Community based study of sexually transmitted diseases in rural women in the highlands of Papua New Guinea: prevalence and risk factors

Abstract

Objective: To estimate the prevalence of sexually transmitted diseases (STDs) and determine their risk factors/markers among a rural population of women in the highlands of Papua New Guinea. Methods: Community based random cluster sample of women of reproductive age were interviewed and examined and had specimens collected for laboratory confirmation of chlamydial and trichomonal infection, gonorrhoea, syphilis, and bacterial vaginosis. Results: Chlamydia trachomatis was detected in 26%, Trichomonas vaginalis in 46%, Neisseria gonorrhoeae in 1%, syphilis in 4%, pelvic inflammatory disease (PID) (diagnosed clinically) in 14%, and bacterial vaginosis in 9% of 201 women. 59% of the women had at least one STD. In a multivariate logistic regression analysis taking the clustered sampling into account, independent risk factors for chlamydial infection were age < 25 years, < four living children, visualisation of yellow mucopurulent endocervical secretions on a white swab, and bacterial vaginosis. Being married to a man who did not have other wives was protective. For trichomonal infection, independent risk factors were having no formal education, infertility, more than one sexual partner in the previous 12 months, treatment for genital complaints in the previous 3 months, abnormal vaginal discharge detected on examination, and chlamydial infection. Similar levels of trichomonal infection were found in all age groups. Among married women, rates of infection correlated with their perception of their husband having had other sexual partners in the previous 3 months, and this relationship was significant for chlamydial infection among women over 25. Conclusion: STDs are a major problem in this population, with the risk factors varying by outcome. Current treatment regimens are inappropriate given the high prevalence of trichomonal infection, and the available services are inadequate. EVective interventions are required urgently to reduce this burden and to prevent the rapid transmission of HIV. (Sex Transm Inf 1998;74:120-127)

Reproductive tract infections among women attending gynaecology outpatient department

“…15, 18,, 20, 14, 19 The infection rate is quite similar to another study in Nepal, New Guinea. 12,16 The higher rate in the other studies may be attributed to a wider age range of participants and the fact that adolescent women had been sexually active. It is difficult to compare the incidence of STIs in one region with that of other because of different medical, social and economical factors.…”

“…19 In this study gonococcal infection rate was much higher than elsewhere. 15,16,17,18,19,20 The organism Neisseria gonorrhoeae is associated with behavior of persons. Nepal is still largely a traditional country and multiple sex partners of married women are very rare due to cultural, legal and social taboos.…”

Use of intravaginal microbicides to prevent acquisition of Trichomonas vaginalis infection in Lactobacillus-pretreated, estrogenized young mice.

“…Results were analyzed using a one-tailed Fisher's exact test in a pair-wise comparison of the three treatments with placebo. 5 Mice received a 3 ϫ 10 6 T. vaginalis intravaginal challenge 5 min after intravaginal pre-treatment. Number of infected mice divided by the number of mice per group.…”

Patients with Vaginal Discharge: A Survey in a University Primary Care Clinic in Riyadh City

“…1,9,10 In this study, the finding of G. vaginalis as the most commonly isolated organism, with a prevalence rate of 28%, is in agreement with other studies that showed different rates ranging from 9% to 53%. 4,9,[11][12][13][14][15] These variations in the rates could be related to geographical distribution or systematic differences in the various population samples, however, there is continuing controversy about its importance as a pathogen and its ability to cause vaginitis. 4,16 The term "bacterial vaginosis" (BV) is a variant of bacterial vaginitis and is the most prevalent vaginal infection.…”