The RTs studied are not useful for screening for NG at the point of care. In case of CT a recommendation about their use in routine care should be supported by a cost-effectiveness analysis. In screening populations at high risk of sexually transmitted infections or pregnant women, the RTs for syphilis should be used.

Objetivo: estimar la prevalencia y etiología de las infecciones de transmisión sexual, y de las infecciones endógenas en mujeres en edad reproductiva con síntomas de infección del tracto genital inferior sintomáticas, y describir los factores asociados. Materiales y métodos: estudio de corte transversal en tres centros de atención en Bogotá. Se realizó el diagnóstico etiológico mediante puntaje de Nugent para vaginosis bacteriana (VB), cultivo para Candida, y frotis en fresco para trichomonas. En un subgrupo de pacientes se realizó cultivo In Pouch TM para T. vaginalis (TV), PCR para C. trachomatis (CT) y N. gonorroheae (NG), y pruebas serológicas para sífilis y VIH. Los factores de riesgo fueron evaluados comparando los dos grupos por medio del Odds Ratio (OR) y el intervalo de confianza del 95%. Resultados: 1385 mujeres fueron incluidas, de ellas 115 (8,3%) eran trabajadoras sexuales. Se confirmó la presencia de alguna infección del tracto genital (ITG) en 731 (52,7%) de las mujeres; 560 (40,4%) presentaron infecciones endógenas y 170 (12,3%) infecciones de transmisión sexual (ITS). La etiología más frecuente fue la VB en 549 (39,6%), seguida por candidiasis en 153 (11%). CT fue detectada en 134 (9,7%) y NG en 19 (1,4%). TV fue detectada por frotis en fresco en 11 (0,8%) y por cultivo en 8 de 634 (1,2%), sífilis en 12 (0,8%) y VIH en 1 (0,07%). Las mujeres trabajadoras sexuales tuvieron mayor riesgo de presentar cualquier ITS (OR: 2,0; IC 95% 1,2-3,3). Las mujeres con ITS tuvieron una edad promedio de 27,9 (± 7,8), y aquellas que no tenían ITS de 31,9 (± 8,9) años. El consumo de licor con frecuencia entre diaria y semanal fue mayor en las mujeres con ITS (OR: 2,6; IC 95%: 1,4-4,5). Conclusiones: se identificó la etiología en el 52,7% de las mujeres que consultaron por síntomas de infección del tracto genital inferior. La infección más frecuente fue vaginosis bacteriana, y clamidia dentro de la infecciones de transmisión sexual. No se identificó ninguna etiología infecciosa específica en el 47,3% de las mujeres aun cuando se utilizó el patrón de oro diagnóstico para los diferentes microorganismos.

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Objetives To determine the prevalence and aetiology of lower genital tract infections (LGTIs) in symptomatic women of reproductive age and describe the risk factors. Methods Cross sectional study. Symptomatic women who consulted at three ambulatory care centres in Bogotá, Colombia. Exclusions: pregnancy, hysterectomy, antibiotics in the previous 7 days. Samples were obtained for etiologic diagnosis using gold standard tests for: bacterial vaginosis (VB) by Nugent's criteria; blood agar culture for Candida and a wet smear and In pouch™ culture for T. vaginalis. PCR for C. trachomatis (CT) and N. gonorroheae (NG), and serologic tests for syphilis (RPR, TPHA) and HIV. Results 1385 women were recruited from February to December 2010. 115 (8.3%) of them were sexual workers. A LGTI was confirmed in 731 (52.7%); 560 (40.4%) had an endogenous infection and 170 (12.3%) a sexually transmitted infection (STI). The most frequent aetiology was VB in 549 (39.6%), followed by candidiasis in 153 (11%). CT was detected in 134 (9.7%), NG in 19 (1.4%), Trichomonas by wet smear in 11 (0.8%) and by culture in 8/634 (1.2%), syphilis in 12 (0.8%) and HIV in 1 case. The risk factors of STI are: sex workers (OR: 2.0, CI 95% 1.2 -3.3), younger age (28 ± 7.8 vs. 32 ± 8.9 (mean ± SD), no health insurance (23.5 vs. 15.4%) and alcohol users (OR: 2.6 (95% CI: 1.4 -4.5)) Conclusions: 52.7% of women who consult for symptoms of LGTIs an aetiology can be identified, being BV the most common and Chlamydia the most frequent STI. Almost the same number of women (47.3%) has no specific aetiology identified, even with the use of gold standard diagnostic technology. This information should be used by policy makers and clinicians for prioritisation of prevention and diagnosis of LGTIs and use of syndromic management Background Recommendations for the frequency of STI screening in high-risk populations are limited by lack of data about when infections occur following a negative screening test. Methods Participants (18-29 years of age; women [N = 192] and men [N = 156]) in a 12-week study of incident STI were recruited from a county STI clinic. Self-collected vaginal samples (women) and urine samples (men) were obtained weekly at participant's home. Nucleic acid amplification tests (NAAT) were used for diagnosis of C. trachomatis, N. gonorrhoeae, and T. vaginalis infections. Infections diagnosed at enrollment were treated immediately. Based on cumulative diary reports of partner-specific sexual behaviours, an exposure variable was created to indicate vaginal exposure with only one partner, or with more than one partner. Time to infection was modelled using Kaplan-Meier curves; group differences were

Background There are little data on the prevalence and clinical outcomes of coccidian parasites infection in HIV positive patients in Africa. Methods We conducted a cross-sectional study at the Opportunistic Infections Clinic of the Provincial Hospital of Bukavu, from April 2010 to October 2011. HIV patients attending the clinic, aged 15 years and above were included after obtaining their consent, the CD4 count and patient details were recorded, stool samples were collected according to the WHO procedure. A single stool sample was collected and conserved in formalin -ether 10% and transported to the Provincial Laboratory of Bukavu for analysis. A consecutive sample of 108 patients was collected.Smears were stained according to the modified ziehl neelsen procedure and examined at x100 magnification using an oil immersion microscope. Data were analysed with EPI-INFO 3.5. Differences with P-values < 0.05 were considered significant. Results 58.3% were female. Mean (±SD) age 40 ± 15.7 years old. Stools were diarrheic in 66.7%. Overall prevalence of Cryptosporidium spp was 57.9% (95% CI: 41.8 -76.1), Cyclospora cayetanensis 31.6% (95% CI: 19.3 -47.5). 63.9% of patients were on antiretroviral therapy. Patients with CD4 counts < 50cells/μL, presented with a higher prevalence of either Cryptosporidium spp (62.1%) or Cyclospora cayetanensis (27.6%) (P = 0.0000). In diarrheic stools we recorded 59.6% (28/47) Cryptosporidium spp (P = 0.0001), 27.7% (13/47) Cyclospora cayetanensis. Dual infections were more noted in the CD4 count range of < 100 cells/μL, 63.4% (26/41) for CD4 count < 50cells/μL and 36.6% (15/41) for CD4 50 -100cells/μL (P = 0.0000). On ARV, only subjects with100 -200 cells/μL of CD4, had a good clinical evolution (P = 0.0000). Conclusions Cryptosporidium parvum and Cyclospora cayetanensis are highly prevalent in HIV patients with advanced diseases and major causes of chronic diarrhoea. Dual infection is related to very low CD4 count.