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Bassichetto KC, Sperandei S, McCartney DJ, Luppi CG, da Silva RJC, Araújo S, Magno L, Bazzo ML, Hughes G, Mayaud P, Dourado I, Veras MADSM. Prevalence of chlamydia and gonorreheae among transgender women and travestis in five Brazilian capitals, 2019-2021. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2024; 27Suppl 1:e240006.supl.1. [PMID: 39166578 PMCID: PMC11338534 DOI: 10.1590/1980-549720240006.supl.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 12/21/2023] [Accepted: 01/03/2024] [Indexed: 08/23/2024] Open
Abstract
OBJECTIVE To estimate the prevalence and factors associated with the detection of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) in transgender women and travestis in five Brazilian capitals. METHODS Data were obtained from a cross-sectional study conducted between 2019 and 2021, with participants recruited through Respondent Driven Sampling in São Paulo, Campo Grande, Manaus, Porto Alegre and Salvador. Detection of CT and NG was analyzed at three collection sites (anorectal, oropharyngeal and urethral). Mixed logistic regression models were employed to identify associated factors. RESULTS A total of 1,297 recruited participants provided biological material to detect these infections. The prevalences of CT, NG and coinfection were 11.5%, 13.3% and 3.6%, respectively. Independent associations with CT infections included past (OR=1.73; 95%CI 1.02-2.95), current (OR=2.13; 95%CI 1.23-3.69), and part-time sex work (OR=2.75; 95%CI 1.60-4.75), as well as lifetime injectable drug use (OR=3.54; 95%CI 1.49-8.40). For NG, associations were observed with lifetime injectable drug use (OR=1.91; 95%CI 1.28-2.84) and sexual orientation, including heterosexual (OR=3.44; 95%CI 1.35-8.82), homosexual (OR=5.49; 95%CI 1.89-15.97), and bisexual (OR=3.21; 95%CI 1.06-9.68). Coinfection was associated with use of illicit drugs in the last 12 months (OR=2.34, 95%CI 1.10-5.00), and younger age was associated with all investigated outcomes. CONCLUSION Estimated prevalences of CT, NG and co-infection were higher among transgender women and travestis compared to the general population, particularly among younger, individuals engaged in sex work and illicit drug use.
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Affiliation(s)
| | - Sandro Sperandei
- Western Sydney University, Translational Health Research Institute – Sydney, Australia
| | - Daniel Jason McCartney
- London School of Hygiene & Tropical Medicine, Faculty of Infectious & Tropical Diseases, Department of Clinical Research – London, United Kingdom
| | - Carla Gianna Luppi
- State Health Secretariat of São Paulo, STD/AIDS Reference and Training Center – São Paulo (SP), Brazil
| | | | - Sandra Araújo
- State Health Secretariat of São Paulo, STD/AIDS Reference and Training Center – São Paulo (SP), Brazil
| | - Laio Magno
- Universidade do Estado da Bahia, Department of Life Sciences – Salvador (BA), Brazil
- Universidade Federal da Bahia, Institute of Public Health – Salvador (BA), Brazil
| | - Maria Luíza Bazzo
- Universidade Federal de Santa Catarina, Postgraduate Program in Pharmacy/Health Sciences Center, Laboratory of Molecular Biology, Microbiology and Serology – Florianópolis (SC), Brazil
| | - Gwenda Hughes
- London School of Hygiene & Tropical Medicine, Faculty of Infectious & Tropical Diseases, Department of Clinical Research – London, United Kingdom
| | - Philippe Mayaud
- London School of Hygiene & Tropical Medicine, Faculty of Infectious & Tropical Diseases, Department of Clinical Research – London, United Kingdom
| | - Inês Dourado
- Universidade Federal da Bahia, Institute of Public Health – Salvador (BA), Brazil
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Miranda AE, Gaspar PC, Schörner MA, Barazzetti FH, Dias GB, Bigolin A, Pascom ARP, Barreira D, Bazzo ML. Prevalence of Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, and Mycoplasma genitalium and risk factors among pregnant women in Brazil: Results from the national molecular diagnosis implementation project. Int J Gynaecol Obstet 2024; 166:71-79. [PMID: 38425195 DOI: 10.1002/ijgo.15447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 01/20/2024] [Accepted: 02/09/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Sexually transmitted infections (STIs) are a public health problem. The aim of the present study was to assess the prevalence and risk factors associated with at least one STI (Chlamydia trachomatis [CT], Neisseria gonorrhoeae [NG], Trichomonas vaginalis [TV], and Mycoplasma genitalium [MG]) in Brazil. METHODS A cross-sectional study was conducted using secondary data from the pilot implementation of the National Service for molecular diagnosis of CT, NG, TV, and MG in pregnancy. We obtained Ministry of Health surveillance data from the implementation project. Data encompassing pregnant women aged 15-49 years from public antenatal clinics in Brazil in 2022 were included. RESULTS A total of 2728 data of pregnant women were analyzed. The prevalence of at least one infection was 21.0% (573), with the highest prevalence in the Southeast region (23.3%) and the lowest in the Center-West region (15.4%). The prevalence of CT was 9.9% (270), NG 0.6% (16), TV 6.7% (184), and MG 7.8% (212). Factors associated with any infection were from 15 to 24 years (AOR = 1.93; 95% CI: 1.58-2.35); reported family income up to US$400 (AOR = 1.79; 95% CI: 1.03-3.34); declared not living maritally with their partners (AOR = 1.90, 95% CI: 1.52-2.37) and had more than one sexual partner in their lifetime (AOR = 2.09, 95% CI: 1.55-2.86). CONCLUSION This study showed a high prevalence of at least one STI among pregnant women in Brazil, particularly among younger women. It also provides up-to-date national data on CT, NG, TV, and MG infections in this population. These findings underscore the importance of enhancing access to STI screening for young pregnant women within the Brazilian public health system.
