scholarly journals 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

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
E. Morikawa ◽  
M. Mudau ◽  
D. Olivier ◽  
L. de Vos ◽  
D. Joseph Davey ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Sexually Transmitted Infections ◽  
South African ◽  
Trichomonas Vaginalis ◽  
Point Of Care ◽  
Diagnostic Testing ◽  
Nucleic Acid Amplification ◽  
National Guidelines ◽  
Sexually Transmitted

Background. Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Trichomonas vaginalis (TV) infections may increase the risk of vertical transmission of the human immunodeficiency virus (HIV). In resource-limited settings, symptomatic screening, and syndromic management of sexually transmitted infections (STIs) during pregnancy continue to be the standard of care. In the absence of diagnostic testing, asymptomatic infections in pregnant women go untreated. Objective. To describe the acceptability and feasibility of integrating diagnostic STI screening into first antenatal care visits for HIV-infected pregnant women. Methods. HIV-infected pregnant women were recruited during their first antenatal care visit from three antenatal care clinics in Tshwane District, South Africa, between June 2016 and October 2017. Self-collected vaginal swabs were used to screen for CT, NG, and TV with a diagnostic point-of-care (POC) nucleic acid amplification test. Those with STIs were provided treatment per South African national guidelines. Results. Of 442 eligible women, 430 (97.3%) agreed to participate and were tested. Of those with a positive STI test result (n = 173; 40.2%), 159 (91.9%) received same-day results and treatment; 100% of STI-infected women were treated within seven days. Conclusions. Integration of POC diagnostic STI screening into first-visit antenatal care services was feasible and highly acceptable for HIV-infected pregnant women.

Acceptability and feasibility of screening pregnant women for sexually transmitted infections in Rawalpindi, Pakistan

2021 ◽  
pp. 095646242110076
Author(s):  
Ameen E Chaudry ◽  
Rizwana Chaudhri ◽  
Aasia Kayani ◽  
Lamar W Hayes ◽  
Claire C Bristow ◽  
...  
Keyword(s):  
Chlamydia Trachomatis ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Sexually Transmitted Infections ◽  
Sexually Transmitted Infection ◽  
Trichomonas Vaginalis ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Sti Testing ◽  
Sexual Histories

Objectives: To understand the acceptability and feasibility of sexually transmitted infection (STI) testing during antenatal care, along with the prevalence of STIs, in Rawalpindi, Pakistan. Methods: We enrolled pregnant women seeking antenatal care and performed STI testing using Cepheid GeneXpert® CT/NG and TV kits and Alere Determine™ HIV and syphilis tests. We used interviewer-administered surveys to collect medical, social, and sexual histories. Participants testing positive for STIs and their partners were treated. Results: We enrolled 1001 women from September to December 2019. Nearly all women offered to participate in this study enrolled. Most women understood the effects an STI can have on their pregnancy (99.6%) and valued STI screening during pregnancy (98.1%). 11 women tested positive for any STI: ( Chlamydia trachomatis = 4, Neisseria gonorrhoeae = 1, and Trichomonas vaginalis = 6). Of those, six presented for a test-of-cure, and two were positive for Trichomonas vaginalis. None tested positive for HIV infection or syphilis ( n = 503). Conclusions: STI testing during antenatal care in Rawalpindi was acceptable, valued, understood, and feasible. The prevalence of STIs in pregnant women was low. Continued prevalence monitoring is warranted.

scholarly journals Prevalence of sexually transmitted infections among pregnant women attending antenatal clinics in West Coast Region of The Gambia

2021 ◽  
Vol 21 (2) ◽  
pp. 585-592
Author(s):  
Alphonsus Isara ◽  
Aru-Kumba Baldeh
Keyword(s):  
Pregnant Women ◽  
Sexually Transmitted Infections ◽  
West Coast ◽  
Trichomonas Vaginalis ◽  
The Gambia ◽  
Age Group ◽  
The West ◽  
Sexually Transmitted ◽  
Neisseria Gonorrhoea ◽  
Coast Region

