Vallely Lisa M, Toliman Pamela, Ryan Claire, Rai Glennis, Wapling Johanna, Tomado Carolyn, Huliafi Savarina, Munnull Gloria, Rarau Patricia, Phuanukoonnon Suparat, Wand Handan, Siba Peter, Mola Glen D L, Kaldor John M, Vallely Andrew J
Public Health Interventions Research Group, Kirby Institute, UNSW Australia, Wallace Wurth Building, Sydney, NSW, 2052, Australia.
Sexual and Reproductive Health Unit, Papua New Guinea Institute of Medical Research, Homate Street, Goroka, Eastern Highlands Province 441, Papua New Guinea.
Sex Health. 2016 Oct;13(5):420-427. doi: 10.1071/SH15227.
Background Papua New Guinea (PNG) is estimated to have among the highest prevalences of HIV and sexually transmissible infections (STIs) of any Asia-Pacific country, and one of the highest burdens of maternal syphilis globally. The prevalence of curable STIs, such as Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Trichomonas vaginalis (TV), among pregnant women in PNG is relatively unknown.
A cross-sectional bio-behavioural survey to investigate the epidemiology of CT, NG, TV and other STIs among pregnant women in three provinces of PNG was undertaken. Women aged 18-35 years attending their first antenatal clinic visit were invited to participate. Participants completed a short interview and provided self-collected vaginal specimens for CT, NG and TV laboratory-based nucleic acid amplification tests and a venepuncture specimen for laboratory testing for syphilis and Herpes simplex virus type-2 (HSV-2) serology. Routine antenatal assessment was conducted according to national guidelines, including HIV counselling and testing and point-of-care syphilis screening.
A total of 765 women were enrolled. Overall, 43% (95% confidence interval (CI): 39.2-46.4) had one or more of CT, NG or TV infection. CT was the most prevalent STI (22.9%, 175/765; 95% CI: 19.9-25.9), followed by TV (22.4%, 171/765; 95% CI: 19.4-25.4), and NG (14.2%, 109/765; 95% CI: 11.7-16.7). The prevalence of active syphilis was 2.2% (17/765; 95% CI: 1.2-3.3), HSV-2 was 28.0% (214/765; 95% CI: 24.8-31.2) and HIV, 0.8% (6/765; 95% CI: 0.2-1.4). Prevalences were highest among primigravid women, women aged <25 years, and among those in Central Province.
High prevalences of curable genital STIs were observed among women attending routine antenatal clinic services in PNG. These infections have been associated with adverse pregnancy outcomes and could be important contributors to poor maternal and neonatal health in this setting.
背景 据估计，巴布亚新几内亚（PNG）是亚太地区艾滋病毒和性传播感染（STIs）患病率最高的国家之一，也是全球孕产妇梅毒负担最重的国家之一。在巴布亚新几内亚，孕妇中可治愈的性传播感染，如沙眼衣原体（CT）、淋病奈瑟菌（NG）和阴道毛滴虫（TV）的患病率相对未知。
开展了一项横断面生物行为调查，以调查巴布亚新几内亚三个省份孕妇中CT、NG、TV和其他性传播感染的流行病学情况。邀请年龄在18 - 35岁、首次到产前诊所就诊的妇女参与。参与者完成简短访谈，并提供自行采集的阴道样本用于CT、NG和TV的实验室核酸扩增检测，以及静脉穿刺样本用于梅毒和2型单纯疱疹病毒（HSV - 2）血清学实验室检测。根据国家指南进行常规产前评估，包括艾滋病毒咨询和检测以及即时梅毒筛查。
共纳入765名妇女。总体而言，43%（95%置信区间（CI）：39.2 - 46.4）的妇女感染了CT、NG或TV中的一种或多种。CT是最常见的性传播感染（22.9%，175/765；95% CI：19.9 - 25.9），其次是TV（22.4%，171/765；95% CI：19.4 - 25.4），以及NG（14.2%，109/765；95% CI：11.7 - 16.7）。活动性梅毒患病率为2.2%（17/765；95% CI：1.2 - 3.3），HSV - 2为28.0%（214/765；95% CI：24.8 - 31.2），艾滋病毒为0.8%（6/765；95% CI：0.2 - 1.4）。初产妇、年龄小于25岁的妇女以及中央省的妇女患病率最高。
在巴布亚新几内亚接受常规产前诊所服务的妇女中，可治愈的生殖器性传播感染患病率较高。这些感染与不良妊娠结局相关，可能是导致该地区孕产妇和新生儿健康状况不佳的重要因素。
