Masha Simon Chengo, Wahome Elizabeth, Vaneechoutte Mario, Cools Piet, Crucitti Tania, Sanders Eduard J
Centre for Geographic Medicine Research-Coast, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya.
Laboratory Bacteriology Research, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
PLoS One. 2017 Mar 31;12(3):e0175166. doi: 10.1371/journal.pone.0175166. eCollection 2017.
Women attending antenatal care (ANC) in resource-limited countries are frequently screened for syphilis and HIV, but rarely for other sexually transmitted infections (STIs). We assessed the prevalence of curable STIs, defined as infection with either Chlamydia trachomatis or Neisseria gonorrhoeae or Trichomonas vaginalis, from July to September 2015.
In a cross-sectional study, women attending ANC at the Kilifi County Hospital, Kenya, had a urine sample tested for C. trachomatis/N. gonorrhoeae by GeneXpert® and a vaginal swab for T. vaginalis by culture. Bacterial vaginosis (BV) was defined as a Nugent score of 7-10 of the Gram stain of a vaginal smear in combination with self-reported vaginal discharge. Genital ulcers were observed during collection of vaginal swabs. All women responded to questions on socio-demographics and sexual health and clinical symptoms of STIs. Predictors for curable STIs were assessed in multivariable logistic regression.
A total of 42/202 (20.8%, 95% confidence interval (CI):15.4-27.0) women had a curable STI. The prevalence was 14.9% for C. trachomatis (95% CI:10.2-20.5), 1.0% for N. gonorrhoeae (95% CI: 0.1-3.5), 7.4% for T. vaginalis (95% CI:4.2-12.0), 19.3% for BV (95% CI: 14.1-25.4) and 2.5% for genital ulcers (95% CI: 0.8-5.7). Predictors for infection with curable STIs included women with a genital ulcer (adjusted odds ratio (AOR) = 35.0, 95% CI: 2.7-461.6) compared to women without a genital ulcer, women who used water for cleaning after visiting the toilet compared to those who used toilet paper or other solid means (AOR = 4.1, 95% CI:1.5-11.3), women who reported having sexual debut ≤ 17 years compared to women having sexual debut ≥18 years (AOR = 2.7, 95% CI:1.1-6.6), and BV-positive women (AOR = 2.7, 95% CI:1.1-6.6) compared to BV-negative women.
One in five women attending ANC had a curable STI. These infections were associated with genital ulcers, hygiene practices, early sexual debut and bacterial vaginosis.
在资源有限的国家，接受产前护理（ANC）的女性经常接受梅毒和艾滋病毒筛查，但很少接受其他性传播感染（STI）的筛查。我们评估了2015年7月至9月可治愈性传播感染的患病率，可治愈性传播感染定义为沙眼衣原体、淋病奈瑟菌或阴道毛滴虫感染。
在一项横断面研究中，肯尼亚基利菲县医院接受产前护理的女性，其尿液样本通过GeneXpert®检测沙眼衣原体/淋病奈瑟菌，阴道拭子通过培养检测阴道毛滴虫。细菌性阴道病（BV）定义为阴道涂片革兰氏染色 Nugent 评分为7-10分且伴有自我报告的阴道分泌物。在采集阴道拭子时观察生殖器溃疡。所有女性都回答了关于社会人口统计学、性健康和性传播感染临床症状的问题。在多变量逻辑回归中评估可治愈性传播感染的预测因素。
共有42/202名（20.8%，95%置信区间（CI）：15.4-27.0）女性患有可治愈性传播感染。沙眼衣原体患病率为14.9%（95%CI：10.2-20.5），淋病奈瑟菌为1.0%（95%CI：0.1-3.5），阴道毛滴虫为7.4%（95%CI：4.2-12.0），细菌性阴道病为19.3%（95%CI：14.1-25.4），生殖器溃疡为2.5%（95%CI：0.8-5.7）。可治愈性传播感染的预测因素包括有生殖器溃疡的女性（调整优势比（AOR）=35.0，95%CI：2.7-461.6）与无生殖器溃疡的女性相比，上厕所后用水清洁的女性与使用卫生纸或其他固体方式清洁的女性相比（AOR = 4.1，95%CI：1.5-11.3），报告初次性行为年龄≤17岁的女性与初次性行为年龄≥18岁的女性相比（AOR = 2.7，95%CI：1.1-6.6），以及细菌性阴道病阳性的女性（AOR = 2.7，95%CI：1.1-6.6）与细菌性阴道病阴性的女性相比。
每五名接受产前护理的女性中就有一名患有可治愈性传播感染。这些感染与生殖器溃疡、卫生习惯、初次性行为早和细菌性阴道病有关。
