Prevalence and risk factors associated with sexually transmitted infections (STIs) among women of reproductive age in Swaziland

Abstract

BackgroundSexually transmitted infections (STIs) remain an important public health problem with approximately half a billion new cases annually among persons aged 15–49 years. Epidemiological data on STIs among women of reproductive age in Swaziland are limited. The availability of epidemiological data on STIs and associated risk factors in this population is essential for the development of successful prevention, diagnosis and management strategies in the country. The study aimed to determine the prevalence and risk factors associated with STIs.MethodsA total of 655 women aged 15–49 years were systematically enrolled from five health facilities using a cross-sectional study design. Cervical specimen were tested using GeneXpert CT/NG Assays for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG), GeneXpertTV Assay for Trichomonas vaginalis (TV), and GeneXpert HPV Assays for hr-HPV. Blood samples were tested using Alere Determine HIV-1/2Ag/Ab Combo and Trinity Biotech Uni-Gold Recombigen HIV test for confirmation for HIV, and Rapid Plasma Reagin and TPHA test for confirmation for Treponema pallidum (syphilis). Genital warts were assessed prior to specimen collection. Survey weighted analyses were done to estimate the population burden of STIs.ResultsThe four most common curable STIs: CT, NG, TV, Treponema pallidum (syphilis), as well as genital warts were considered in this study. The overall weighted prevalence of any of these five STIs was 19.4% (95% CI: 14.9–24.8), corresponding to 72 990 women with STIs in Swaziland. The estimated prevalences were 7.0% (95% CI: 4.1–11.2) for CT, 6.0% (95% CI: 3.8–8.8) for NG, 8.4% (95% CI: 5.4–12.8) for TV, 1.4% (95% CI: 1.1–10.2) for syphilis and 2.0% (95% CI: 1.0–11.4) for genital warts. The overall weighted HIV prevalence was 42.7% (95%CI: 35.7–46.2). Among hr-HPV positive women, 18.8% (95% CI: 13.1–26.3) had one STI, while 6.3% (95% CI: 3.3–11.7) had multiple STIs. Risk factors associated with STIs were being employed (OR = 2.2, 95% CI: 1.0–4.7), self-employed (OR = 2.8, 95% CI: 1.5–5.5) and being hr-HPV positive (OR = 2.0, 95% CI: 1.3–3.1). Age (0.9, 95% CI: 0.8–0.9), being married (OR = 0.4, 95% CI: 0.3–0.7) and not using condoms with regular partners (OR = 0.5, 95% CI: 0.3–0.9) were inversely associated with STIs.ConclusionSTIs are highly prevalent among women of reproductive age in Swaziland. Thus, a comprehensive STIs screening, surveillance and treatment programme would be justified and could potentially lower the burden of STIs in the country.

Risk Factors of Sexually Transmitted Infections among Women of Child-Bearing Age in IDP camps in Abuja

“…The proportion of cases that used sexual enhancers compared with cases who did not was 40.3% to 19.7%. This fi ndings corresponds with studies carried out by Ginindza, et al, [6], Men´endez et al, [10], Hughes, et al, [11], where risk factors for STI which were signifi cant were alcohol consumption and having more than one sexual partner, having the partner living in another area, number of sexual partners and ever injected drugs respectively. In addition, studies by Saroj, Murthy, Kumar, & Kumar [9], which stated that a signifi cantly higher proportion of cases liked to take alcohol/illicit drugs while having sex (46/106, 43.4% cases vs. 6/45, 13.3% controls, P<0.001) with an Odds ratio of 17.538 for those who had a history of alcohol intake supported this study fi ndings.…”

“…When socio-demographic characteristics were considered in this study, result showed being single as a risk factor for STIs was signifi cantly associated with STI morbidity. Previous studies by [6], which stated that being married (OR=0.4, 95% CI: 0.3-0.7) is inversely associated with STIs and [7], which stated that being single is directly associated with STIs [Odds Ratio (OR) 1.82, (95% CI 1.08, 3.05)] supported this fi nding. The reason for this may be because single persons are more likely to have multiple sexual relationships than married persons.…”

“…This corresponded with the fi ndings by [8], in their study that there was no signifi cant difference in age, and employment status between cases and controls. However, in other studies by, Ginindza, et al, [6], Saroj, Murthy, Kumar, & Kumar, [9], risk factors signifi cantly associated with STIs were age and employment status (OR=0.9, 95% CI: 0.8-0.9), [Chi-square=7.669 and P-value=0.022] respectively .This difference in fi ndings maybe as a result of the scope of this study which focused on only women unlike other studies which had men as part of their study population.…”

Factors associated with HIV and syphilis screenings among pregnant women at first antenatal visit in Lusaka, Zambia

“…All aPRs and 95% CIs were adjusted for age, marital status, education, history of known syphilis infection, and previous pregnancy. These variables were selected a priori based on the existing literature [13,26,27]. All statistical analyses were conducted using SAS 9.4 (SAS Institute Inc., Cary, NC).…”

Trichomonas Vaginalis as A Risk Factor for Human Papillomavirus: A Study With Women Undergoing Cervical Cancer Screening

“…It is the most common, non-viral, sexually transmitted agent worldwide, responsible for 143 million cases in 2012 and 110.4 million in 2018 [2]. Epidemiological studies have shown that TV infection can lead to an increased risk of cervical cancer [13][14][15][16]. The interaction between cervical cancer and TV is not yet fully elucidated, but it is believed that the in ammatory process caused by this protozoan predisposes the epithelium to carcinogenesis [12,[17][18][19].…”