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Monteiro IP, Azzi CFG, Bilibio JP, Monteiro PS, Braga GC, Nitz N. Prevalence of sexually transmissible infections in adolescents treated in a family planning outpatient clinic for adolescents in the western Amazon. PLoS One 2023; 18:e0287633. [PMID: 37352297 PMCID: PMC10289307 DOI: 10.1371/journal.pone.0287633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 06/09/2023] [Indexed: 06/25/2023] Open
Abstract
Sexually transmitted infections (STIs) are among the most common public health problems worldwide, especially among adolescents and young adults, who account for almost 50% of all STI patients. Studies on the subject in the western Amazon are limited. This study aimed to evaluate the prevalence of STIs (chlamydia, gonorrhea, trichomoniasis, herpes simplex virus, syphilis, human immunodeficiency virus [HIV], hepatitis B, and hepatitis C) in adolescents treated at a family planning outpatient clinic in the western Amazon: Porto Velho, Rondônia, Brazil. A total of 196 adolescents were enrolled. During the gynecological examination, endocervical samples were collected to test for four STIs (chlamydia, gonorrhea, trichomoniasis, and herpes simplex virus), and blood samples were collected for the detection of HIV, syphilis, and hepatitis B and C. The mean age was 17.3 ± 1.5 years, the age at sexarche was 14.4 ± 1.6 years, and 54.6% of participants had their first sexual intercourse at 14 years or younger. Only 1.0% of the adolescents used condoms in all sexual relations, and 19.9% had casual partner(s) in the last year. In the evaluation of prevalence, we found that 32% of the adolescents had at least one STI, with the most prevalent being chlamydia (23%), followed by trichomoniasis (5.6%), herpes simplex (4.6%), and gonorrhea (3.1%). No positive cases of hepatitis B, hepatitis C, or HIV were detected, but 1% of the adolescents tested positive for syphilis. These indicators will support more effective health care strategies aimed at improving the quality of life of populations in this region of the western Amazon. In conclusion, our findings demonstrated high rates of STIs in the studied patients, reinforcing the need to expand epidemiological studies to implement more appropriate public policies and intervention strategies to prevent STIs in adolescents and other vulnerable populations in the western Amazon.
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Affiliation(s)
- Ida Peréa Monteiro
- Municipal Health Department, Mãe Esperança Municipal Maternity, Porto Velho, Rondônia, Brazil
| | - Camila Flávia Gomes Azzi
- Molecular Biology Laboratory, Central Laboratory of Public Health of Rondônia, Porto Velho, Rondônia, Brazil
| | - João Paolo Bilibio
- Faculty of Medicine, Centro Universitário de Brusque–UNIFEBE, Brusque, Santa Catarina, Brazil
| | | | - Giordana Campos Braga
- Department of Social Medicine, Ribeirao Preto Medical School, University of São Paulo, Ribeirao Preto, São Paulo, Brazil
| | - Nadjar Nitz
- Faculty of Medicine, Interdisciplinary Laboratory of Biosciences, University of Brasília, Brasília, Brazil
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Bardach A, Alconada T, Palermo C, Rojas-Roque C, Sandoval MM, Gomez J, Pinto T, Ciapponi A. Burden of Disease of Gonorrhoea in Latin America: Systematic Review and Meta-analysis. Infect Dis Ther 2023:10.1007/s40121-023-00814-0. [PMID: 37261611 DOI: 10.1007/s40121-023-00814-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 04/19/2023] [Indexed: 06/02/2023] Open
Abstract
INTRODUCTION Neisseria gonorrhoeae causes gonorrhoea, a globally neglected but increasing disease. This systematic review and meta-analysis reviewed the epidemiology and economic burden of gonorrhoea in Latin America and the Caribbean (LAC). METHODS We searched PubMed, EMBase, Cochrane Library, EconLIT, CINAHL, CRD, LILACS, Global Health, Global Dissertations and Theses, SciELO, Web of Science databases, countries' ministries of health, and the IHME's Global Burden of Disease databases. Studies published in the last 10 years (20 years for economic studies) were included if conducted in any LAC country, without language restrictions. The main outcome measures were incidence/prevalence, proportion of co-infections, case fatality rates, specific mortality/hospitalisation rates, direct/indirect costs, and impact of gonorrhoea on quality of life. To assess evidence quality, we used a checklist developed by the US National Heart, Lung, and Blood Institute for observational studies and trial control arms, the Cochrane Effective Practice Organization of Care Group tool for randomised controlled trials, and the CICERO checklist for economic studies. RESULTS We identified 1290 articles; 115 included epidemiological studies and one included an economic study. Ministry of health data from Argentina, Brazil, Chile, Colombia, Mexico, and Uruguay were identified. Gonorrhoea prevalence was 1.46% (95% confidence interval [CI] 1.00-2.00%) from 48 studies and 5.68% (95% CI 4.23-7.32%) from 58 studies for non-high-risk and high-risk populations, respectively. Cumulative incidence for the high-risk population was 2.05 cases per 100 persons/year. Few published studies were rated as "good" in the risk of bias assessments. Variations in the methodology of the sources and limited information found in the countries' surveillance systems hinder the comparison of data. CONCLUSION The burden of gonorrhoea in LAC is not negligible. Our results provide public health and clinical decision support to assess potential interventions to prevent gonorrhoea. TRIAL REGISTRATION The protocol is registered on PROSPERO (CRD42021253342). The study was funded by GlaxoSmithKline Biologicals SA (GSK study identifier VEO-000025).
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Affiliation(s)
- Ariel Bardach
- Institute for Clinical Effectiveness and Health Policy, Dr Emilio Ravignani 2024, C1014CPV, Buenos Aires, Argentina
| | - Tomás Alconada
- Institute for Clinical Effectiveness and Health Policy, Dr Emilio Ravignani 2024, C1014CPV, Buenos Aires, Argentina
| | - Carolina Palermo
- Institute for Clinical Effectiveness and Health Policy, Dr Emilio Ravignani 2024, C1014CPV, Buenos Aires, Argentina
| | - Carlos Rojas-Roque
- Institute for Clinical Effectiveness and Health Policy, Dr Emilio Ravignani 2024, C1014CPV, Buenos Aires, Argentina
| | - María Macarena Sandoval
- Institute for Clinical Effectiveness and Health Policy, Dr Emilio Ravignani 2024, C1014CPV, Buenos Aires, Argentina
| | | | | | - Agustin Ciapponi
- Institute for Clinical Effectiveness and Health Policy, Dr Emilio Ravignani 2024, C1014CPV, Buenos Aires, Argentina.
