalho Silva Patrícia, de Melo Poliana Gomes, Dacal Alfredo Raimundo C, de Carvalho Eduardo Maia Freese, Feldmeier Hermann
Department of Pathology, Faculty of Medicine, University of Health Sciences, Maceió, Alagoas, Brazil.
Trop Med Int Health. 2003 Jul;8(7):595-603. doi: 10.1046/j.1365-3156.2003.01078.x.
To determine the prevalence of major sexually transmitted infections (STIs) and gynaecological morbidity in women of reproductive age living in rural communities in north-east Brazil and to assess risk factors associated with the presence of STIs.
A total of 341 women (84%) were examined gynaecologically and colposcopically. The gynaecological history was taken by means of a standardized, pre-tested questionnaire. Cervical smears were obtained and vaginal fluid was collected. Vulvovaginal candidiasis (VC), bacterial vaginosis (BV), trichomoniasis (TV) and syphilis seroreactivity were determined by standard laboratory techniques. Infections with Neisseria gonorrhoeae, Chlamydia trachomatis and human papilloma virus (HPV) were diagnosed by hybrid capture assays using vaginal lavage fluid. Odds ratios (OR) were calculated to assess risk factors associated with STIs.
The prevalence of HPV, BV and TV was 26%, 15% and 10%, respectively. VC as well as infections with N. gonorrhoeae and C. trachomatis were detected in 6%; syphilis seroreactivity, in 3%. Multiple infections were very common, and 51% of women had at least one STI. Vaginal discharge, the predominant morbidity (56%), was significantly associated with BV (OR = 6.3; P < 0.001), vulvovaginal itching with VC (OR = 3.5; P < 0.05) and lower abdominal pain with C. trachomatis infection (OR = 2.6; P < 0.04). Colpitis was diagnosed in 27% of women and significantly associated with TV (OR = 3.5%; P < 0.001) and VC (OR = 2.9; P < 0.05). Being unmarried was a significant risk factor for having an STI (OR = 2.4; P < 0.05). Among unmarried women, age (<20 years) was a significant risk factor (OR = 3.3; P = 0.01).
The STIs are highly prevalent in this female population in the rural hinterland of north-east Brazil and associated with considerable morbidity. In view of the expected spread of HIV from the urban centres at the coast to the interior there is an urgent need for providing STI-related health care and health education for adolescents and women in rural Brazil.
确定巴西东北部农村社区育龄妇女主要性传播感染（STIs）的患病率和妇科疾病发病率，并评估与STIs存在相关的危险因素。
对总共341名妇女（84%）进行了妇科和阴道镜检查。通过标准化的、预先测试的问卷获取妇科病史。采集宫颈涂片和阴道分泌物。采用标准实验室技术确定外阴阴道念珠菌病（VC）、细菌性阴道病（BV）、滴虫病（TV）和梅毒血清反应性。使用阴道灌洗液通过杂交捕获试验诊断淋病奈瑟菌、沙眼衣原体和人乳头瘤病毒（HPV）感染。计算比值比（OR）以评估与STIs相关的危险因素。
HPV、BV和TV的患病率分别为26%、15%和10%。VC以及淋病奈瑟菌和沙眼衣原体感染的检出率为6%；梅毒血清反应性为3%。多重感染非常常见，51%的妇女至少有一种STI。阴道分泌物异常是主要的疾病表现（56%），与BV显著相关（OR = 6.3；P < 0.001），外阴阴道瘙痒与VC相关（OR = 3.5；P < 0.05），下腹部疼痛与沙眼衣原体感染相关（OR = 2.6；P < 0.04）。27%的妇女被诊断为阴道炎，与TV（OR = 3.5%；P < 0.001）和VC（OR = 2.9；P < 0.05）显著相关。未婚是患STI的一个重要危险因素（OR = 2.4；P < 0.05）。在未婚妇女中，年龄（<20岁）是一个重要危险因素（OR = 3.3；P = 0.01）。
在巴西东北部农村腹地的这一女性人群中，STIs非常普遍，并伴有相当高的发病率。鉴于预计艾滋病毒将从沿海城市中心向内陆传播，迫切需要为巴西农村的青少年和妇女提供与STIs相关的医疗保健和健康教育。