Background: Sexually Transmitted Infections (STI) are the second most common cause of healthy life years lost by women in the 15 – 44 years age group in Africa. Aim/Objective: To determine the prevalence of STIs among pregnant women attending antenatal care (ANC) clinics in the West Coast Region of The Gambia. Materials and Methods: Blood, urine, and high vaginal swabs samples from 280 pregnant women attending ANC in Brika- ma District Hospital, Brikama, and Bandung Maternity and Child Health Hospital, Bandung were examined. Serum samples were tested for HIV using western blot technique and for syphilis using the Venereal Disease Research Laboratory (VDRL) test, and rapid plasma regimen. Candida albicans, Group B Streptococcus and Neisseria gonorrhoea were identified using Analytical Profile Index (API). Direct urine microscopy was used to identify C. albicans and Trichomonas vaginalis while Chlamydia trachomatis was identified using Direct Fluorescent Antibody (DFA) test. Results: The overall prevalence of STIs was 53.6%. The pathogenic agents isolated were Candida albicans (31.8%), Strep- tococcus agalactiae (15.0%), Treponema pallidum (6.8%), HIV (5.7%), Trichomonas vaginalis (3.9%), Neisseria gonorrhoea (1.8%) and Chlamydia trachomatis (0.7%). STIs were more prevalent among women in the younger age group of 15 – 24 years (54.7%), unemployed (54.0%), Primipara (62.3%), and in the third trimester of pregnancy (72.7%). Conclusion: A high prevalence of STIs was found among pregnant women attending ANC in the West Coast region of The Gambia. Public health intervention programmes should be strengthened to promote the sexual and reproductive health of pregnant women in The Gambia. Keywords: Sexually transmitted infections; pregnant women; antenatal clinics; The Gambia.

scholarly journals Association of malaria and curable sexually transmitted infections with pregnancy outcomes in rural Burkina Faso

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Serge Henri Zango ◽  
Moussa Lingani ◽  
Innocent Valea ◽  
Ouindpanga Sekou Samadoulougou ◽  
Biebo Bihoun ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Antenatal Care ◽  
Burkina Faso ◽  
Pregnant Women ◽  
Sexually Transmitted Infections ◽  
Pregnancy Outcomes ◽  
Rural Setting ◽  
Sexually Transmitted ◽  
The Impact

Abstract Background Malaria and curable sexually transmitted infections (STIs) are severe infections associated with poor pregnancy outcomes in sub-Saharan countries. These infections are responsible for low birth weight, preterm birth, and miscarriage. In Burkina Faso, many interventions recommended by the World Health Organization were implemented to control the impact of these infections. After decades of intervention, we assessed the impact of these infections on pregnancy outcomes in rural setting of Burkina Faso. Methods Antenatal care and delivery data of pregnant women attending health facilities in 2016 and 2017 were collected in two rural districts namely Nanoro and Yako, in Burkina Faso. Regression models with likelihood ratio test were used to assess the association between infections and pregnancy outcomes. Results During the two years, 31639 pregnant women received antenatal care. Malaria without STI, STI without malaria, and their coinfections were reported for 7359 (23.3%), 881 (2.8 %), and 388 (1.2%) women, respectively. Low birth weight, miscarriage, and stillbirth were observed in 2754 (10.5 %), 547 (2.0 %), and 373 (1.3 %) women, respectively. Our data did not show an association between low birth weight and malaria [Adjusted OR: 0.91 (0.78 – 1.07)], STIs [Adjusted OR: 0.74 (0.51 – 1.07)] and coinfection [Adjusted OR: 1.15 (0.75 – 1.78)]. Low birth weight was strongly associated with primigravidae [Adjusted OR: 3.53 (3.12 – 4.00)]. Both miscarriage and stillbirth were associated with malaria [Adjusted OR: 1.31 (1.07 – 1.59)], curable STI [Adjusted OR: 1.65 (1.06 – 2.59)], and coinfection [Adjusted OR: 2.00 (1.13 – 3.52)]. Conclusion Poor pregnancy outcomes remained frequent in rural Burkina Faso. Malaria, curable STIs, and their coinfections were associated with both miscarriage and stillbirth in rural Burkina. More effort should be done to reduce the proportion of pregnancies lost associated with these curable infections by targeting interventions in primigravidae women.

scholarly journals Online prescribing for sexually transmitted infections – what’s on offer? An evaluation of internet pharmacies based in the United Kingdom

2021 ◽  
Author(s):  
Elizabeth Okecha ◽  
Emily Boardman ◽  
Saleha Patel ◽  
Emile Morgan
Keyword(s):  
Herpes Simplex ◽  
Chlamydia Trachomatis ◽  
Neisseria Gonorrhoeae ◽  
Sexual Health ◽  
Sexually Transmitted Infections ◽  
Trichomonas Vaginalis ◽  
National Guidelines ◽  
Sexually Transmitted ◽  
Internet Pharmacies ◽  
Online Pharmacies