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dos Santos LM, de Souza JD, Mbakwa HA, Nobre AFS, Vieira RC, Ferrari SF, Rodrigues AR, Ishikawa EAY, Guerreiro JF, de Sousa MS. High prevalence of sexual infection by human papillomavirus and Chlamydia trachomatis in sexually-active women from a large city in the Amazon region of Brazil. PLoS One 2022; 17:e0270874. [PMID: 35849577 PMCID: PMC9292084 DOI: 10.1371/journal.pone.0270874] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 06/07/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The Human Papillomavirus (HPV) and Chlamydia trachomatis are the most prevalent Sexually Transmitted Infections (STIs) worldwide, and are associated cervical cancer and pelvic inflammatory disease, respectively. However, 80% of women testing positive are asymptomatic. In the Amazon region, young women, in particular, are widely exposed to the infections and their consequences. OBJECTIVES Determine the prevalence of sexual infection by HPV and C. trachomatis in young, sexually-active women treated at a university health program in a large city of the Brazilian Amazon region. METHODS We amplified the L1 gene of HPV. We amplified ompA gene of C. trachomatis by nested PCR, and the study participants filled in a questionnaire on their social, epidemiological, and reproductive health characteristics. The data were analyzed using the Odds Ratio, to evaluate the degree of association of these variables with the observed infections. RESULTS The prevalence of infection by HPV was 15.5% (47/303). This infection was recorded in 32.2% of the women of less than 25 years of age (OR:3.02 [CI95%] = 1.32-6.92; p = 0.014), 17.9% of the single women (OR: 2.41 [CI95%] = 1.22-4.75; p = 0.014), 23.8% of the women that reported having first sexual intercourse at less than 15 years of age (OR: 2.22 [CI95%] = 1.16-4.23; p = 0.021), 20% of those that reported having had more than one sexual partner during their lifetime (OR: 3.83 [CI95%] = 1.56-9.37; p = 0.003), and in 28.3% that use oral contraceptives (CI95% = 1.33-5.43; p = 0.008). The prevalence of sexual infection by C. trachomatis was 4.6% (14/303), and this bacterium was present in 16.1% of the young women of less than 25 years of age (OR: 2.86 [CI95%] = 1.33-5.43; p = 0.008). CONCLUSIONS We found a high prevalence of HPV in young, unmarried women who started their sex lives early, who had several sexual partners in their lives and who used oral contraceptives. The prevalence of C. trachomatis was high only in young women. Our data are in accordance with other studies in Brazil and in the world and may serve to base the formulation of diagnostic and screening measures for these infections in women in the Amazon.
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Affiliation(s)
- Leonardo Miranda dos Santos
- Laboratory of Molecular and Cellular Biology, Tropical Medicine Center, Universidade Federal do Pará, Belém, Pará, Brazil
- Tropical Medicine Center, Universidade Federal do Pará, Belém, Pará, Brazil
- * E-mail:
| | | | - Hilary Acha Mbakwa
- Graduation in Medicine, Universidade Federal do Pará, Belém, Pará, Brazil
| | - Akim Felipe Santos Nobre
- Laboratory of Molecular and Cellular Biology, Tropical Medicine Center, Universidade Federal do Pará, Belém, Pará, Brazil
| | - Rodrigo Covre Vieira
- Laboratory of Molecular and Cellular Biology, Tropical Medicine Center, Universidade Federal do Pará, Belém, Pará, Brazil
| | | | | | - Edna Aoba Yassui Ishikawa
- Laboratory of Molecular and Cellular Biology, Tropical Medicine Center, Universidade Federal do Pará, Belém, Pará, Brazil
| | | | - Maísa Silva de Sousa
- Laboratory of Molecular and Cellular Biology, Tropical Medicine Center, Universidade Federal do Pará, Belém, Pará, Brazil
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Vallejo-Ortega MT, Gaitán Duarte H, Mello MB, Caffe S, Perez F. A systematic review of the prevalence of selected sexually transmitted infections in young people in Latin America. Rev Panam Salud Publica 2022; 46:e73. [PMID: 35747471 PMCID: PMC9211030 DOI: 10.26633/rpsp.2022.73] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 03/03/2022] [Indexed: 11/24/2022] Open
Abstract
Objective To estimate the burden of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Treponema pallidum (TP), and human papillomavirus (HPV) infections among people aged 10 to 25 in Latin America and the Caribbean. Methods The MEDLINE, EMBASE, and LILACS databases were searched, as well as documents from regional organizations or national health Institutions. Population-based studies that reported prevalence or incidence of CT, NG, TP, and HPV detected through confirmatory tests in adolescents and young people were included. Two reviewers independently selected studies and extracted data. The quality of studies was assessed using the Newcastle-Ottawa Scale. Pooled estimators were calculated in cases where heterogeneity was <70%; when not feasible, prevalence ranges were reported. Results Out of a total of 3 583 references, 15 prevalence studies complied with the inclusion criteria. Due to substantial heterogeneity (>70%), it was not possible to pool frequency estimators. Among the general population, the prevalence of CT infection ranged between 2.1% and 30.1% (9 studies, 5 670 participants); for NG, prevalence ranged between 0% and 2.9% (8 studies, 5 855 participants); for TP, prevalence varied between 0% and 0.7% (3 studies, 11 208 participants), and for HPV infection, prevalence ranged between 25.1% and 55.6% (8 studies, 3 831 participants). Conclusions Reliable, population-based data on sexually transmitted infections (STIs) in adolescents and youth in Latin America and the Caribbean are limited. Additional studies are needed to better understand the burden of STIs in this population. However, given the substantial prevalence of STIs detected, countries need public health policies for prevention, early diagnosis, and treatment of STIs in young people.