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Affiliation(s)
- Angélica Espinosa Miranda
- Departamento de HIV/AIDS, Tuberculose, Hepatites Virais e Infecções Sexualmente Transmissíveis do Ministério da Saúde, Brasília, Distrito Federal, Brazil
- Programa de Pós-Graduação em Doenças Infecciosas da Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Pâmela Cristina Gaspar
- Departamento de HIV/AIDS, Tuberculose, Hepatites Virais e Infecções Sexualmente Transmissíveis do Ministério da Saúde, Brasília, Distrito Federal, Brazil
- Programa de Pós-Graduação em Saúde Coletiva da Universidade de Brasília, Brasília, Distrito Federal, Brazil
| | - Marcos André Schörner
- Laboratório de Biologia Molecular, Microbiologia e Sorologia do Programa de Pós-Graduação em Farmácia da Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Fernando Hartmann Barazzetti
- Laboratório de Biologia Molecular, Microbiologia e Sorologia do Programa de Pós-Graduação em Farmácia da Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Guilherme Borges Dias
- Departamento de HIV/AIDS, Tuberculose, Hepatites Virais e Infecções Sexualmente Transmissíveis do Ministério da Saúde, Brasília, Distrito Federal, Brazil
| | - Alisson Bigolin
- Departamento de HIV/AIDS, Tuberculose, Hepatites Virais e Infecções Sexualmente Transmissíveis do Ministério da Saúde, Brasília, Distrito Federal, Brazil
| | - Ana Roberta Pati Pascom
- Departamento de HIV/AIDS, Tuberculose, Hepatites Virais e Infecções Sexualmente Transmissíveis do Ministério da Saúde, Brasília, Distrito Federal, Brazil
| | - Dráurio Barreira
- Departamento de HIV/AIDS, Tuberculose, Hepatites Virais e Infecções Sexualmente Transmissíveis do Ministério da Saúde, Brasília, Distrito Federal, Brazil
| | - Maria Luiza Bazzo
- Laboratório de Biologia Molecular, Microbiologia e Sorologia do Programa de Pós-Graduação em Farmácia da Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, 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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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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Menezes MLB, Giraldo PC, Linhares IM, Boldrini NAT, Aragon MG. Comments on Ricardo F Savaris' Letter to the Editor regarding the publication in the JBSTM-Brazilian Protocol for Sexually Transmitted Infections, 2020: "Pelvic Inflammatory Disease". Rev Soc Bras Med Trop 2021; 54:e0457. [PMID: 34787269 PMCID: PMC8582959 DOI: 10.1590/0037-8682-0457-2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 08/25/2021] [Indexed: 11/22/2022] Open
Affiliation(s)
| | - Paulo Cesar Giraldo
- Universidade Estadual de Campinas, Departamento de Tocoginecologia, Campinas, SP, Brasil
| | - Iara Moreno Linhares
- Universidade de São Paulo, Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, São Paulo, SP, Brasil
| | | | - Mayra Gonçalves Aragon
- Ministério da Saúde, Secretaria de Vigilância em Saúde, Brasília, DF, Brasil.,Universidade Federal do Espírito Santo, Programa de Pós-Graduação em Doenças Infecciosas, Vitória, ES, Brasil
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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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Dorado Criado M, Fabra Garrido C, Merino San Martín E, González Arboleya C, Gómez-Arroyo B, González-Donapetry P, Baquero-Artigao F, de la Calle M, Quiles-Melero I, Calvo C. Is an Antenatal Screening for Chlamydia trachomatis Necessary in the Current Society? Pediatr Infect Dis J 2021; 40:1034-1036. [PMID: 34321448 DOI: 10.1097/inf.0000000000003229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A screening of Chlamydia trachomatis infection in young pregnant women (≤25 years old) and their newborns was conducted. A total of 136 women were tested with urine samples in the immediate postpartum period. The prevalence was 18.4% (95% confidence interval [CI]: 11.9-24.9%) (25/136) and the rate of perinatal transmission was 35% (7/20). These results support the need for antenatal screening programs in high-risk women in Madrid (Spain).
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Affiliation(s)
- Marta Dorado Criado
- From the Pediatrics and Infectious Disease Unit; Fundación IdiPaz; Traslational Research Network of Pediatric Infectious Diseases (RITIP)
| | - Celia Fabra Garrido
- From the Pediatrics and Infectious Disease Unit; Fundación IdiPaz; Traslational Research Network of Pediatric Infectious Diseases (RITIP)
| | | | | | | | | | - Fernando Baquero-Artigao
- From the Pediatrics and Infectious Disease Unit; Fundación IdiPaz; Traslational Research Network of Pediatric Infectious Diseases (RITIP)
| | - María de la Calle
- From the Pediatrics and Infectious Disease Unit; Fundación IdiPaz; Traslational Research Network of Pediatric Infectious Diseases (RITIP)
| | | | - Cristina Calvo
- From the Pediatrics and Infectious Disease Unit; Fundación IdiPaz; Traslational Research Network of Pediatric Infectious Diseases (RITIP)
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8
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Bancalari P, Nicholas C, Halpern M, Stonbraker S, Taylor B, Soriano L, Ljubicic D, Amesty S. High prevalence of rectal chlamydia among pregnant adolescents in La Romana, Dominican Republic warrants extragenital STI testing. Int J STD AIDS 2021; 33:31-37. [PMID: 34565231 DOI: 10.1177/09564624211043082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
To our knowledge, there are no studies estimating the prevalence of extragenital sexually transmitted infections (STIs) among pregnant adolescents in the Caribbean. This study sought to fill this gap by assessing the prevalence and correlates of oral, genital, and rectal chlamydia (CT) among a sample of pregnant adolescents in La Romana, Dominican Republic. Two hundred pregnant youths, aged 15-24 years, were recruited by systematic sampling during their first prenatal visit to a maternal care unit. A sociodemographic and behavioral questionnaire was administered and urine and oral/anal swabs were collected and tested for CT. Descriptive analyses and Fisher's exact tests were performed. The prevalence of oral, genital, and rectal CT was 6%, 15%, and 23%, respectively, although less than 5% of participants reported ever engaging in receptive anal intercourse. This discrepancy could be explained by autoinoculation, concurrent transmission during sex, undertreatment of rectal CT, or underreporting of anal sex. Almost half of CT infections would have been missed if only genital samples were collected, as current protocol dictates. More research is needed to understand sexual behaviors and rectal STI risk factors among heterosexual adolescent women. STI screening procedures for pregnant and sexually active adolescents should include routine testing of extragenital sites.