AbstractBackgroundOnline pharmacies offer an alternative approach for patients to manage their sexual health. Our aim was to determine the type of antimicrobials sold as treatment for sexually transmitted infections (STIs) by UK internet pharmacies and if providers were adhering to national guidelines.MethodsA search engine results page (SERP) generated a list of registered UK online pharmacies offering treatment for the following infections: Chlamydia trachomatis, Neisseria gonorrhoeae, Herpes simplex and Trichomonas vaginalis. An initial audit in 2017 benchmarked each provider against the British Association of Sexual Health & HIV (BASHH guidelines. Results were fed back to each provider before re-audit in 2020. Websites selling antibiotics for non-gonococcal urethritis (NGU) and Mycoplasma genitalium were included at re-audit.ResultsThere were 30 pharmacies identified in 2017 of which, five were excluded. Treatment could be obtained for Neisseria gonorrhoeae from five pharmacies without providing a culture result; three (60%) pharmacies sold BASHH approved antibiotics for Neisseria gonorrhoeae. All 25 pharmacies sold Chlamydia trachomatis treatment; 22 (88%) offered first line treatment options but no website assessed for proctitis. Herpes simplex treatment was sold on 22 websites of which, 13 (59%) offered treatment recommended by BASHH. Trichomonas vaginalis treatment was sold by four websites in line with BASHH. Results at re-audit showed an improvement in standards, although advice before, during and after treatment remained variable.DiscussionOur work has allowed us to engage with providers to improve prescribing within the UK online pharmacy industry. However, tougher regulation is needed in order to embed sustainable change for patients who choose to access treatment online.

Converging epidemics of sexually transmitted infections and bacterial vaginosis in southern African female adolescents at risk of HIV

2017 ◽  
Vol 29 (6) ◽  
pp. 531-539 ◽  
Author(s):  
Shaun L Barnabas ◽  
Smritee Dabee ◽  
Jo-Ann S Passmore ◽  
Heather B Jaspan ◽  
David A Lewis ◽  
...  
Keyword(s):  
Bacterial Vaginosis ◽  
Sexually Transmitted Infections ◽  
South African ◽  
Hiv Risk ◽  
Trichomonas Vaginalis ◽  
Vaginal Discharge ◽  
Clinical Symptoms ◽  
Cape Town ◽  
Behavioral Risk ◽  
Sexually Transmitted

Adolescents in Africa are at high risk for HIV infection, other sexually transmitted infections (STIs) and bacterial vaginosis (BV). Since behavior and burden of STIs/BV may influence HIV risk, behavioral risk factors and prevalence of STIs/BV were compared in HIV-seronegative adolescent females (n = 298; 16–22 years) from two South African communities (Soweto and Cape Town). STIs ( Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Mycoplasma genitalium, herpes simplex virus (HSV)-1, HSV-2, Treponema pallidum, and Haemophilus ducreyi) were detected by multiplex polymerase chain reaction, human papillomavirus (HPV) by Roche Linear Array, and BV by Nugent scoring. Rates of BV (Nugent ≥7; 46.6%) and HPV (66.8%) were high in both communities. Prevalence of C. trachomatis and N. gonorrhoeae were >2-fold higher in Cape Town than Soweto (Chlamydia: 42% [62/149] versus 18% [26/148], p < 0.0001; gonorrhoea 11% [17/149] versus 5% [7/148], p = 0.05). Only 24% of adolescents with vaginal discharge-causing STIs or BV were symptomatic. In South African adolescents, clinical symptoms compatible with vaginal discharge syndrome had a sensitivity of 23% and specificity of 85% for the diagnosis of discharge-causing STI or BV. In a region with high HIV prevalence and incidence, >70% of young women with treatable conditions that could enhance HIV risk would have been missed because they lacked symptoms associated with syndromic management.

scholarly journals Prevalence of and risk factors for curable sexually transmitted infections on Bubaque Island, Guinea Bissau

2020 ◽  
pp. sextrans-2019-054351
Author(s):  
Giovanna Cowley ◽  
Gregory Milne ◽  
Eunice Teixeira da Silva ◽  
Jose Nakutum ◽  
Amabelia Rodrigues ◽  
...  
Keyword(s):  
Risk Factors ◽  
Sexually Transmitted Infections ◽  
Trichomonas Vaginalis ◽  
Protective Factor ◽  
Diagnostic Testing ◽  
Significant Risk ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Sexually Transmitted ◽  
Guinea Bissau