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Affiliation(s)
| | - Hernando Gaitán Duarte
- Universidad Nacional de Colombia Bogotá Colombia Universidad Nacional de Colombia, Bogotá, Colombia
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Whelan J, Abbing-Karahagopian V, Serino L, Unemo M. Gonorrhoea: a systematic review of prevalence reporting globally. BMC Infect Dis 2021; 21:1152. [PMID: 34763670 PMCID: PMC8582208 DOI: 10.1186/s12879-021-06381-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 06/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The World Health Organization (WHO) recommends periodic gonorrhoea prevalence assessments in the general population or proxies thereof (including pregnant women, women attending family planning clinics, military recruits, and men undergoing employment physicals for example) and in population groups at increased risk, including men-who-have-sex-with-men (MSM) and sex workers. METHOD We evaluated reported prevalence data, including estimates from proxy general population samples to reflect the WHO recommendations. We describe the outcomes from the general population country-by-country and extend previous reviews to include MSM, sex workers, and extragenital infections. RESULT AND CONCLUSION In our systematic search, 2015 titles were reviewed (January 2010-April 2019) and 174 full-text publications were included. National, population-based prevalence data were identified in only four countries (the United States of America, the United Kingdom, Peru, New Caledonia) and local population-based estimates were reported in areas within five countries (China, South Africa, Brazil, Benin, and Malawi). The remaining studies identified only reported test positivity from non-probability, proxy general population samples. Due to the diversity of the reviewed studies, detailed comparison across studies was not possible. In MSM, data were identified from 64 studies in 25 countries. Rectal infection rates were generally higher than urogenital or pharyngeal infection rates, where extragenital testing was conducted. Data on sex workers were identified from 41 studies in 23 countries; rates in female sex workers were high. Current prevalence monitoring was shown to be highly suboptimal worldwide. Serial prevalence monitoring of critical epidemiological variables, and guidelines to optimize prevalence study conduct and reporting beyond antenatal settings are recommended.
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Affiliation(s)
- Jane Whelan
- Clinical and Epidemiology Research and Development, GSK, Amsterdam, The Netherlands.
| | | | - Laura Serino
- Clinical and Epidemiology Research and Development, GSK, Siena, Italy
| | - Magnus Unemo
- WHO Collaborating Centre for Gonorrhoea and other STIs, Department of Laboratory Medicine, Microbiology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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6
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Miranda AE, da Silveira MF, Pinto VM, Alves GC, de Carvalho NS. Brazilian Protocol for Sexually Transmitted Infections, 2020: infections that cause cervicitis. Rev Soc Bras Med Trop 2021; 54:e2020587. [PMID: 34008716 PMCID: PMC8210491 DOI: 10.1590/0037-8682-587-2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 03/10/2021] [Indexed: 12/05/2022] Open
Abstract
Infections that cause cervicitis are a topic presented in the "Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections", published by the Brazilian Ministry of Health in 2020. The document was developed based on scientific evidence and validated in discussions with experts. This article presents epidemiological and clinical aspects of infections that cause cervicitis and recommendations on screening, diagnosis, and treatment of affected people and their sexual partnerships. Also, it discusses strategies for surveillance, prevention, and control of these infections for health professionals and health service managers involved in the programmatic and operational management of sexually transmitted infections. Expanding access to diagnostic tests and early treatment are crucial for controlling the spread of pathogens that cause cervicitis. Associated factors to cervicitis: sexually active women younger than 25 years old, new or multiple sexual partners, partners with STI, previous history or presence of other STI, and irregular use of condoms.
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Affiliation(s)
| | | | - Valdir Monteiro Pinto
- Secretaria Estadual de Saúde de São Paulo, Programa Estadual de DST/Aids, São Paulo, SP, Brasil
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7
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Miranda AE, Silveira MFD, Pinto VM, Alves GC, Carvalho NSD. [Brazilian Protocol for Sexually Transmitted Infections 2020: infections that cause cervicitis]. ACTA ACUST UNITED AC 2021; 30:e2020587. [PMID: 33729399 DOI: 10.1590/s1679-4974202100008.esp1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 09/16/2020] [Indexed: 11/22/2022]
Abstract
Infections that cause cervicitis are a topic presented in the "Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections", published by the Brazilian Ministry of Health in 2020. The document was developed based on scientific evidence and validated in discussions with experts. This article presents epidemiological and clinical aspects of infections that cause cervicitis, as well as recommendations on screening, diagnosis and treatment of affected people and their sexual partnerships. In addition, it discusses strategies for surveillance, prevention and control of these infections for health professionals and health service managers involved in the programmatic and operational management of sexually transmitted infections. Expanding access to diagnostic tests and early treatment are crucial for controlling the spread of pathogens that cause cevicitis.
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Affiliation(s)
| | | | - Valdir Monteiro Pinto
- Secretaria Estadual de Saúde de São Paulo, Programa Estadual de DST/Aids, São Paulo, SP, Brasil
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8
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Dias JA, Luciano TV, Santos MCLFS, Musso C, Zandonade E, Spano LC, Miranda AE. [Sexually transmissible infections in African-descendant women in maroon communities in Brazil: prevalence and associated factors]. CAD SAUDE PUBLICA 2021; 37:e00174919. [PMID: 33624738 DOI: 10.1590/0102-311x00174919] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 06/29/2020] [Indexed: 11/22/2022] Open
Abstract
The study aimed to estimate the prevalence of sexually transmissible infections (STIs) and associated factors in women in quilombola (maroon) communities in Brazil. This was a population-based cross-sectional study of quilombola women from March 2017 to January 2019. A questionnaire was used with sociodemographic, behavioral, and clinical information. A gynecological examination was performed for the collection of uterine cervical cells for oncotic cytology and the detection of Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, and human papillomavirus (HPV) via polymerase chain reaction. Rapid tests for HIV and syphilis were performed. The main outcome was defined as infection with one or more sexually transmissible pathogens. The analysis used chi-square test and hierarchical logistic regression. From a total of 380 women, 352 (92.6%) were included in the study. Prevalence of at least one STI was 18.5% (95%CI: 14.76-22.85). The highest prevalence was for HPV, with 11.1%, followed by 6.3% for T. vaginalis and 4.3% for C. trachomatis. There were no cases of N. gonorrhoeae. Prevalence was 0.3% for HIV and 4.3% for syphilis. Cervical-vaginal cytology was altered in 7.7% of the women. Detection of one or more STIs was significantly associated with age 25 to 44 years (OR = 2.33; 95%CI: 1.05-5.18), alcohol consumption (OR = 1.96; 95%CI: 1.06-3.64), altered cervical cytology (OR = 3.96; 95%CI: 1.65-9.48), and bacterial vaginosis (OR = 3.61; 95%CI: 2.01-6.47). Quilombola women showed high prevalence of one or more STIs, emphasizing the importance of organizing prevention strategies targeted to these women.
