Ureaplasma parvum and urealyticum Prevalence in Symptomatic and Asymptomatic Reproductive Aged Gambian Women Seeking Primary Health Care: A  Case - Control Study

Abstract

Background Sexually transmitted infections (STIs) are a major public health concern, as most of these infections are asymptomatic in women, potentially leading to adverse reproductive health. The aim of this study was to determine the prevalence of urogenital Ureaplasma parvum, Ureaplasma urealyticum, Mycoplasma genitalium, Chlamydia trachomatis, Trichomonas vaginalis, and Neisseria gonorrhoeae in reproductive-aged Gambian women attending Edward Francis Small Teaching Hospital (EFSTH), the main referral hospital for The Gambia. Method A total of 232 reproductive women aged 20–49 years were recruited in a case‒control study (115 symptomatic and 117 asymptomatic). Both vaginal and endocervical swabs were collected. Nucleic acid was extracted and tested by real-time PCR for Ureaplasma parvum, Ureaplasma urealyticum, Mycoplasma genitalium, Chlamydia trachomatis, and Neisseria gonorrhoeae. Microbiological analysis was carried out for Trichomonas vaginalis and Neisseria gonorrhoea. A questionnaire was administered to assess risk factors that may be associated with Ureaplasma infection. Results The overall prevalence of Ureaplasma was 46%. The distribution in symptomatic and asymptomatic participants was as follows: Ureaplasma parvum (38% symptomatic, 52% asymptomatic); Ureaplasma urealyticum (4% symptomatic, 14% asymptomatic); Neisseria gonorrhoeae (6% symptomatic, 4% asymptomatic); and Trichomonas vaginalis (4% symptomatic, 3% asymptomatic). Eighty percent of participants’ partners had never used a condom during sexual intercourse. Early sexual debut and new sexual partners were found to be statistically associated with Ureaplasma infection (p ≤ 0.05). Conclusion This is the first study to highlight the burden of Ureaplasma infection in Gambian women of reproductive age. The high prevalence observed in this pilot study requires further investigation to determine its association with adverse reproductive outcomes and the need for enhanced surveillance for Ureaplasma in countries where there is limited data on prevalence.