Sexually transmitted infections in young pregnant women in Bangui, Central African Republic

Abstract

In early 1996, 481 women visiting the antenatal services of the 3 major governmental health centres in the capital city of the Central African Republic (CAR) were included in the study. All study participants underwent the health centre's routine gynaecological examination, including laboratory diagnosis of trichomoniasis, candidiasis, gonorrhoea, syphilis and bacterial vaginosis. Cervical secretions and blood samples from study participants were sent to the National STD Reference Centre for diagnosis of Chlamydia trachomatis, Neisseria gonorrhoeae, Candida albicans, Treponema pallidum, and HIV. Overall, 34% of the study women were diagnosed with at least one sexually transmitted infection (STI) (3.1% N. gonorrhoeae, 6.2% C. trachomatis, 9.9% T. vaginalis, 6.7% T. pallidum, 12.2% HIV-1). In addition, 29.1% of women were diagnosed with bacterial vaginosis and 46.6% with candidiasis. Only a small proportion of these women had sought treatment during the weeks before, despite the recognition of genital symptoms. Self-reported and health worker-recognized symptoms, signs and laboratory results exhibited only low sensitivities, specificities, and positive predictive values in the diagnosis of STIs. These findings confirm the high vulnerability of young African women to STIs and emphasize the need for specific control interventions which should include affordable and user-friendly services. Moreover, these results call for more effective quality control in case of laboratory-based STI control strategies and question the validity of syndromic STI management strategies in women attending antenatal care services in Africa.

Assessing therapeutic management of vaginal and urethral symptoms in an anonymous HIV testing centre in Luanda, Angola

“…In relation to other causes of vaginal/urethral discharge, bacterial vaginosis was the most commonly found (58.7% of symptomatic patients). In the present study, candidiasis is found in 31,7% of the individuals and trichomoniasis in 2,9%, while Blankhart et al [4] and Fonck et al [18] respectively found a prevalence of 46,6% and 35% for candidaisis and 9,9% and 2,5% for trichomoniasis. In this ATC clinic, clinical diagnosis was aided by Gram-stain and wet-smear test, which were observed to have a positive contribution, since they assured some kind of treatment to patients who presented a positive microscopy for an STI agent.…”

“…In this study, the prevalence of N. gonorrhoeae and C. trachomatis (8.3% and 7.9%) was high, taking into account that some samples were taken from asymptomatic patients. In other studies in Africa, the prevalence varied from 2,5% to 6% and from 4% to 6% for N. gonorrhoeae and C. trachomatis, respectively [4,[18][19]. In relation to other causes of vaginal/urethral discharge, bacterial vaginosis was the most commonly found (58.7% of symptomatic patients).…”

“…Sexually transmitted infections (STIs) are increasing in many countries in Europe [1][2][3] and they continue to be prevalent in developing countries [4][5][6]. As they may predispose to HIV acquisition [7][8][9], the World Health Organization (WHO) has recommended that efforts to decrease HIV prevalence should include programs to prevent and control other STIs [10].…”

Adverse birth outcomes in United Republic of Tanzania - impact and prevention of maternal risk factors

“…First, as in other studies in subsSaharan Africa, there was a high prevalence of RTIs in pregnancy. 31,32 However, apart from untreated BV, these had no significant association with adverse pregnancy outcome. Untreated RTIs have been ass s sociated with all the adverse pregnancy outcomes documented in this study.…”

Cervico-vaginal monitoring in pregnancy in Italy

“…Il problema è presente in misura maggiore nei paesi con basso tenore socio-economico e ridotta assistenza sanitaria, nei quali risulta più difficile implementare programmi di screening e prevenzione ante-parto. Inerentemente questi paesi, infatti, la letteratura presenta dati di prevalenza significativamente elevati per infezioni da agenti etiologici di STIs (4,6) sebbene l'entità degli attuali flussi migratori contribuisca ad estendere il problema anche ai paesi sede di immigrazione. La sorveglianza microbiologica rappresenta un punto fondamentale nel controllo e nella prevenzione delle infezioni feta-…”