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Affiliation(s)
- Pilar Bancalari
- 33638Columbia University Mailman School of Public Health, New York, NY, USA
| | - Catherine Nicholas
- 12294Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Mina Halpern
- Clínica de Familia La Romana, La Romana, Dominican Republic
| | - Samantha Stonbraker
- 129263University of Colorado College of Nursing, Anschutz Medical Campus, Aurora, CO, USA
| | - Barbara Taylor
- University of Texas Health Science Center San Antonio, San Antonio, TX, USA
| | - Leidy Soriano
- Clínica de Familia La Romana, La Romana, Dominican Republic
| | - Dana Ljubicic
- 236434Columbia University School of General Studies, New York, NY, USA
| | - Silvia Amesty
- 33638Columbia University Mailman School of Public Health, New York, NY, USA
- 12294Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- 5798Columbia University Irving Medical Center, New York, NY, USA
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9
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Miranda AE, Freitas FLS, de Passos MRL, Lopez MAA, Pereira GFM. Public policies on sexually transmitted infections in Brazil. Rev Soc Bras Med Trop 2021; 54:e2020611. [PMID: 34008725 PMCID: PMC8210478 DOI: 10.1590/0037-8682-611-2020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 03/10/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
- Angélica Espinosa Miranda
- Ministério da Saúde, Secretaria de Vigilância em Saúde, Brasília, DF, Brasil
- Universidade Federal do Espírito Santo, Vitória, Brasil
| | - Francisca Lidiane Sampaio Freitas
- Ministério da Saúde, Secretaria de Vigilância em Saúde, Brasília, DF, Brasil
- Universidade de Brasília, Programa de Pós-Graduação em Saúde Coletiva, Brasília, DF, Brasil
| | | | - Miguel Angel Aragón Lopez
- Organização Pan-Americana da Saúde, Unidade Técnica de Doenças Transmissíveis e Determinantes Ambientais da Saúde, Brasília, DF, Brasil
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Araujo MAL, Uesono J, Machado NMDS, Pinto VM, Amaral E. Brazilian Protocol for Sexually Transmitted infections 2020: approaching sexually active individuals. Rev Soc Bras Med Trop 2021; 54:e2020628. [PMID: 34008727 PMCID: PMC8210482 DOI: 10.1590/0037-8682-628-2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 03/10/2021] [Indexed: 11/21/2022] Open
Abstract
This article aims to present concepts and clinical practices recommended to approach people with active sex life. These concepts are an integral part of the recommendations of the Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections (STI), published by the Ministry of Health of Brazil in 2020. The article proposes a comprehensive approach to sexuality for health promotion. It presents significant aspects of the communication process that must develop, without prejudice and judgment, focusing on sexual and reproductive health. It also highlights relevant points about the exercise of sexuality at specific stages of life, recommending assessment of risks and vulnerabilities and screening for STI and condom use. In this way, it is possible to contribute to exercise their sexuality fully, responsibly, and safely. Sexual health is the physical, emotional, mental, and social wellbeing associated with the exercise of sexuality, with sexual and reproductive rights considered fundamental.
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Affiliation(s)
- Maria Alix Leite Araujo
- Universidade de Fortaleza (UNIFOR), Programa de Pós-Graduação em Saúde Coletiva, Fortaleza, CE, Brasil
| | - Juliana Uesono
- Ministério da Saúde, Secretaria de Vigilância em Saúde, Brasília, DF, Brasil
| | | | - Valdir Monteiro Pinto
- Secretaria do Estado da Saúde de São Paulo, CRT-IST/Aids, Programa Estadual de IST/Aids, São Paulo, SP, Brasil.,Secretaria Municipal da Saúde, Coordenação Municipal de IST/Aids, São Paulo, SP. Brasil
| | - Eliana Amaral
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Campinas, SP, Brasil
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Menezes MLB, Giraldo PC, Linhares IM, Boldrini NAT, Aragon MG. Brazilian Protocol for Sexually Transmitted infections, 2020: pelvic inflammatory disease. Rev Soc Bras Med Trop 2021; 54:e2020602. [PMID: 34008722 PMCID: PMC8210479 DOI: 10.1590/0037-8682-602-2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 11/25/2022] Open
Abstract
Pelvic Inflammatory Disease is a topic included 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. Pelvic inflammatory disease is an upper female genital tract acute infection due to canalicular spread of endogenous cervicovaginal microorganisms and especially the sexually transmitted microorganisms. Standing out among the etiological agents involved are Chlamydia trachomatis and Neisseria gonorrhoeae. The main sequelae are chronic pelvic pain, infertility, and ectopic pregnancy. Clinical diagnosis is the most important practical approach. Antibiotic treatment must start immediately after the clinical suspicion. Guidelines for health service managers and health professionals on diagnostic tests, treatment, follow-up, counseling, notification, handling sexual partners and special populations are described. Given the increased availability of the molecular biology techniques in Brazil, C. trachomatis and N. gonorrhoeae screening are recommended as a disease prevention strategy. Pelvic inflammatory disease is one of the most significant sexually transmitted infections, and in most cases, it is a main consequence of cervicitis.
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Affiliation(s)
| | - Paulo Cesar Giraldo
- Universidade Estadual de Campinas, Departamento de Tocoginecologia, Campinas, SP, Brasil
| | - Iara Moreno Linhares
- Universidade de São Paulo, Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, São Paulo, SP, Brasil
| | | | - Mayra Gonçalves Aragon
- Ministério da Saúde, Secretaria de Vigilância em Saúde, Brasilia, DF, Brasil
- Universidade Federal do Espírito Santo, Programa de Pós-Graduação em Doenças Infecciosas, Vitória, ES, Brasil
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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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Araujo MAL, Uesono J, Machado NMDS, Pinto VM, Amaral E. [Brazilian Protocol for Sexually Transmitted Infections 2020: approaching sexually active individuals]. ACTA ACUST UNITED AC 2021; 30:e2020628. [PMID: 33729410 DOI: 10.1590/s1679-4974202100003.esp1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 10/23/2020] [Indexed: 11/21/2022]
Abstract
This article aims to present concepts and clinical practices recommended to approach people with an active sex life. These concepts are an integral part of the recommendations of the Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections (STI), published by the Ministry of Health of Brazil in 2020.The article proposes a comprehensive approach to sexuality for health promotion and presents important aspects of the communication process that must develop clearly, without prejudice and judgment, with a focus on sexual and reproductive health. It also highlights relevant points about the exercise of sexuality at specific stages of life, recommending assessment of risks and vulnerabilities, as well as screening for STI and condom use. In this way, it is possible to contribute so that people can exercise their sexuality fully, responsibly and safely.
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Affiliation(s)
- Maria Alix Leite Araujo
- Universidade de Fortaleza, Programa de Pós-Graduação em Saúde Coletiva, Fortaleza, CE, Brasil
| | - Juliana Uesono
- Ministério da Saúde, Secretaria de Vigilância em Saúde, Brasília, DF, Brasil
| | | | - Valdir Monteiro Pinto
- Prefeitura Municipal de São Paulo, Secretaria Municipal da Saúde, São Paulo, SP, Brasil
| | - Eliana Amaral
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Campinas, SP, Brasil
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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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Miranda AE, Freitas FLS, Passos MRLD, Lopez MAA, Pereira GFM. [Public policies on sexually transmitted infections in Brazil]. ACTA ACUST UNITED AC 2021; 30:e2020611. [PMID: 33729408 DOI: 10.1590/s1679-4974202100019.esp1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 09/08/2020] [Indexed: 11/21/2022]
Affiliation(s)
| | | | | | - Miguel Angel Aragón Lopez
- Organização Pan-Americana da Saúde, Unidade Técnica de Doenças Transmissíveis e Determinantes Ambientais da Saúde, Brasília, DF, Brasil
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Menezes MLB, Giraldo PC, Linhares IM, Boldrini NAT, Aragón MG. [Brazilian Protocol for Sexually Transmitted Infections 2020: pelvic inflammatory disease]. ACTA ACUST UNITED AC 2021; 30:e2020602. [PMID: 33729405 DOI: 10.1590/s1679-4974202100011.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
Pelvic Inflammatory Disease is a topic included 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. Pelvic inflammatory disease is an acute infection of the upper female genital tract due to canalicular spread of endogenous cervicovaginal microorganisms, in particular sexually transmitted organisms. Standing out among the etiological agents involved are Chlamydia trachomatis and Neisseria gonorrhoeae. The most important sequels are chronic pelvic pain, infertility and ectopic pregnancy. Clinical diagnosis is the most important practical approach. Antibiotic treatment should start immediately upon clinical suspicion. The article contains guidance for health service managers and health professionals on diagnostic tests, treatment, follow-up, counseling, notification, handling of sexual partnerships and special populations. In view of increased availability of the molecular biology technique in Brazil, C. trachomatis and N. gonorrhoeae screening is recommended as a disease prevention strategy.
