High prevalence of asymptomatic sexually transmitted infections among human immunodeficiency virus-infected pregnant women in a low-income South African community

Abstract

There is a lack of evidence on the burden of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Trichomonas vaginalis (TV) among HIV-infected pregnant women in South Africa. We conducted a cross-sectional analysis of HIV-infected pregnant women in two healthcare facilities in a South African township to determine the prevalence of CT, NG and TV. HIV-infected pregnant women were recruited during the first antenatal care visit for their current pregnancy and requested to self-collect vulvovaginal swab specimens. Specimens were tested for CT, NG and TV using the Xpert® assay (Cepheid, Sunnyvale, CA). Of 247 tested for CT, NG and TV, 47.8% tested positive for at least one organism; CT = 36.8%, TV = 23.9%, NG = 6.9%. Forty three (17.4%) had multiple infections, of which 42 included CT as one of the infecting organisms. Of the 118 participants who tested positive for at least one sexually transmitted infection (STI), 23.7% reported STI-like symptoms. Among women who tested positive for CT, 29.7% reported symptoms while 47.1 and 27.1% of those who tested positive for NG and TV, respectively, reported symptoms. The high STI prevalence coupled with the low symptom prevalence among infected individuals justifies the use of diagnostic screening approaches rather than syndromic management of STIs in this setting.

Acceptability and Feasibility of Integrating Point-of-Care Diagnostic Testing of Sexually Transmitted Infections into a South African Antenatal Care Program for HIV-Infected Pregnant Women

“…We evaluated the acceptability and feasibility of integrating POC STI diagnostic screening and same-day treatment into the antenatal care (ANC) services provided by public clinics to HIV-infected pregnant women during their first ANC visit. For this analysis we used data collected from women enrolled into a prospective cohort study investigating the impact of POC diagnostic screening and treatment of CT, NG, and TV on adverse birth outcomes and HIV MTCT [ 15 ].…”

Prevalence and Pattern of Sexually Transmitted Diseases in a Tertiary Care Hospital in Chamba, Himachal Pradesh

“…Other factors like lack of resources for the study and diagnosis at institutions (medical and academic) and lack of interdepartmental collaboration contribute significantly. 15,16,17 The current study is aimed to analyse the aforementioned on the basis of demographic and socio-economic data collected and laboratory investigations at STI clinic. There is gradual increase in the attendance at the ICTC (r 2 =0.86) (p < 0.05) and STI clinics (r 2 =0.97) (p < 0.001) (fig-5) annually which contribute to fact that the awareness, education and the basic medical facility has been improved in the region, this contributes to the successful implementation of WHO policy.…”

“…14 A large population (29.55%) attending the STI clinic were asymptomatic as in accordance with M. Mudau et.al. 16 widespread use of antibacterials, HIV positive patient (38%) were infected while working outside their hometown, the fact that migration for job opportunities in big cities 17 , while 85.71% cases were infected by casual sex. Condom distribution and partner management is done very often at the clinic to educate the masses and clear the stigmatized minds for STIs prevention.…”

Laboratory Validation of Xpert Chlamydia trachomatis/Neisseria gonorrhoeae and Trichomonas vaginalis Testing as Performed by Nurses at Three Primary Health Care Facilities in South Africa

“…Participants self-collected three vulvovaginal swabs. The first swab was immediately processed and tested using Xpert CT/NG and TV assays (Cepheid, Sunnyvale, CA) at the PHC facility per the manufacturer's instruction and as described elsewhere ( 3 ). The two other swabs were shipped to the Department of Medical Microbiology, University of Pretoria, for additional laboratory and molecular analysis.…”