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Affiliation(s)
| | | | | | - Carlos Musso
- Universidade Federal do Espírito Santo, Vitória, Brasil
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Suehiro TT, Gimenes F, Souza RP, Taura SKI, Cestari RCC, Irie MMT, Boer CG, Consolaro MEL, Silva VRSD. High molecular prevalence of HPV and other sexually transmitted infections in a population of asymptomatic women who work or study at a Brazilian university. Rev Inst Med Trop Sao Paulo 2021; 63:e1. [PMID: 33503149 PMCID: PMC7816866 DOI: 10.1590/s1678-9946202163001] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 12/04/2020] [Indexed: 01/22/2023] Open
Abstract
Sexually transmitted infections (STIs) represent a global health problem with
variable prevalence depending on the geographical region and the type of
population. Human papillomavirus (HPV) encompasses widespread virus types
related to cervical carcinogenesis. The present study investigated the molecular
prevalence of HPV and seven other important STIs in asymptomatic women working
or studying at a Brazilian university. A secondary aim was to assess cytological
abnormalities associated with HPV and other STIs coinfections. We recruited 210
women from a Brazilian university. HPV was detected using a single-round
polymerase chain reaction (sPCR) followed by a viral genotyping by restriction
fragment length polymorphism (RFLP-PCR). The presence of seven STIs:
Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum,
Trichomonas vaginalis, Mycoplasma genitalium, herpes simplex virus
(HSV)-1 and HSV-2 was detected by multiplex PCR (M-PCR). Furthermore,
cytological findings and epidemiological characteristics were evaluated.The mean
age of the participants was 27.1 years old. HPV prevalence was 33.8%, and HPV16
was the most frequently detected papillomavirus genotype. Moreover, multiple HPV
infections were common (42.2%). We detected at least one STI agent in 11.4% of
the tested women, most frequently C. trachomatis (6.7%). Among
HPV-positive women, 14.1% were coinfected with other STI agents. Cytological
abnormalities were observed in 9.5% of smears, and HPV-DNA, high-risk HPV
(HR-HPV), HPV16 and HPV multiple infections were associated with abnormal
cytological findings. There was a high prevalence of HPV, and C.
trachomatis was the most prevalent STI agent, with low rates of
cytological abnormalities. These findings highlight the need of timely STI
diagnosis in young asymptomatic women and of a public policy design for STI
prevention.
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Affiliation(s)
- Tamy Taianne Suehiro
- Universidade Estadual de Maringá, Departamento de Análises Clínicas e Biomedicina, Maringá, Paraná, Brazil
| | - Fabrícia Gimenes
- Universidade Estadual de Maringá, Departamento de Análises Clínicas e Biomedicina, Maringá, Paraná, Brazil
| | - Raquel Pantarotto Souza
- Universidade Estadual de Maringá, Departamento de Análises Clínicas e Biomedicina, Maringá, Paraná, Brazil
| | - Sergio Ken Iti Taura
- Hospital Universitário Regional de Maringá, Ambulatório Médico e de Enfermagem, Maringá, Paraná, Brazil
| | | | - Mary Mayumi Taguti Irie
- Universidade Estadual de Maringá, Departamento de Análises Clínicas e Biomedicina, Maringá, Paraná, Brazil
| | - Cinthia Gandolfi Boer
- Universidade Estadual de Maringá, Departamento de Análises Clínicas e Biomedicina, Maringá, Paraná, Brazil
| | | | - Vânia Ramos Sela da Silva
- Universidade Estadual de Maringá, Departamento de Análises Clínicas e Biomedicina, Maringá, Paraná, Brazil
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Miralha AL, Chermont AG, Orlandi PP, Rugolo LS, Sant'Anna G. Prophylaxis for ophthalmia neonatorum in Brazil: A snapshot using a multi-professional national survey. J Neonatal Perinatal Med 2020; 14:203-211. [PMID: 32894255 DOI: 10.3233/npm-200503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Brazil is a large country with an elevated incidence of Chlamydiatrachomatis (CT) and Neisseriagonorrhoeae (NG) during pregnancy and variable access to health care. The objective of the study was to identify ophthalmia neonatorum prophylaxis practices in the country. METHODS A prospective multidisciplinary survey was conducted using a closed social media group. Fifteen questions were developed after literature review. Specific content included categorization of respondents and practices such as type of medication, age at administration, occurrence of clinical and/or chemical conjunctivitis and microbiology identification. Questions were multiple choice, but some allowed written response. RESULTS A total of 1.015 professionals responded, representing 24 states (92%) and 181 cities; mainly neonatologists (64%) and general pediatricians (21%). 96% of respondents reported performing prophylaxis at their institutions, mostly at birth or <1 h of life (99%), and regardless the mode of delivery (73%). Frequently used medications are: 1% silver nitrate (64%), 2.5% povidone iodine (18%) or 10% silver vitelinate (12%), with some regional variations. Occurrence of chemical conjunctivitis was stated by 58% of the respondents and microbiology identification was unusual. CONCLUSIONS Ophthalmia neonatorum prophylaxis Brazil is almost universal and mainly performed by the use of anti-septic medications, with some regional variability. However, identification and treatment of CT and NG in both parents and newborns is not accomplished.