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Affiliation(s)
| | - Paulo Cesar Giraldo
- Universidade Estadual de Campinas, Departamento de Tocoginecologia, Campinas, SP, Brasil
| | - Iara Moreno Linhares
- Universidade de São Paulo, Departamento de Obstetrícia e Ginecologia, São Paulo, SP, Brasil
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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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Rowley J, Vander Hoorn S, Korenromp E, Low N, Unemo M, Abu-Raddad LJ, Chico RM, Smolak A, Newman L, Gottlieb S, Thwin SS, Broutet N, Taylor MM. Chlamydia, gonorrhoea, trichomoniasis and syphilis: global prevalence and incidence estimates, 2016. Bull World Health Organ 2019; 97:548-562P. [PMID: 31384073 PMCID: PMC6653813 DOI: 10.2471/blt.18.228486] [Citation(s) in RCA: 877] [Impact Index Per Article: 175.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 04/08/2019] [Accepted: 05/03/2019] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To generate estimates of the global prevalence and incidence of urogenital infection with chlamydia, gonorrhoea, trichomoniasis and syphilis in women and men, aged 15-49 years, in 2016. METHODS For chlamydia, gonorrhoea and trichomoniasis, we systematically searched for studies conducted between 2009 and 2016 reporting prevalence. We also consulted regional experts. To generate estimates, we used Bayesian meta-analysis. For syphilis, we aggregated the national estimates generated by using Spectrum-STI. FINDINGS For chlamydia, gonorrhoea and/or trichomoniasis, 130 studies were eligible. For syphilis, the Spectrum-STI database contained 978 data points for the same period. The 2016 global prevalence estimates in women were: chlamydia 3.8% (95% uncertainty interval, UI: 3.3-4.5); gonorrhoea 0.9% (95% UI: 0.7-1.1); trichomoniasis 5.3% (95% UI:4.0-7.2); and syphilis 0.5% (95% UI: 0.4-0.6). In men prevalence estimates were: chlamydia 2.7% (95% UI: 1.9-3.7); gonorrhoea 0.7% (95% UI: 0.5-1.1); trichomoniasis 0.6% (95% UI: 0.4-0.9); and syphilis 0.5% (95% UI: 0.4-0.6). Total estimated incident cases were 376.4 million: 127.2 million (95% UI: 95.1-165.9 million) chlamydia cases; 86.9 million (95% UI: 58.6-123.4 million) gonorrhoea cases; 156.0 million (95% UI: 103.4-231.2 million) trichomoniasis cases; and 6.3 million (95% UI: 5.5-7.1 million) syphilis cases. CONCLUSION Global estimates of prevalence and incidence of these four curable sexually transmitted infections remain high. The study highlights the need to expand data collection efforts at country level and provides an initial baseline for monitoring progress of the World Health Organization global health sector strategy on sexually transmitted infections 2016-2021.
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Affiliation(s)
- Jane Rowley
- Department of Reproductive Health and Research, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Stephen Vander Hoorn
- School of Mathematics and Statistics, University of Melbourne, Melbourne, Australia
| | | | - Nicola Low
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Magnus Unemo
- WHO Collaborating Centre for Gonorrhoea and Other STIs, Örebro University, Örebro, Sweden
| | - Laith J Abu-Raddad
- Department of Healthcare Policy and Research, Weill Cornell Medical College - Qatar, Doha, Qatar
| | - R Matthew Chico
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, England
| | - Alex Smolak
- Department of Healthcare Policy and Research, Weill Cornell Medical College - Qatar, Doha, Qatar
| | - Lori Newman
- Enteric and Sexually Transmitted Infections Branch, National Institute of Allergy and Infectious Diseases, Washington DC, United States of America
| | - Sami Gottlieb
- Department of Reproductive Health and Research, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Soe Soe Thwin
- Department of Reproductive Health and Research, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Nathalie Broutet
- Department of Reproductive Health and Research, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Melanie M Taylor
- Department of Reproductive Health and Research, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
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Rodrigues LLS, Hardick J, Nicol AF, Morgado MG, Martinelli KG, de Paula VS, Pilotto JH, Gaydos CA. Sexually transmitted infections among HIV-infected and HIV-uninfected women in the Tapajós region, Amazon, Brazil: Self-collected vs. clinician-collected samples. PLoS One 2019; 14:e0215001. [PMID: 31013277 PMCID: PMC6478302 DOI: 10.1371/journal.pone.0215001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 03/25/2019] [Indexed: 11/18/2022] Open
Abstract
The anogenital prevalence of sexually transmitted infections (STIs) and the use of cervico-vaginal self-collected vs. clinician-collected samples were evaluated for the diagnosis of human immunodeficiency virus (HIV)-infected and HIV-uninfected women in the Tapajós region, Amazon, Brazil. We recruited 153 women for a cross-sectional study (112 HIV-uninfected and 41 HIV-infected) who sought health services. Anal and cervical scrapings and cervico-vaginal self-collection samples were collected. Real-time polymerase chain reaction methods were used for Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis and Mycoplasma genitalium. A syphilis test was also performed. Risk factors for STIs were identified by multivariate analysis. The overall prevalence of STIs was 30.4% (34/112) in HIV-uninfected women and 24.4% (10/41) in HIV-infected women. Anogenital Chlamydia trachomatis infection was the most prevalent in both groups of women (20.5% vs 19.5%). There was significant agreement for each STI between self-collected and clinician-collected samples: 91.7%, kappa 0.67, 95% confidence interval (CI) 0.49-0.85 for Chlamydia trachomatis; 99.2%, kappa 0.85, 95% CI 0.57-1.00 for Neisseria gonorrhoeae; 97.7%, kappa 0.39, 95% CI -0.16-0.94 for Trichomonas vaginalis; and 94.7%, kappa 0.51, 95% CI 0.20-0.82 for Mycoplasma genitalium. Women with human papillomavirus had coinfection or multiple infections with other STIs. Risk factors for STIs were being ≤ 25 years old, being employed or a student, reporting a history of STI and having a positive HPV test. A high prevalence of STIs in women in the Tapajós region was found. Cervico-vaginal self-collection is a useful tool for STI screening and can be used in prevention control programs in low-resource settings, such as in northern Brazil.
