Peters Remco P H, Dubbink Jan Henk, van der Eem Lisette, Verweij Stephan P, Bos Myrte L A, Ouburg Sander, Lewis David A, Struthers Helen, McIntyre James A, Morré Servaas A
From the *Anova Health Institute, Johannesburg and Tzaneen, South Africa; †Institute for Public Health Genomics (IPHG), Department of Genetics and Cell Biology, Research School GROW (School for Oncology & Developmental Biology), Faculty of Health, Medicine & Life Sciences, University of Maastricht, Maastricht, the Netherlands; ‡Laboratory of Immunogenetics, Department of Medical Microbiology & Infection Control, VU University Medical Centre, Amsterdam, the Netherlands; §Centre for HIV and STIs, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa; ¶Faculty of Health Sciences, Department of Internal Medicine, University of the Witwatersrand, Johannesburg, South Africa; ∥Division of Infectious Diseases & HIV Medicine, Department of Medicine, and **School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa.
Sex Transm Dis. 2014 Sep;41(9):564-9. doi: 10.1097/OLQ.0000000000000175.
Epidemiological data of genital chlamydia and gonorrhea, required to inform design and implementation of control programs, are limited for rural Africa. There are no data on the prevalence of rectal or pharyngeal infections among African women.
A cross-sectional study of 604 adult women visiting 25 primary health care facilities in rural South Africa was conducted. Vaginal, anorectal, and oropharyngeal swabs were tested for Chlamydia trachomatis and Neisseria gonorrhoeae.
Prevalence of genital chlamydia was 16% and that of gonorrhea was 10%; rectal chlamydial infection was diagnosed in 7.1% and gonococcal in 2.5% of women. One woman had pharyngeal chlamydia. Most women with genital chlamydia (61%) and gonorrhea (57%) were asymptomatic. Independent risk factors for genital chlamydia were younger age (adjusted odds ratio [aOR], 0.96 per year; 95% confidence interval [CI], 0.93-0.98), hormonal contraceptive use (aOR, 2.2; 95% CI, 1.3-3.7), pregnancy (aOR, 2.4; 95% CI, 1.3-4.4), and intravaginal cleansing (aOR, 1.7; 95% CI, 1.04-2.8). Intravaginal cleansing was associated with genital gonorrhea (aOR, 1.9; 95% CI, 1.1-3.3).
Genital and rectal, but not pharyngeal, chlamydia and gonorrhea are highly prevalent and frequently asymptomatic in women in rural South Africa. Young women attending health care facilities for antenatal care or family planning should be prioritized in control efforts.
对于非洲农村地区而言，用于指导控制项目设计与实施所需的生殖道衣原体和淋病的流行病学数据有限。目前尚无关于非洲女性直肠或咽部感染患病率的数据。
对南非农村地区25家初级卫生保健机构的604名成年女性进行了一项横断面研究。对阴道、肛门直肠和口咽拭子进行沙眼衣原体和淋病奈瑟菌检测。
生殖道衣原体感染率为16%，淋病感染率为10%；7.1%的女性被诊断为直肠衣原体感染，2.5%的女性被诊断为直肠淋球菌感染。有一名女性患有咽部衣原体感染。大多数患有生殖道衣原体感染（61%）和淋病（57%）的女性没有症状。生殖道衣原体感染的独立危险因素包括年龄较小（调整后的优势比[aOR]，每年0.96；95%置信区间[CI]，0.93 - 0.98）、使用激素避孕药（aOR，2.2；95% CI，1.3 - 3.7）、怀孕（aOR，2.4；95% CI，1.3 - 4.4）以及阴道内冲洗（aOR，1.7；95% CI，1.04 - 2.8）。阴道内冲洗与生殖道淋病有关（aOR，1.9；95% CI，1.1 - 3.3）。
在南非农村地区的女性中，生殖道和直肠的衣原体及淋病感染率很高，且常常没有症状，但咽部感染情况并非如此。在控制措施中，应优先关注到卫生保健机构进行产前检查或计划生育的年轻女性。
