Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
Department of Physiotherapy, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal.
PLoS One. 2021 Apr 23;16(4):e0250361. doi: 10.1371/journal.pone.0250361. eCollection 2021.
Sexually transmitted infections (STIs) are common during pregnancy and can result in adverse delivery and birth outcomes. The purpose of this study was to estimate the prevalence of STIs; Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Treponema pallidum (syphilis), Trichomonas vaginalis (trichomoniasis), and Human Immunodeficiency Virus (HIV) among pregnant women visiting an antenatal care center in Nepal.
We adapted and piloted the WHO standard protocol for conducting a prevalence survey of STIs among pregnant women visiting antenatal care center of Dhulikhel Hospital, Nepal. Patient recruitment, data collection, and specimen testing took place between November 2019-March 2020. First catch urine sample was collected from each eligible woman. GeneXpert platform was used for CT and NG testing. Wet-mount microscopy of urine sample was used for detection of trichomoniasis. Serological test for HIV was done by rapid and enzyme-linked immunosorbent assay tests. Serological test for syphilis was done using "nonspecific non-treponemal" and "specific treponemal" antibody tests. Tests for CT, NG and trichomoniasis were done as part of the prevalence study while tests for syphilis and HIV were done as part of the routine antenatal testing.
672 women were approached to participate in the study, out of which 591 (87.9%) met the eligibility criteria and consented to participate. The overall prevalence of any STIs was 8.6% (51/591, 95% CI: 6.3-10.8); 1.5% (95% CI: 0.5-2.5) for CT and 7.1% (95% CI: 5.0-9.2) for trichomoniasis infection. None of the samples tested positive for NG, HIV or syphilis. Prevalence of any STI was not significantly different among women, age ≤ 24 years (10%, 25/229) compared to women age ≥25 years (7.1%, 26/362) (p = 0.08).
The prevalence of trichomoniasis among pregnant women in this sub-urban population of Nepal was high compared to few cases of CT and no cases of NG, syphilis, and HIV. The WHO standard protocol provided a valuable framework for conducting STI surveillance that can be adapted for other countries and populations.
性传播感染（STI）在妊娠期间很常见，可导致不良分娩和出生结局。本研究的目的是估计在尼泊尔一家产前护理中心就诊的孕妇中 STI 的流行率；沙眼衣原体（CT）、淋病奈瑟菌（NG）、梅毒螺旋体（梅毒）、阴道毛滴虫（滴虫病）和人类免疫缺陷病毒（HIV）。
我们改编并试行世界卫生组织（WHO）标准方案，用于对尼泊尔 Dhulikhel 医院产前护理中心就诊的孕妇进行 STI 流行率调查。患者招募、数据收集和标本检测于 2019 年 11 月至 2020 年 3 月进行。每位符合条件的女性均采集第一份尿液样本。CT 和 NG 检测采用 GeneXpert 平台。尿液样本的湿片显微镜检查用于检测滴虫病。HIV 采用快速和酶联免疫吸附试验进行血清学检测。梅毒采用“非特异性非梅毒螺旋体”和“特异性梅毒螺旋体”抗体检测进行血清学检测。CT、NG 和滴虫病检测作为流行率研究的一部分进行，而梅毒和 HIV 检测作为常规产前检测的一部分进行。
共招募了 672 名女性参与研究，其中 591 名（87.9%）符合入选标准并同意参与。任何 STI 的总体流行率为 8.6%（51/591，95%CI：6.3-10.8）；CT 为 1.5%（95%CI：0.5-2.5），滴虫病为 7.1%（95%CI：5.0-9.2）。无 NG、HIV 或梅毒检测呈阳性。≤24 岁的女性（10%，25/229）与≥25 岁的女性（7.1%，26/362）（p=0.08）任何 STI 的流行率无显著差异。
与少数 CT 病例和无 NG、梅毒和 HIV 病例相比，尼泊尔这个城郊人群中孕妇的滴虫病流行率较高。世界卫生组织（WHO）标准方案为进行 STI 监测提供了一个有价值的框架，可适用于其他国家和人群。