ObjectivesComplications from sexually transmitted infections (STIs) can result in severe morbidity and mortality. To date, no STI population studies have been conducted on the Bijagos Islands, Guinea Bissau. Our objective was to estimate the prevalence of and identify risk factors for Chlamydia trachomatis (Ct), Neisseria gonorrhoea (Ng), Mycoplasma genitalium (Mg), Trichomonas vaginalis (Tv) and Treponema pallidum (Tp) on Bubaque, the most populated island.MethodsA cross-sectional survey was conducted on the island of Bubaque among people aged 16–49 years. Participants were asked to answer a questionnaire on STI risk factors, to provide urine samples (men and women) and vaginal swabs (women) for PCR testing for Ct, Ng, Mg and Tv, and to provide dry blood spots for Tp particle agglutination assays. Data were analysed to estimate the prevalence of STIs and logistic regression was used to identify risk factors.ResultsIn total, 14.9% of participants were found to have a curable STI, with the highest prevalence being observed for Tv (5.9%) followed by Ct (3.8%), Ng (3.8%), Mg (1.9%) and Tp (0.8%). Significant risk factors for having any STI included being female, younger age and concurrent partnership. Having had a previous STI that was optimally treated was a protective factor.ConclusionsThis study demonstrates that there is a considerable burden of STI on the Bijagos Islands, stressing the need for diagnostic testing to facilitate early detection and treatment of these pathogens to stop ongoing transmission. Moreover, these results indicate the need to conduct further research into the STI burden on the Bijagos Islands to help inform and develop a national STI control strategy.

scholarly journals Sexually Transmitted Infections and HIV: Knowledge, Attitudes and Practices as Transmission Risk Factors in Pregnant Women at Maxixe Health Centre, Mozambique

2019 ◽  
Vol 4 (3) ◽  
Keyword(s):  
Risk Factors ◽  
Prenatal Care ◽  
Pregnant Women ◽  
Sexually Transmitted Infections ◽  
Trichomonas Vaginalis ◽  
Health Centre ◽  
Sub Saharan Africa ◽  
Sexually Transmitted ◽  
Attitudes And Practices ◽  
Increased Risk

Sexually transmitted infections are among the most common public health problems worldwide. Female and male infertility, mother to child transmission, causing miscarriages or congenital disease, and increased risk for Human Immunodeficiency Virus infection (HIV) are some of their consequences. In Sub-Saharan Africa countries, such as Mozambique, the prevalence of these infections is high, women being those who carry the higher burden. Thus we developed this cross-sectional study with objective of characterizing some sexually transmitted infections, HIV infection, syphilis and trichomoniasis in pregnant women, verifying if their management was in accordance with guidelines and recommendations in the country and identifying practice, Knowledge and associated risk factors. Samples were collected from 253 pregnant women attending Centro de Saúde de Maxixe. Vaginal samples were obtained and observed microscopically by wet mount and direct microscopic examination (Trichomonas vaginalis). HIV antibody testing was performed with the tests Determine HIV-1/2 and Uni-GoldTM and against, T. pallidum by RPR, SD BIOLINE Syphilis 3.0 and Determine TP tests in plasma samples. In this study, 11.1% of the pregnant women were infected with HIV, 2.8% with active syphilis, 5.1% with Trichomonas vaginalis and 9.1% with yeast. Antibodies against T. pallidum were identified in 8,3% of these women. In relation to HIV, 7, 5% of them were new cases. Samples were taken from 253 pregnant women attending ante-natal outpatient consultation at the health centre, which were informed about the nature of the study and submitted to a semi-structured interview after signing the free informed consent. In this study, the inconsistency on condoms use and the existence of multiple partners by the participants contributing for these infections transmission. Participants have shown that they had information about these infections modes of transmission, as also which measures to use to prevent them. A significant number of women present with any symptom related to infections that were diagnosed to them, proving that the use of syndrome approach in vaginal discharge must be given some thought in relation to its value in this situation. The data obtained in this study shows that some gaps also exist in the prenatal care clinics of this Centre, from routine procedures that are not performed in accordance with MISAU recommendations. The high prevalence of some STI found in this population, their risk behavior, together with the non-observance of some guidelines in the management of those infections by the health personal very worrying. The implementation of a teaching program on quality control, prevention and management of these infections by the health professional seems to us to be of utmost importance, so these can act in accordance with the present guidelines and transmit correct information to the pregnant women who attend prenatal care.