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Affiliation(s)
- Luana L. S. Rodrigues
- Laboratório de AIDS e Imunologia Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
- Instituto de Saúde Coletiva, Universidade Federal do Oeste do Pará, Santarém, Pará, Brazil
| | - Justin Hardick
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Alcina F. Nicol
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Mariza G. Morgado
- Laboratório de AIDS e Imunologia Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Katrini G. Martinelli
- Departamento de Medicina Social, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Vanessa S. de Paula
- Laboratório de Virologia Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - José H. Pilotto
- Laboratório de AIDS e Imunologia Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Charlotte A. Gaydos
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
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Azevedo MJND, Nunes SDS, Oliveira FGD, Rocha DAP. High prevalence of Chlamydia trachomatis in pregnant women attended at Primary Health Care services in Amazon, Brazil. Rev Inst Med Trop Sao Paulo 2019; 61:e6. [PMID: 30785560 PMCID: PMC6376923 DOI: 10.1590/s1678-9946201961006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 11/26/2018] [Indexed: 11/21/2022] Open
Abstract
Chlamydia trachomatis (CT) infection is often silent and can
lead to long-term reproductive complications in women. In this study, we
determined the prevalence of CT infection and possible associations between the
presence of the infection and clinical-epidemiological variables in pregnant
women attended at the Basic Health Units of the Coari city, Amazonas, Brazil.
From July 2016 to March 2017, 164 pregnant women undergoing prenatal care were
recruited. One hundred of these women were tested for CT infection using two
types of samples: cervico-vaginal and urine. The diagnosis was confirmed by PCR
with primers specific for the omp1 gene of CT chromosomal DNA. Of the 100
pregnant women, 18 (18%) had CT infection, 8 (8%) of which were positive in both
samples, 7 (7%) only in the urine sample and 3 (3%) only in cervical-vaginal
sample. There was moderate agreement (Kappa=0.55) and no statistically
significant difference between sample types (p = 0.400). The mean age of
infected women was 21.1 years (SD = 4.6). Of the clinical-epidemiological
variables analyzed, “more than 2 partners in the last 12 months” (p = 0.022) and
gynecological complaint of “pain after intercourse” (p = 0.020) were associated
with CT infection. This study showed a high prevalence (18%) of CT infection
among pregnant women in Coari / Amazonas. Urine sampales were as good as
cervical-vaginal ones for the screening of CT infection during the prenatal
period.
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Affiliation(s)
| | - Suzana Dos Santos Nunes
- Universidade Federal do Amazonas, Instituto de Saúde e Biotecnologia, Coari, Amazonas, Brazil
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Frequency of Chlamydia trachomatis, Mycoplasma genitalium, and Ureaplasma urealyticum Isolated From Vaginal Samples of Women in Kerman, Iran. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2018. [DOI: 10.5812/archcid.65334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Prevalence of Curable Sexually Transmitted Infections in Pregnant Women in Low- and Middle-Income Countries From 2010 to 2015: A Systematic Review. Sex Transm Dis 2017; 43:450-8. [PMID: 27322048 DOI: 10.1097/olq.0000000000000460] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Current literature comparing the prevalence rates of curable sexually transmitted infections (STIs) in pregnant women in various global regions is limited. As a result, antenatal screening practices for curable STIs in pregnant women, specifically Treponema pallidum (syphilis), Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT), and Trichomonas vaginalis (TV) vary around the world, differing by country and particular STI. METHODS We conducted a systematic review of publications on STI prevalence among pregnant women in 30 different low- and middle-income countries. We searched PubMed for studies reporting prevalence of syphilis, CT, NG, and TV in pregnant women. English language studies published between January 1, 2010, and March 1, 2015, were included. The adjusted mean STI prevalence by region was calculated via multivariable linear regression adjusting for health care setting, women's mean age, study sample size, and sensitivity of diagnostic test. RESULTS We identified 75 studies that met inclusion criteria, providing 116 point prevalence estimates for curable STIs among 3,489,621 pregnant women. Adjusted mean prevalence for NG ranged from 1.2% (95% confidence interval [CI], 1.0-1.3) in Latin America to 4.6% (95% CI, 4.0-5.2) in Southern Africa; syphilis prevalence ranged from 1.1% (95% CI, 0.5-1.6) in Asia to 6.5% (95% CI, 4.7-6.3) in Southern Africa; CT ranged from 0.8% (95% CI, 0.4-1.1) in Asia to 11.2% (95% CI, 6.0-16.4) in Latin America; and TV ranged from 3.9% (95% CI, 2.2-5.6) in Latin America to 24.6% (95% CI, 17.9-31.4) in Southern Africa. CONCLUSIONS Although we observed a wide variation in STI burden in pregnancy after adjusting for age, test, and health care setting, further valid comparison may depend on adjustment for access to care and screening practices.
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Miranda AE, Silveira MF, Travassos AG, Tenório T, Val ICCD, Lannoy LD, Junior HSDM, Carvalho NSD. Prevalence of Chlamydia trachomatis and Neisseria gonorrhea and associated factors among women living with Human Immunodeficiency Virus in Brazil: a multicenter study. Braz J Infect Dis 2017; 21:402-407. [PMID: 28528844 PMCID: PMC9428037 DOI: 10.1016/j.bjid.2017.03.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 03/15/2017] [Accepted: 03/17/2017] [Indexed: 11/28/2022] Open
Abstract
Background Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) cause infections in the female genital tract, increasing susceptibility to and infectiousness of HIV. The objectives of the present study were to determine the prevalence and associated factors of CT and GC infection among HIV-infected women in Brazil. Methods Cross-sectional study conducted from March to December 2015, including HIV-infected women attending referral centers in nine states of Brazil, aged 18–49 years, nonpregnant. An interview was conducted including socio-demographic, epidemiological and clinical characteristics. After the interview, gynecological examination was conducted to collect cervical cytology and vaginal secretion to C. trachomatis and N. gonorrhoeae tests through molecular biology. Results A total of 802 (89.1%) women participated. The prevalence of CT was 2.1% (17/802) and CG was 0.9% (7/802). The prevalence of a positive test for both CT and/or GC was 2.7%. The factors associated with positive CT/GC test in the multivariate logistic regression analysis were abnormal Papanicolau smear (OR 4.1; 95% CI: 1.54–11.09) and the presence of abnormal cervical discharge (OR 2.6; 95% CI: 1.02–6.71). Among 377 women who reported previous STI 245 (65.0%) reported using condom more frequently after being diagnosed. 62 (16.4%) discovered the STI after the partner told he was infected; 157 (41.6%) had STI symptoms and looked for care, and 158 (41.9%) discovered it in a routine consultation for another reason. Conclusions The control of STI represents a unique opportunity to improve reproductive health of women living with HIV. STI diagnosis can change their behavior and reduce the sexual transmission of HIV and bacterial STI.