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Affiliation(s)
- A L Miralha
- Universidade Federal do Amazonas, Faculdade de Medicina, Manaus, Amazonas, Brazil
| | - A G Chermont
- Universidade Federal do Pará, Faculdade de Medicina, Belém, Pará, Brazil
| | - P P Orlandi
- Fundação Oswaldo Cruz (ILMD), Manaus, Amazonas, Brazil
| | - L S Rugolo
- Faculdade de Medicina, Universidade Estadual Paulista Júlio Mesquita Filho, Botucatu, São Paulo, Brazil
| | - G Sant'Anna
- McGill University Health Center, Montreal, Quebec, Canada
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11
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Ribeiro AA, Saddi VA, Carneiro MA, Figueiredo-Alves RR, da Silva Barros NK, de Almeida Carvalho KP, do Nascimento Tavares SB, de Araújo Teles S, D'Alessandro WB, Rabelo-Santos SH. Human papillomavirus and Chlamydia trachomatis infections in adolescents and young women: Prevalence and risk factors. Diagn Cytopathol 2020; 48:736-744. [PMID: 32379403 DOI: 10.1002/dc.24460] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 04/20/2020] [Accepted: 04/21/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND The objective of this study was to estimate the prevalence of Human papillomavirus (HPV) genotypes and Chlamydia trachomatis (CT) infections among adolescents and young adult women and to identify the risk factors associated. METHODS This study included 276 sexually active participants, classified as adolescents (15-19 years) and young adult women (20-24 years) that realized conventional cytology and were tested for 27 HPV genotypes and for CT. Bivariate and multivariate analyses were performed to evaluate the factors associated with both infections. RESULTS The prevalence of HPV infection was 50.7% in adolescents and 43.0% in young adult women. The HPV-16 was the most prevalent (27.7%), followed by HPV-68 (6.9%), HPV-52 (6.2%), HPV-39 (4.6%), and HPV-73 (4.6%). The prevalence of CT infection was 11.5% among adolescents and 6.2% among young adult women. Cytological abnormalities were found in 14.2% among adolescents, of which 80.9% were positive for HPV and 10% of young adult women of which 84.6% were positive for HPV infection. HPV16 and HPV 68 were detected in 35.7% and 32.1% of cases with cytological abnormalities. Factors independently associated with HPV infection obtained by multivariate analysis were unmarried or divorced marital status and the presence of cytological abnormalities. The same variables were analyzed for the association with CT infection, and the association with cytological abnormalities remained significant. CONCLUSION HPV and CT infections are very prevalent in adolescent and young adult women; these findings reinforce the need of early vaccination, prior to the onset of sexual activity, and justify implementation of molecular screening tests.
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Affiliation(s)
- Andrea Alves Ribeiro
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Brazil
| | | | | | | | | | | | | | - Sheila de Araújo Teles
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Brazil
| | | | - Silvia Helena Rabelo-Santos
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Brazil.,School of Pharmacy, Federal University of Goiás, Goiânia, Brazil
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12
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Silveira MF, Bruni MP, Stauffert D, Golparian D, Unemo M. Prevalence and risk factors associated with Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycoplasma genitalium among women in Pelotas, Southern Brazil. Int J STD AIDS 2020; 31:432-439. [PMID: 32192370 DOI: 10.1177/0956462419898982] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The frequently asymptomatic sexually transmitted infections (STIs) caused by Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Mycoplasma genitalium (MG) are poorly diagnosed in Brazil and can lead to severe complications/sequelae without timely detection and treatment. We investigated prevalence of CT, NG, and MG infections and associated demographic, behavioral, and clinical factors in consecutive women attending a gynecology and obstetrics outpatient clinic in Pelotas, Southern Brazil. Vaginal swab samples were prospectively obtained from asymptomatic and symptomatic women (n = 498) from August 2015 to December 2016 and tested with Aptima Combo2 and Aptima M. genitalium assays (Hologic). The prevalence of CT, NG, and MG was 6.8% (34/498), 1.0% (5/498), and 4.2% (21/498), respectively. Three (0.6%) cases of CT and NG co-infection and one (0.2%) case of CT and MG co-infection were identified. The risk factors associated with these bacterial STIs were youth (<30 years), no steady sexual partner, infection with additional STI, and lack of income. Bacterial STIs, particularly CT and MG, were prevalent among women, including pregnant women (60% of positive cases), in Pelotas, Brazil. Sensitive and specific diagnostic testing and early treatment are essential to control STIs, limit transmission chains, avoid future complications/sequelae, and reduce health and cost burdens on the population.
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Affiliation(s)
- M F Silveira
- Maternal and Child Department, School of Medicine, Federal University of Pelotas (UFPel), Pelotas, Brazil
| | - M P Bruni
- Post Graduate Program in Parasitology, Biology Institute, Federal University of Pelotas (UFPel), Pelotas, Brazil
| | - D Stauffert
- Maternal and Child Department, School of Medicine, Federal University of Pelotas (UFPel), Pelotas, Brazil
| | - D Golparian
- WHO Collaborating Centre for Gonorrhoea and other STIs, Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - M Unemo
- WHO Collaborating Centre for Gonorrhoea and other STIs, Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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13
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Ji Y, Ma XX, Li Z, Peppelenbosch MP, Ma Z, Pan Q. The Burden of Human Papillomavirus and Chlamydia trachomatis Coinfection in Women: A Large Cohort Study in Inner Mongolia, China. J Infect Dis 2019; 219:206-214. [PMID: 30192954 DOI: 10.1093/infdis/jiy497] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 08/29/2018] [Indexed: 11/13/2022] Open
Abstract
Background Chlamydia trachomatis may coinfect with human papillomavirus (HPV) and complicate the cervical pathogenesis. This study aimed to evaluate the prevalence, risk factors, and clinical outcomes of HPV/C. trachomatis coinfection in women from Inner Mongolia, China. Methods We performed a polymerase chain reaction (PCR)-based HPV/C. trachomatis screening and cervical samples were analyzed by thinprep cytologic test. Statistical analysis was used to assess the association between demographic factors and coinfection. Results Among the 2345 women recruited, the prevalences of HPV, C. trachomatis, and HPV/C. trachomatis coinfection were 36.0%, 14.3%, and 4.8%, respectively. The rate of multiple HPV genotypes was higher in coinfected women. HPV66 was the most frequently identified genotype in coinfected participants. The HPV DNA load was significantly higher in HPV monoinfected cases. In contrast, the DNA load of C. trachomatis was significantly higher in the coinfection group. Risk factors, including single women (odds ratio [OR] = 6.0, 95% confidence interval [CI], 4.044-8.782) and women with multiple sex partners (OR = 1.9, 95% CI, 1.324-2.824), were associated with coinfection. Importantly, coinfection was associated with increased risk for high-grade squamous intraepithelial lesions. Conclusions HPV and C. trachomatis coinfection is an important risk factor for the progression of cervical lesions.
