Aboud Said, Buhalata Simon N, Onduru Onduru G, Chiduo Mercy G, Kwesigabo Gideon P, Mshana Stephen E, Manjurano Alphaxard M, Temu Mansuet M, Kishamawe Coleman, Changalucha John M
Departments of Microbiology and Immunology, Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam P.O. Box 65001, Tanzania.
National Institute for Medical Research, Mwanza Research Centre, Mwanza P.O. Box 1462, Tanzania.
Trop Med Infect Dis. 2023 Jan 13;8(1):62. doi: 10.3390/tropicalmed8010062.
We determined the prevalence and reported risk factors associated with sexually transmitted and reproductive tract infections (STI/RTIs) among patients who presented with genital symptoms in STI/outpatient department (OPD) clinics in two regional referral hospitals and six health centres in six regions in Tanzania. Methods: The patients were consecutively recruited, and the data collection was conducted in eight health care facilities from 2014 to 2016. Genital swabs were collected for the detection of the aetiological pathogens of STI/RTIs. Results: A total of 1243 participants were recruited in the study; the majority (1073, 86%) were women. The overall median age was 27.8. The prevalence of Neisseria gonorrhoeae was 25.7% (319/1243), with proportions of 50.9 and 21.5% for men and women, respectively, of Chlamydia trachomatis 12.9% (160/1241) and Mycoplasma genitalium 4.7% (53/1134). Unmarried men were more often likely to be infected with gonococcal infections as compared to their women counterparts (57.9 vs. 24.1%) p < 0.001. The majority presented with genital discharge syndrome (GDS) 93.6% (1163/1243), genital ulcer disease (GUD) 13.0% (162/1243) and GDS + GUD 9.6% (119/1243). GDS was more common in the health centres, 96.1% (1195/1243), vs. the regional referral hospitals, 92.2% (1146/1243) (p = 0.01), but those reported to the regional referral hospitals were more likely to be infected with N. gonorrhoeae (OR = 2.5) and C. trachomatis (OR = 2.1) than those from the health centres (p < 0.001). The prevalence of bacterial vaginosis (BV) and vaginal candidiasis (VC) was 24.1 and 10.4%, respectively. Interestingly, unmarried and BV-positive women were less likely to be infected with VC (p = 0.03), though VC was strongly inversely associated with an N. gonorrhoeae infection (p < 0.001). High proportions of N. gonorrhoeae (51.1%) and C. trachomatis (23.3%) were found in the Dodoma and Dar es Salaam regions, respectively. M. genitalium (7.6%) was found to be the highest in Mwanza. Conclusion: We reported a high prevalence of STI/RTIs. The findings suggest that these infections are common and prevalent in STI/OPD clinics in six regions of Tanzania. We recommend surveillance to be conducted regularly to elucidate the true burden of emerging and classical STI/RTIs by employing modern and advanced laboratory techniques for the detection and monitoring of STI/RTIs in low- and high-risk populations, including the community settings.
我们确定了坦桑尼亚六个地区的两家地区转诊医院和六个健康中心的性传播感染/生殖道感染（STI/RTIs）门诊中出现生殖器症状患者的STI/RTIs患病率及报告的相关风险因素。方法：连续招募患者，并于2014年至2016年在八个医疗机构收集数据。采集生殖器拭子以检测STI/RTIs的病原病原体。结果：本研究共招募了1243名参与者；大多数（1073名，86%）为女性。总体中位年龄为27.8岁。淋病奈瑟菌的患病率为25.7%（319/1243），男性和女性沙眼衣原体的患病率分别为50.9%和21.5%，生殖支原体的患病率为4.7%（53/1134）。与女性相比，未婚男性感染淋球菌感染的可能性更高（57.9%对24.1%），p<0.001。大多数患者表现为生殖器分泌物综合征（GDS）93.6%（1163/1243）、生殖器溃疡疾病（GUD）13.0%（162/1243）和GDS+GUD 9.6%（119/1243）。GDS在健康中心更为常见，为96.1%（1195/1243），而在地区转诊医院为92.2%（1146/1243）（p=0.01），但报告至地区转诊医院的患者感染淋病奈瑟菌（OR=2.5）和沙眼衣原体（OR=2.1）的可能性高于来自健康中心的患者（p<0.001）。细菌性阴道病（BV）和阴道念珠菌病（VC）的患病率分别为24.1%和10.4%。有趣的是，未婚且BV阳性的女性感染VC的可能性较小（p=0.03），尽管VC与淋病奈瑟菌感染呈强烈负相关（p<0.001）。多多马和达累斯萨拉姆地区分别发现高比例的淋病奈瑟菌（51.1%）和沙眼衣原体（23.3%）。姆万扎地区生殖支原体的感染率最高（7.6%）。结论：我们报告了STI/RTIs的高患病率。研究结果表明，这些感染在坦桑尼亚六个地区的STI/门诊中很常见且普遍。我们建议定期进行监测，通过采用现代先进的实验室技术，在包括社区环境在内的低风险和高风险人群中检测和监测STI/RTIs，以阐明新出现的和经典的STI/RTIs的真实负担。