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Pinto VM, Tancredi MV, Silva RJDCD, Khoury Z, Buchalla CM. Prevalence and factors associated with Chlamydia trachomatis infection among women with HIV in São Paulo. Rev Soc Bras Med Trop 2017; 49:312-8. [PMID: 27384828 DOI: 10.1590/0037-8682-0169-2016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 06/09/2016] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION This study aimed to estimate the prevalence and risk factors associated with Chlamydia trachomatis (CT) infection among women with HIV in São Paulo. METHODS This cross-sectional study included women with HIV who were receiving care from sixteen public health services in São Paulo (October 2013 to March 2014). All participants answered a questionnaire regarding their sociodemographic, behavioral, and clinical characteristics. A urine sample was tested for CT and Neisseria gonorrhoeae (NG) using the polymerase chain reaction. The chi-square test and a logistic regression model were used to test the associations with CT or NG infections. RESULTS We evaluated 853 women and ultimately included 836 (98%) women. The mean age was 40.5 ± 0.34 years, and the prevalences of CT and NG infections were 1.8% and 0.5%, respectively. CT infection was associated with CD4+ T-cell counts of <350 cells/mm3 [adjusted odds ratio (ORadj): 24.5], age of 18-25 years (ORadj: 23.2), the non-use of condoms during the last 6 months (ORadj: 10.2), a self-reported history of a sexually transmitted infection (ORadj: 9.4), and having two or more sexual partners during the last year (ORadj: 6.1). CONCLUSIONS Although we observed a low prevalence of CT infection among women with HIV, younger age was associated with a high risk of infection. Therefore, it may be appropriate to include screening for CT as part of the routine care for this population.
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Affiliation(s)
- Valdir Monteiro Pinto
- Programa Estadual de DST/AIDS, Centro de Referência e Treinamento em DST/AIDS, Secretaria de Estado da Saúde, São Paulo, São Paulo, Brasil.,Programa Municipal de DST/AIDS, Secretaria Municipal de Saúde de São Paulo, São Paulo, São Paulo, Brasil
| | - Mariza Vono Tancredi
- Programa Estadual de DST/AIDS, Centro de Referência e Treinamento em DST/AIDS, Secretaria de Estado da Saúde, São Paulo, São Paulo, Brasil
| | - Roberto Jose de Carvalho da Silva
- Programa Estadual de DST/AIDS, Centro de Referência e Treinamento em DST/AIDS, Secretaria de Estado da Saúde, São Paulo, São Paulo, Brasil
| | - Zarifa Khoury
- Programa Municipal de DST/AIDS, Secretaria Municipal de Saúde de São Paulo, São Paulo, São Paulo, Brasil
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Silveira MFD, Sclowitz IKT, Entiauspe LG, Mesenburg MA, Stauffert D, Bicca GLDO, Pieniz C, Manta AB. Chlamydia trachomatis infection in young pregnant women in Southern Brazil: a cross-sectional study. CAD SAUDE PUBLICA 2017; 33:e00067415. [PMID: 28226066 DOI: 10.1590/0102-311x00067415] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 03/11/2016] [Indexed: 11/22/2022] Open
Abstract
This study estimated the prevalence of Chlamydia trachomatis infection during pregnancy in a sample of women up to 29 years of age in the city of Pelotas, Rio Grande do Sul State, Brazil, and investigated socio-demographic risk factors such as maternal age, marital status, maternal schooling, and family income. C. trachomatis infection was diagnosed with PCR using BD ProbeTecTM CT/GC Amplified DNA Assay. Socio-demographic, behavioral, and reproductive data were collected using structured questionnaires. All collections were performed by previously trained medical students. The study included a stratified probabilistic sample from four maternity hospitals in the city. The sample included 562 pregnant women, and prevalence of C. trachomatis infection was 12.3% (95%CI: 9.6-15.0). No significant association was identified between C. trachomatis infection and any of the target variables, including obstetric outcomes such as history of preterm delivery. Our findings in terms of low treatment adherence, only 43% of the women and 9.7% of partners, associated with high C. trachomatis prevalence, reinforce the need to implement routine screening for C. trachomatis during prenatal care. The attempt to diagnose and treat this infection after delivery, as in this study, limits the possibility of success.
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Affiliation(s)
| | | | | | - Marilia Arndt Mesenburg
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brasil
| | - Dulce Stauffert
- Faculdade de Medicina, Universidade Federal de Pelotas, Pelotas, Brasil
| | | | - Carine Pieniz
- Faculdade de Medicina, Universidade Federal de Pelotas, Pelotas, Brasil
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Neves D, Sabidó M, Bôtto-Menezes C, Benzaken NS, Jardim L, Ferreira C, Leturiondo A, Santos CGD, Benzaken AS. Evaluation of screening for Chlamydia trachomatis among young women in primary health care services in Manaus, Amazonas State, Brazil. CAD SAUDE PUBLICA 2016; 32:e00101015. [PMID: 27783757 DOI: 10.1590/0102-311x00101015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 01/05/2016] [Indexed: 11/22/2022] Open
Abstract
Screening for Chlamydia trachomatis is not routinely offered to young asymptomatic women in Brazil. This study evaluated the performance, usefulness, and operational suitability of the Digene Hybrid Capture II (HCII) CT-ID DNA-test as an opportunistic screening tool to detect C. trachomatis in the public health system in Manaus, Amazonas State. Women aged 14-25 years who attended primary health care services were interviewed and one cervical specimen was collected during cytological screening. The HCII CT test was evaluated for its ability to detect the presence of C. trachomatis and against real-time PCR (q-PCR) in a subset of samples. Operational performance was assessed through interviews with providers and patients. Overall, 1,187 women were screened, and 1,169 had a HCII CT-ID test result (292 of these were also tested by q-PCR). Of those, 13.1% (n = 153) were positive. The sensitivity, specificity, positive and negative predictive values of HCII CT were 72.3% (95%CI: 65.4-78.6), 91.3% (95%CI: 84.1-95.9), 93.8% (95%CI: 88.5-97.1), and 64.4% (95%CI: 56.0-72.1), respectively. Sample collection caused discomfort in 19.7% of women. Among health professionals (n = 52), the main barriers reported included positive cases who did not return for results (56.4%), unwillingness to screen without an appointment (45.1%), and increase in their workload (38.8%). HCII CT-ID identified a high proportion of C. trachomatis cases among young women in Manaus. However, its moderate sensitivity limits its use as an opportunistic screening tool in primary health care settings in Manaus. Screening was well accepted although the barriers we identified, especially among health professionals, challenge screening detection and treatment efforts.