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Affiliation(s)
- Yunpeng Ji
- Biomedical Research Center, Northwest Minzu University, Lanzhou, China.,Department of Genetics, Inner Mongolia Maternal and Child Care Hospital, Hohhot, China.,Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Xiao-Xia Ma
- Biomedical Research Center, Northwest Minzu University, Lanzhou, China
| | - Zhaocai Li
- State Key Laboratory of Veterinary Etiological Biology, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Gansu, China
| | - Maikel P Peppelenbosch
- Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Zhongren Ma
- Biomedical Research Center, Northwest Minzu University, Lanzhou, China
| | - Qiuwei Pan
- Biomedical Research Center, Northwest Minzu University, Lanzhou, China.,Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands
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14
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França ISXD, Coura AS, Sousa FSD, Aragão JDS, Silva AFR, Santos SRD. Acquiring of knowledge about sexual health by blind people: an action research. Rev Lat Am Enfermagem 2019; 27:e3163. [PMID: 31340347 PMCID: PMC6687357 DOI: 10.1590/1518-8345.3006.3163] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 03/08/2019] [Indexed: 11/22/2022] Open
Abstract
Objective: to evaluate knowledge about sexual health, with blind people, before and
after educational intervention. Method: action research conducted with 58 blind people enrolled in a philanthropic
educational institution. A form with sociodemographic and knowledge
variables about Sexually Transmitted Infections was used. The Chi-square and
Fisher tests were performed. Results: men presented higher frequency of alcoholism (p <0.001) and illicit drugs
(p = 0.006). It was found that they used a male condom more frequently than
women using a female condom (p = 0.003), although they had more knowledge
about the prevention of Sexually Transmitted Infections (p = 0.006). Among
these infections, Trichomonas vaginalis (52.4%) was more frequent. Knowledge
gaps on risk factors and safe sex were identified. After the intervention,
an increase in the knowledge about sexual health was detected. Conclusion: the educational intervention, in the light of problematizing pedagogy, (re)
constructed the knowledge on sexual health, empowering the participants
regarding the prevention of Sexually Transmitted Infections. Therefore, it
is necessary that nurses carry out educational interventions with this
clientele, aiming to soften deficits of knowledge about the thematic in
screen.
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Affiliation(s)
| | | | | | - Jamilly da Silva Aragão
- Universidade Estadual da Paraíba, Campina Grande, PB, Brasil.,Universidade de Pernambuco, Recife, PE, Brasil.,Bolsista da Fundação de Amparo a Ciência e Tecnologia do Estado de Pernambuco (FACEPE), Brasil
| | - Arthur Felipe Rodrigues Silva
- Universidade Estadual da Paraíba, Campina Grande, PB, Brasil.,Universidade de Pernambuco, Recife, PE, Brasil.,Bolsista da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brasil
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15
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dos Santos LM, Vieira MRMDS, Oliveira JFG, Trindade JQ, Brasiliense DM, Ferrari SF, Tsutsumi MY, Fuzii HT, Sousa Junior EC, Ishikawa EAY, Ishak R, de Sousa MS. High prevalence of sexual Chlamydia trachomatis infection in young women from Marajó Island, in the Brazilian Amazon. PLoS One 2018; 13:e0207853. [PMID: 30496244 PMCID: PMC6264820 DOI: 10.1371/journal.pone.0207853] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 11/07/2018] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Chlamydia trachomatis is the most prevalent bacterial sexually transmitted infection (STI) in the world. Approximately 80% of infected women are asymptomatic, although this infection can lead to serious complications in the female reproductive tract. Few data on Chlamydia infection are available in rural Amazonian communities. OBJECTIVES To evaluate the prevalence of sexual C. trachomatis infection in women from Marajó Archipelago communities in the Amazon region of Brazil and to identify associated factors and genotypes. METHODS We utilized amplification of the ompA gene by nested PCR. Positive samples were genotyped by sequencing. Study participants completed a questionnaire on social, epidemiological, and reproductive health variables. A Poisson regression was used to evaluate the degree of association of these variables with the infection. RESULTS The sexual infection by C. trachomatis was observed in 4% (16/393) of the subjects, and was more often found in women aged ≤25 (14.3%; 95% CI = 2.83-35.47; p <0.001), and in women with a household income of less than one Brazilian monthly minimum wage (5.2%; 95% CI = 1.33-11.37; p = 0.014). The ompA gene was sequenced in 13 samples, revealing F genotypes (38.4%, n = 5), D (23%, n = 3), E (15.3%, n = 2), Ia (7.6%, N = 1), J (7.6%, n = 1) and B (7.6%, n = 1). CONCLUSIONS We recorded a high prevalence of sexual infection by C. trachomatis in young and poor women from the interior of the Brazilian Amazon. This high prevalence and the frequencies of the main genotypes were similar to those found in major Brazilian urban centers. Our results reinforce the importance of the screening of this neglected infection, and the prevention of later sequelae in young women from rural and urban areas of Brazil.
