Thomas T, Choudhri S, Kariuki C, Moses S
Department of Medical Microbiology, University of Manitoba, Canada.
Genitourin Med. 1996 Oct;72(5):334-8. doi: 10.1136/sti.72.5.334.
To examine characteristics of pregnant women associated with cervical infection, and to evaluate the accuracy of symptom-based and risk assessment systems which have been developed for identifying cervical infection in antenatal women.
Interviews were conducted and physical examinations performed on 291 consecutive antenatal clinic attenders in nairobi, Kenya. Vaginal, cervical, urine and blood specimens were also obtained for analysis.
The following disease prevalences were observed: candidiasis 26.2%; trichomoniasis 19.9%; bacterial vaginosis 20.6%; any vaginal infection 53.8%; chlamydial cervicitis (CT) 8.8%; gonococcal cervicitis (GC) 2.4%; any cervical infection 10.8%. The only statistically significant association with GC and/or CT cervical infection was the presence of cervical friability (OR = 2.1, P = 0.05). There were trends towards associations with the presence of endocervical mucopus (OR = 2.6, P = 0.06), reporting a new sex partner in the past 3 months (OR = 2.2, P = 0.16) and reporting that a sex partner had an STD-related symptom (OR = 4.4, P = 0.13). There were no associations with other demographic, behavioural or medical characteristics. Risk scores previously developed for detecting GC/CT cervicitis in developing country antenatal populations generally performed poorly.
The prevalences of vaginal and cervical infection observed were extremely high among these "low risk" women. Owing probably to high levels of vaginal infection and to behavioural characteristics of this urban population, factors which elsewhere have been associated with cervical infection were not found to be so in this setting. Further work on symptom-based approaches and risk assessment for STD case detection in pregnant women is required before STD management recommendations can be generalised.
研究与宫颈感染相关的孕妇特征，并评估已开发的基于症状和风险评估系统在识别产前妇女宫颈感染方面的准确性。
对肯尼亚内罗毕连续就诊的291名产前门诊患者进行访谈和体格检查。还采集了阴道、宫颈、尿液和血液标本进行分析。
观察到以下疾病患病率：念珠菌病26.2%；滴虫病19.9%；细菌性阴道病20.6%；任何阴道感染53.8%；衣原体宫颈炎（CT）8.8%；淋菌性宫颈炎（GC）2.4%；任何宫颈感染10.8%。与GC和/或CT宫颈感染唯一具有统计学意义的关联是宫颈脆弱（OR = 2.1，P = 0.05）。与宫颈内膜有黏液脓性分泌物（OR = 2.6，P = 0.06）、报告在过去3个月有新性伴侣（OR = 2.2，P = 0.16）以及报告性伴侣有与性传播疾病相关症状（OR = 4.4，P = 0.13）存在关联趋势。与其他人口统计学、行为或医学特征无关联。先前为在发展中国家产前人群中检测GC/CT宫颈炎而开发的风险评分总体表现不佳。
在这些“低风险”女性中观察到的阴道和宫颈感染患病率极高。可能由于阴道感染水平高以及该城市人群的行为特征，在其他地方与宫颈感染相关的因素在本研究中未发现如此。在可以推广性传播疾病管理建议之前，需要进一步开展基于症状的方法和孕妇性传播疾病病例检测风险评估的研究。