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Affiliation(s)
- Dária Neves
- Programa de Pós-graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brasil
| | - Meritxell Sabidó
- Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, Brasil
| | - Camila Bôtto-Menezes
- Programa de Pós-graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brasil
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Abstract
BACKGROUND Sexually transmitted infections (STIs) such as Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) can lead to adverse pregnancy and neonatal outcomes. The prevalence of STIs and its association with HIV mother-to-child transmission (MTCT) were evaluated in a substudy analysis from a randomized, multicenter clinical trial. METHODOLOGY Urine samples from HIV-infected pregnant women collected at the time of labor and delivery were tested using polymerase chain reaction testing for the detection of CT and NG (Xpert CT/NG; Cepheid, Sunnyvale, CA). Infant HIV infection was determined by HIV DNA polymerase chain reaction at 3 months. RESULTS Of the 1373 urine specimens, 249 (18.1%) were positive for CT and 63 (4.6%) for NG; 35 (2.5%) had both CT and NG detected. Among 117 cases of HIV MTCT (8.5% transmission), the lowest transmission rate occurred among infants born to CT- and NG-uninfected mothers (8.1%) as compared with those infected with only CT (10.7%) and both CT and NG (14.3%; P = 0.04). Infants born to CT-infected mothers had almost a 1.5-fold increased risk for HIV acquisition (odds ratio, 1.47; 95% confidence interval, 0.9-2.3; P = 0.09). CONCLUSIONS This cohort of HIV-infected pregnant women is at high risk for infection with CT and NG. Analysis suggests that STIs may predispose to an increased HIV MTCT risk in this high-risk cohort of HIV-infected women.
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Piñeiro L, Lekuona A, Cilla G, Lasa I, Martinez-Gallardo LP, Korta J, Pérez-Trallero E. Prevalence of Chlamydia trachomatis infection in parturient women in Gipuzkoa, Northern Spain. SPRINGERPLUS 2016; 5:566. [PMID: 27247863 PMCID: PMC4864740 DOI: 10.1186/s40064-016-2268-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 05/03/2016] [Indexed: 11/21/2022]
Abstract
The prevalence of Chlamydia trachomatis infection in Southern Europe is poorly understood and its identification is essential for the design of appropriate prevention policies. The prevalence of C. trachomatis in 2011–2014 was determined through polymerase chain reaction in urine samples from 11,687 unselected parturient women from the Basque Country, Spain (San Sebastián area). The overall age-adjusted prevalence was 1.0 % (95 % CI 0.8–1.2). The prevalence of infection in women younger than 25 years was 6.4 % and decreased substantially with increasing age: 2.0 % in 25–29 year-olds and 0.5 % in older women (P < 0.001). The prevalence was higher in parturient of foreign origin (1.9 %, 95 % CI 1.3–2.5) than in Spanish parturients (0.8 %, 95 % CI 0.6–1.0), (P < 0.001). The results of this study support the need to screen young women as part of antenatal care in Spain.
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Affiliation(s)
- Luis Piñeiro
- Microbiology Department, Hospital Universitario Donostia, Paseo Dr Beguiristain s/n, 20014 San Sebastián, Spain
| | - Arantza Lekuona
- Obstetrics and Gynecology Department, Hospital Universitario Donostia, San Sebastián, Spain
| | - Gustavo Cilla
- Microbiology Department, Hospital Universitario Donostia, Paseo Dr Beguiristain s/n, 20014 San Sebastián, Spain ; Biomedical Research Centre Network for Respiratory Diseases (CIBERES), San Sebastián, Spain
| | - Izaskun Lasa
- Obstetrics and Gynecology Department, Hospital Universitario Donostia, San Sebastián, Spain
| | | | - Javier Korta
- Pediatrics Department, Hospital Universitario Donostia, San Sebastián, Spain
| | - Emilio Pérez-Trallero
- Microbiology Department, Hospital Universitario Donostia, Paseo Dr Beguiristain s/n, 20014 San Sebastián, Spain ; Biomedical Research Centre Network for Respiratory Diseases (CIBERES), San Sebastián, Spain ; Department of Medicine Preventive and Public Health, UPV/EHU, San Sebastián, Spain
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Adachi K, Nielsen-Saines K, Klausner JD. Chlamydia trachomatis Infection in Pregnancy: The Global Challenge of Preventing Adverse Pregnancy and Infant Outcomes in Sub-Saharan Africa and Asia. BIOMED RESEARCH INTERNATIONAL 2016; 2016:9315757. [PMID: 27144177 PMCID: PMC4837252 DOI: 10.1155/2016/9315757] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 02/09/2016] [Indexed: 12/28/2022]
Abstract
Screening and treatment of sexually transmitted infections (STIs) in pregnancy represents an overlooked opportunity to improve the health outcomes of women and infants worldwide. Although Chlamydia trachomatis is the most common treatable bacterial STI, few countries have routine pregnancy screening and treatment programs. We reviewed the current literature surrounding Chlamydia trachomatis in pregnancy, particularly focusing on countries in sub-Saharan Africa and Asia. We discuss possible chlamydial adverse pregnancy and infant health outcomes (miscarriage, stillbirth, ectopic pregnancy, preterm birth, neonatal conjunctivitis, neonatal pneumonia, and other potential effects including HIV perinatal transmission) and review studies of chlamydial screening and treatment in pregnancy, while simultaneously highlighting research from resource-limited countries in sub-Saharan Africa and Asia.
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Affiliation(s)
- Kristina Adachi
- Department of Pediatrics, David Geffen School of Medicine, UCLA, Los Angeles, CA 90024, USA
| | - Karin Nielsen-Saines
- Department of Pediatrics, David Geffen School of Medicine, UCLA, Los Angeles, CA 90024, USA
| | - Jeffrey D. Klausner
- Department of Medicine, Division of Infectious Diseases: Global Health, David Geffen School of Medicine, UCLA, Los Angeles, CA 90024, USA
- Department of Epidemiology, Jonathan and Karin Fielding School of Public Health, UCLA, Los Angeles, CA 90024, USA
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Quinónez-Calvache EM, Ríos-Chaparro DI, Ramírez JD, Soto-De León SC, Camargo M, Del Río-Ospina L, Sánchez R, Patarroyo ME, Patarroyo MA. Chlamydia trachomatis Frequency in a Cohort of HPV-Infected Colombian Women. PLoS One 2016; 11:e0147504. [PMID: 26807957 PMCID: PMC4726460 DOI: 10.1371/journal.pone.0147504] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 01/05/2016] [Indexed: 11/22/2022] Open
Abstract
Background Chlamydia trachomatis (C. trachomatis), an obligate intracellular bacterium, is the commonest infectious bacterial agent of sexual transmission throughout the world. It has been shown that the presence of this bacteria in the cervix represents a risk regarding HPV persistence and, thereafter, in developing cervical cancer (CC). Prevalence rates may vary from 2% to 17% in asymptomatic females, depending on the population being analysed. This study reports the identification of C. trachomatis in a cohort of 219 HPV-infected Colombian females. Methods C. trachomatis infection frequency was determined during each of the study’s follow-up visits; it was detected by amplifying the cryptic plasmid sequence by polymerase chain reaction (PCR) using two sets of primers: KL5/KL6 and KL1/KL2. Infection was defined as a positive PCR result using either set of primers at any time during the study. Cox proportional risk models were used for evaluating the association between the appearance of infection and a group of independent variables. Results Base line C. trachomatis infection frequency was 28% (n = 61). Most females infected by C. trachomatis were infected by multiple types of HPV (77.42%), greater prevalence occurring in females infected with HPV-16 (19.18%), followed by HPV-58 (17.81%). It was observed that females having had the most sexual partners (HR = 6.44: 1.59–26.05 95%CI) or infection with multiple types of HPV (HR = 2.85: 1.22–6.63 95%CI) had the greatest risk of developing C. trachomatis. Conclusions The study provides data regarding the epidemiology of C. trachomatis /HPV coinfection in different population groups of Colombian females and contributes towards understanding the natural history of C. trachomatis infection.