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Affiliation(s)
- Leonardo Miranda dos Santos
- Laboratório de Biologia Molecular e Celular, Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Pará, Brasil
- Programa de Pós-graduação em Doenças Tropicais, Universidade Federal do Pará, Belém, Pará, Brasil
| | - Maria Renata Mendonça dos Santos Vieira
- Laboratório de Biologia Molecular e Celular, Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Pará, Brasil
- Programa de Pós-graduação em Análises Clínicas, Universidade Federal do Pará, Belém, Pará, Brasil
| | | | - Josinaide Quaresma Trindade
- Laboratório de Citopatologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Pará, Brasi
| | | | | | - Mihoko Yamamoto Tsutsumi
- Programa de Pós-graduação em Análises Clínicas, Universidade Federal do Pará, Belém, Pará, Brasil
- Laboratório de Citopatologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Pará, Brasi
| | - Hellen Thais Fuzii
- Laboratório de Imunopatologia, Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Pará, Brasil
| | | | - Edna Aoba Yassui Ishikawa
- Laboratório de Biologia Molecular e Celular, Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Pará, Brasil
| | - Ricardo Ishak
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Pará, Brasil
| | - Maísa Silva de Sousa
- Laboratório de Biologia Molecular e Celular, Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Pará, Brasil
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Oliver VO, Otieno G, Gvetadze R, Desai MA, Makanga M, Akelo V, Gust DA, Nyagol B, McLellan-Lemal E. High prevalence of sexually transmitted infections among women screened for a contraceptive intravaginal ring study, Kisumu, Kenya, 2014. Int J STD AIDS 2018; 29:1390-1399. [PMID: 30071799 DOI: 10.1177/0956462418782810] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We assessed prevalence and correlates of bacterial vaginosis (BV) and sexually transmitted infections (STIs) including herpes simplex virus type 2 (HSV-2), gonorrhoea (GC), syphilis (SYP), Chlamydia (CT) and HIV among Kenyan women aged 18–34 years who were screened for a contraceptive intravaginal ring study. Women provided demographic, behavioural and medical information, and underwent medical evaluation, including a pelvic exam. We computed crude and adjusted prevalence ratio (aPR) and 95% confidence interval (CI) using log-binomial regression. Of 463 women screened, 457 provided laboratory specimens and were included in the analysis. The median age was 25 years, interquartile range (21–28), and 68.5% had completed primary or lower education. Overall, 72.2% tested positive for any STI or BV. Point prevalence was 55.6, 38.5, 3.9, 2.0, 4.6, and 14.7% for HSV-2, BV, GC, SYP, CT, and HIV, respectively. Co-infection with HSV-2, BV, and HIV occurred in 28 (6.1%) participants. Having ≥1 STI/BV was associated with younger age at first sex (≤13 versus 17–19 years, aPR=1.27, 95% CI 1.07–1.51), history of exchange sex (aPR = 2.05, 95% CI 1.07–3.92), sexual intercourse in the past seven days (aPR = 1.17, 95% CI 1.01–1.36), and older age (30–34 versus 18–24 years, aPR = 1.26, 95% CI 1.06–1.48). STI/BV diagnosis was less likely for women reporting one lifetime sexual partner compared to women with ≥4 lifetime sexual partners (aPR = 0.70, 95% CI 0.54–0.92). Combination prevention approaches (biomedical, behavioural, social, and structural) tailored to women with diverse risk profiles may help mitigate STI/BV prevalence in this setting.
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Affiliation(s)
- Vincent O Oliver
- HIV Research Branch, Kenya Medical Research Institute, Kisumu, Kenya
| | - George Otieno
- HIV Research Branch, Kenya Medical Research Institute, Kisumu, Kenya
| | - Roman Gvetadze
- US Centers for Disease Control and Prevention, Office of Infectious Diseases, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention, Atlanta, GA, USA
| | - Mitesh A Desai
- US Centers for Disease Control and Prevention, Office of Infectious Diseases, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention, Atlanta, GA, USA
| | - Mumbi Makanga
- HIV Research Branch, Kenya Medical Research Institute, Kisumu, Kenya
| | - Victor Akelo
- HIV Research Branch, Kenya Medical Research Institute, Kisumu, Kenya
| | - Deborah A Gust
- US Centers for Disease Control and Prevention, Office of Infectious Diseases, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention, Atlanta, GA, USA
| | - Beatrice Nyagol
- HIV Research Branch, Kenya Medical Research Institute, Kisumu, Kenya
| | - Eleanor McLellan-Lemal
- US Centers for Disease Control and Prevention, Office of Infectious Diseases, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention, Atlanta, GA, USA
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17
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Ginindza TG, Stefan CD, Tsoka-Gwegweni JM, Dlamini X, Jolly PE, Weiderpass E, Broutet N, Sartorius B. Prevalence and risk factors associated with sexually transmitted infections (STIs) among women of reproductive age in Swaziland. Infect Agent Cancer 2017; 12:29. [PMID: 28559923 PMCID: PMC5445272 DOI: 10.1186/s13027-017-0140-y] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 05/16/2017] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Sexually 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. METHODS A 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. RESULTS The 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. CONCLUSION STIs 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.