Sexually transmitted infections among pregnant women attending antenatal clinics in Mongolia: potential impact on the Mongolian HIV epidemic

2005 ◽  
Vol 16 (2) ◽  
pp. 153-157 ◽  
Author(s):  
Oyunbileg Amindavaa ◽  
Sibylle Kristensen ◽  
Chin Y Pak ◽  
Davaajav Khalzan ◽  
Byambaa Chultemsuren ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Sexually Transmitted Infections ◽  
Trichomonas Vaginalis ◽  
Hiv Transmission ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Sexually Transmitted ◽  
Treatment And Prevention ◽  
Hiv Epidemic ◽  
Triple Infection

We conducted Mongolia's first nation-wide cross-sectional survey of sexually transmitted infections (STIs) among pregnant women attending prenatal care. Among our 2000 participants, 386 (19.3%) were infected with Chlamydia trachomatis, 133 (6.7%) with Trichomonas vaginalis, 121 (6.1%) with Neisseria gonorrhoeae, and 128 (6.4%) were seropositive for Treponemal antibodies. None of our participants were seropositive for HIV infection. Additionally, 605 (30.3%) of the women had at least one STI, 133 (6.7%) had a double infection, and 15 (0.8%) had a triple infection. Our results suggest that STIs are a serious problem in Mongolia. Pregnant women represent a lower-risk general population; these high STI rates suggest that at this nascent stage, the identification, treatment, and prevention of STIs as risk factors for HIV transmission are crucial in the prevention of the emerging Mongolian HIV epidemic.

scholarly journals Prevalence assessment of sexually transmitted infections among pregnant women visiting an antenatal care center of Nepal: Pilot of the World Health Organization’s standard protocol for conducting STI prevalence surveys among pregnant women

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250361
Author(s):  
Rubee Dev ◽  
Shambhu P. Adhikari ◽  
Anjana Dongol ◽  
Surendra K. Madhup ◽  
Pooja Pradhan ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Sexually Transmitted Infections ◽  
Urine Sample ◽  
Serological Test ◽  
Care Center ◽  
World Health ◽  
Enzyme Linked Immunosorbent Assay ◽  
Standard Protocol ◽  
Sexually Transmitted

Introduction Sexually transmitted infections (STIs) are common during pregnancy and can result in adverse delivery and birth outcomes. The purpose of this study was to estimate the prevalence of STIs; Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Treponema pallidum (syphilis), Trichomonas vaginalis (trichomoniasis), and Human Immunodeficiency Virus (HIV) among pregnant women visiting an antenatal care center in Nepal. Materials and methods We adapted and piloted the WHO standard protocol for conducting a prevalence survey of STIs among pregnant women visiting antenatal care center of Dhulikhel Hospital, Nepal. Patient recruitment, data collection, and specimen testing took place between November 2019-March 2020. First catch urine sample was collected from each eligible woman. GeneXpert platform was used for CT and NG testing. Wet-mount microscopy of urine sample was used for detection of trichomoniasis. Serological test for HIV was done by rapid and enzyme-linked immunosorbent assay tests. Serological test for syphilis was done using “nonspecific non-treponemal” and “specific treponemal” antibody tests. Tests for CT, NG and trichomoniasis were done as part of the prevalence study while tests for syphilis and HIV were done as part of the routine antenatal testing. Results 672 women were approached to participate in the study, out of which 591 (87.9%) met the eligibility criteria and consented to participate. The overall prevalence of any STIs was 8.6% (51/591, 95% CI: 6.3–10.8); 1.5% (95% CI: 0.5–2.5) for CT and 7.1% (95% CI: 5.0–9.2) for trichomoniasis infection. None of the samples tested positive for NG, HIV or syphilis. Prevalence of any STI was not significantly different among women, age ≤ 24 years (10%, 25/229) compared to women age ≥25 years (7.1%, 26/362) (p = 0.08). Conclusions The prevalence of trichomoniasis among pregnant women in this sub-urban population of Nepal was high compared to few cases of CT and no cases of NG, syphilis, and HIV. The WHO standard protocol provided a valuable framework for conducting STI surveillance that can be adapted for other countries and populations.

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