High prevalence of sexually transmitted infections in pregnant adolescent girls in Tanzania: a multi-community cross-sectional study

Abstract

Background Limited data document sexually-transmitted infections (STIs) among pregnant adolescents in sub-Saharan Africa, where prenatal screening typically includes only HIV and syphilis. Given that HIV incidence in this population is among the world’s highest, we sought to assess the prevalence and factors associated with STIs in a population of rural pregnant adolescents in Tanzania. Methods We enrolled 403 pregnant adolescent girls from 10 antenatal clinics near Mwanza, Tanzania. Girls answered structured interviews about sexual health and risk factors and were tested for six common STIs. Results One hundred ninety-nine girls (49.4%) had at least one STI. HSV-2 was most prevalent (34.5%), followed by trichomoniasis (12.4%), chlamydia (11.4%), gonorrhoea (6.7%), syphilis (5.2%), and HIV (4.7%). Of note, 53/199 (26.6%) of girls with laboratory-proven STIs were asymptomatic. On multivariable analysis, presence of any STI was associated with being in a long-term (as opposed to short-term) relationship (odds ratio (OR)=2.6 [1.4–4.9] p= 0.004), younger age at first sexual debut (OR =0.9 per year [0.8–0.99], p= 0.034), increasing age difference between the girl and her partner (OR=1.1 [1.0–1.1] per year, p= 0.03), and history of prior pregnancy (OR=1.6 [1.0–2.6], p=0.04). Conclusion STIs affected half of rural pregnant adolescents in Tanzania. Our work demonstrates the urgent need to incorporate routine STI testing into antenatal care in Tanzania to prevent morbidity and mortality in young girls and their babies. We also identify behavioural and demographic risk factors that can be used to target interventions to those at highest risk.

High prevalence ofChlamydia trachomatisinfection among infertile women in Mwanza city, Tanzania: a need to introduce screening and treatment programme

“…This was significantly higher than prevalence among adolescent girls (p<0.001) in the same setting detected in a previous study 1. Moreover, CT was more strongly associated with primary (45/104, 43.3%) than with secondary (60/186, 32.2%) infertility.…”

Low CD4 Counts and Early Sexual Debut Predict Genital Cytomegalovirus Infection among HIV Infected Women in Mwanza, Tanzania

“…This observation is also supported by previous study in Mwanza which showed that most of the women get pregnancy at young age indicating early sexual debut [22]. Additionally, recent study in Mwanza has shown significantly high prevalence rates of STIs among adolescents which may explain the increased risk of acquiring genital CMV [23].…”

Highlights from this issue

“…This month, Becker et al report a study of concordance between child and adult reporting of HIV associated symptoms in South Africa 10. On a related note, we report the prevalence of STI among pregnant adolescents11 and mother to child HIV transmission 12. Other studies report on high levels of HPV in a rural population13 and on novel strains of chlamydia circulating in South Africa 14.…”