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Affiliation(s)
- Themba G. Ginindza
- Discipline of Public Health, School of Nursing and Public Health, University of KwaZulu-Natal, 2nd Floor George Campbell Building, Mazisi Kunene Road, 4041 Durban, South Africa
| | | | - Joyce M. Tsoka-Gwegweni
- Discipline of Public Health, School of Nursing and Public Health, University of KwaZulu-Natal, 2nd Floor George Campbell Building, Mazisi Kunene Road, 4041 Durban, South Africa
| | - Xolisile Dlamini
- Epidemiology Unit, Ministry of Health and Social Welfare, Mbabane, Swaziland
| | - Pauline E. Jolly
- Department of Epidemiology, University of Alabama, Birmingham, USA
| | - Elisabete Weiderpass
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
- Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
| | - Nathalie Broutet
- World Health Organization; Department of Reproductive Health and Research, Geneva, Switzerland
| | - Benn Sartorius
- Discipline of Public Health, School of Nursing and Public Health, University of KwaZulu-Natal, 2nd Floor George Campbell Building, Mazisi Kunene Road, 4041 Durban, South Africa
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Molaei B, Mohmmadian F, Eftekhar M, Hatami R, Tirkan A, Kiani M. The frequency of gonorrheal and chlamydial infections in Zanjanian women in 2013-2014. Int J Reprod Biomed 2017. [DOI: 10.29252/ijrm.15.2.75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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19
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Nonato DR, Alves RR, Ribeiro AA, Saddi VA, Segati KD, Almeida KP, de Lima YA, D’Alessandro WB, Rabelo-Santos SH. Prevalence and factors associated with coinfection of human papillomavirus and Chlamydia trachomatis in adolescents and young women. Am J Obstet Gynecol 2016; 215:753.e1-753.e9. [PMID: 27402054 DOI: 10.1016/j.ajog.2016.07.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 06/28/2016] [Accepted: 07/01/2016] [Indexed: 01/09/2023]
Abstract
BACKGROUND Human papillomavirus and Chlamydia trachomatis share the same route of sexual transmission and possess similar risk factors, indicating that coinfection may act synergistically in the induction of epithelial cell abnormalities. OBJECTIVE This study aimed to determine the prevalence of human papillomavirus and Chlamydia trachomatis in adolescents and young women and identify factors associated with coinfection. STUDY DESIGN This cross-sectional study included 276 female participants, aged 15-24 years, who were sexually active. Interviews were conducted and cervical specimens were collected for cervical smears and molecular tests. All cervical specimens were tested for 27 human papillomavirus genotypes by polymerase chain reaction amplification and hybridization to a human papillomavirus linear array. Detection of Chlamydia trachomatis was performed by polymerase chain reaction using primers directed to the region encoding the cryptic plasmid. Bivariate and multivariate analyses were performed to evaluate the factors associated with coinfection with human papillomavirus and Chlamydia trachomatis. The odds ratio, the adjusted odds ratio, and the 95% confidence interval were calculated. RESULTS The prevalence of infection by Chlamydia trachomatis and human papillomavirus was 9.1% (95% confidence interval, 5.61-12.4) and 47.1% (95% confidence interval, 41.0-53.2), respectively. The prevalence of coinfection with human papillomavirus and Chlamydia trachomatis was 5.8% (95% confidence interval, 3.3-9.2); coinfection with 1 human papillomavirus type was 3.3% (95% confidence interval, 1.5-6.1) and with multiple types was 2.5% (95% confidence interval, 1.0-5.2). The prevalence of cytological abnormalities was 12.3% (95% confidence interval, 8.6-16.79). Human papillomavirus infections of high oncogenic risk were more prevalent (85.4%). Factors independently associated with coinfection of human papillomavirus/Chlamydia trachomatis obtained by multivariate analysis were the initiation of sexual activity under 16 years of age with an an odds ratio of 4.9 (95% confidence interval, 1.0-23.63; P = .05) and cytological abnormalities with an odds ratio of 10.7 (95% confidence interval, 1.9-59.5; P = .01), which indicates there is risk for the detection of cytological abnormalities in adolescents and young women coinfected with human papillomavirus/Chlamydia trachomatis. CONCLUSION The prevalence of coinfection among our study population was of a magnitude that warrants attention by public health services. Adolescents and young women should be monitored for Chlamydia trachomatis infection and vaccinated against human papillomavirus. The association between cytological abnormalities and coinfection with human papillomavirus and Chlamydia trachomatis indicates the potential synergistic role of these infections in carcinogenesis of the cervix.
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Nankinga O, Misinde C, Kwagala B. Gender relations, sexual behaviour, and risk of contracting sexually transmitted infections among women in union in Uganda. BMC Public Health 2016; 16:440. [PMID: 27229928 PMCID: PMC4881206 DOI: 10.1186/s12889-016-3103-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Accepted: 05/13/2016] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Sexually transmitted infections (STIs) are a major reproductive and public health concern, especially in the era of HIV/AIDS. This study examined the relationship between sexual empowerment and STI status of women in union (married or cohabiting) in Uganda, controlling for sexual behaviour, partner factors, and women's background characteristics. METHODS The study, based on data from the 2011 Uganda Demographic and Health Survey (UDHS), analysed 1307 weighted cases of women age 15-49 in union and selected for the domestic violence module. Chi-squared tests and multivariate logistic regressions were used to examine the predicators of STI status. The main explanatory variables included sexual empowerment, involvement in decision making on own health, experience of any sexual violence, condom use during last sex with most recent partner, number of lifetime partners and partner control behaviours. Sexual empowerment was measured with three indicators: a woman's reported ability to refuse sex, ability to ask her partner to use a condom, and opinion regarding whether a woman is justified to refuse sex with her husband if he is unfaithful. RESULTS Results show that 28 % of women in union reported STIs in the last 12 months. Sexual violence and number of lifetime partners were the strongest predictors of reporting STIs. Women's sexual empowerment was a significant predictor of their STI status, but, surprisingly, the odds of reporting STIs were greater among women who were sexually empowered. Reporting of STIs was negatively associated with a woman's participation in decision-making with respect to her own health, and was positively associated with experience of sexual violence, partner's controlling behaviour, and having more than one life partner. CONCLUSIONS Our findings suggest that, with respect to STIs, sexual empowerment as measured in the study does not protect women who have sexually violent and controlling partners. Interventions promoting sexual health must effectively address negative masculine attitudes and roles that perpetuate unhealthy sexual behaviours and gender relations within marriage. It is also important to promote marital fidelity and better communication within union and to encourage women to take charge of their health jointly with their partners.
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Affiliation(s)
- Olivia Nankinga
- Department of Population Studies, School of Statistics and Planning, College of Business and Management, Makerere University, P.O Box 7062, Kampala, Uganda
| | - Cyprian Misinde
- Department of Population Studies, School of Statistics and Planning, College of Business and Management, Makerere University, P.O Box 7062, Kampala, Uganda
| | - Betty Kwagala
- Department of Population Studies, School of Statistics and Planning, College of Business and Management, Makerere University, P.O Box 7062, Kampala, Uganda.
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