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Affiliation(s)
- Edith Margarita Quinónez-Calvache
- Molecular Biology and Immunology Department, Fundación Instituto de Inmunología de Colombia (FIDIC), Bogotá, Colombia
- Biotechnology Institute, Faculty of Sciences, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Dora Inés Ríos-Chaparro
- Grupo de Investigaciones Microbiológicas–UR (GIMUR), Faculty of Natural and Mathematical Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Juan David Ramírez
- Grupo de Investigaciones Microbiológicas–UR (GIMUR), Faculty of Natural and Mathematical Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Sara Cecilia Soto-De León
- Molecular Biology and Immunology Department, Fundación Instituto de Inmunología de Colombia (FIDIC), Bogotá, Colombia
- School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Milena Camargo
- Molecular Biology and Immunology Department, Fundación Instituto de Inmunología de Colombia (FIDIC), Bogotá, Colombia
- School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Luisa Del Río-Ospina
- Molecular Biology and Immunology Department, Fundación Instituto de Inmunología de Colombia (FIDIC), Bogotá, Colombia
- School of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Ricardo Sánchez
- Molecular Biology and Immunology Department, Fundación Instituto de Inmunología de Colombia (FIDIC), Bogotá, Colombia
- School of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Manuel Elkin Patarroyo
- Molecular Biology and Immunology Department, Fundación Instituto de Inmunología de Colombia (FIDIC), Bogotá, Colombia
- School of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Manuel Alfonso Patarroyo
- Molecular Biology and Immunology Department, Fundación Instituto de Inmunología de Colombia (FIDIC), Bogotá, Colombia
- School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
- * E-mail:
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Schmidt R, Muniz RR, Cola E, Stauffert D, Silveira MF, Miranda AE. Maternal Chlamydia trachomatis Infections and Preterm Births in a University Hospital in Vitoria, Brazil. PLoS One 2015; 10:e0141367. [PMID: 26505892 PMCID: PMC4624773 DOI: 10.1371/journal.pone.0141367] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 10/06/2015] [Indexed: 11/19/2022] Open
Abstract
Background Preterm birth (PTB) is a major determinant of neonatal morbimortality with adverse consequences for health. The causes are multifactorial, with intrauterine infection probably explaining most of these outcomes. It is believed that infection with Chlamydia trachomatis (CT) is also involved in PTB and premature rupture of membranes. Objetives To evaluate the prevalence of and associated factors for CT among cases of PTB attended at a University Hospital in Vitoria, Brazil. Methods A cross-sectional study performed among parturient who had preterm birth from June 2012 to August 2013 in Vitoria, Brazil. Participants answered a questionnaire including demographic, behavioral, and clinical data. A sample of urine was collected and screened for CT using polymerase chain reaction. Chi-square tests were used for proportion differences and Student’s-t tests and variance analysis were used for testing differences between mean values. Odds ratio was used as a measure of association with a 95% confidence interval. Results The prevalence of PTB during the period of the study was 26% and the prevalence of CT among them was 13.9%. A total of 31.6% pregnant women were younger than 25 years old and women infected by CT were even younger than women not infected by CT (p = 0.022). Most of them (76.2%) were married or had a living partner, and CT infection was more frequent among the single ones (p = 0.018); 16.7% of women reported their first sexual intercourse under 14 years old. The causes of prematurity were maternal-fetal in 40.9%; rupture of the membranes in 29.7% and premature labor in 29.4%. In multivariate analysis, being married was a protective factor for infection [OR = 0.48 (95%CI:0.24–0.97)]. None of the other characteristics were associated with CT infection. Conclusions This study shows a high prevalence of CT infection among parturient who have preterm birth. This high prevalence highlight the need for defining screening strategies focused on young pregnant women in Brazil.
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Affiliation(s)
- Renylena Schmidt
- Programa de Pós-Graduação em Doenças Infecciosas, Universidade Federal do Espirito Santo, Vitoria, Brasil
| | - Renan Rosetti Muniz
- Programa de Pós-Graduação em Doenças Infecciosas, Universidade Federal do Espirito Santo, Vitoria, Brasil
| | - Elizandra Cola
- Programa de Pós-Graduação em Doenças Infecciosas, Universidade Federal do Espirito Santo, Vitoria, Brasil
| | - Dulce Stauffert
- Departamento Materno Infantil, Faculdade de Medicina, Universidade Federal de Pelotas, Pelotas, Brasil
| | | | - Angelica E. Miranda
- Programa de Pós-Graduação em Doenças Infecciosas, Universidade Federal do Espirito Santo, Vitoria, Brasil
- * E-mail:
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Walsh MS, Hope E, Isaia L, Righarts A, Niupulusu T, Temese SVA, Iosefa-Siitia L, Auvaa L, Tapelu SA, Motu MF, Edwards C, Wernick M, Huston WM, Suaalii-Sauni T, Hill PC. Prevalence of Chlamydia trachomatis infection in Samoan women aged 18 to 29 and assessment of possible risk factors: a community-based study. Trans R Soc Trop Med Hyg 2015; 109:245-51. [PMID: 25732755 DOI: 10.1093/trstmh/trv014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Knowledge about genital Chlamydia trachomatis (CT) infections in the Pacific is limited. In this study we investigated CT infection in Samoan women. METHODS We recruited women having unprotected sex aged 18 to 29 years from 41 Samoan villages. They completed a questionnaire and provided a urine sample for CT testing by PCR. Associations between CT infection and possible risk factors were explored using logistic regression. RESULTS Altogether, 239 women were recruited; 86 (36.0%; weighted estimate of prevalence: 41.9%; 95% CI: 33.4-50.5%) were positive for CT infection. A higher proportion of women aged 18 to 24 were positive (54/145; 37.2%) than those aged 25 to 29 (32/94; 34.0%; p=0.20). Being single (OR 1.92; 95% CI: 1.02-3.63) and having two or more lifetime sexual partners (OR 3.02; 95% CI: 1.19-7.67) were associated with CT infection; 27.6% of those with one lifetime partner were positive. Participants who had a previous pregnancy were less likely to be positive (OR 0.49; 95% CI: 0.27-0.87). Primiparous and multiparous women were less likely to be positive than nulliparous women (OR 0.54; 95% CI: 0.30-0.99 and OR 0.46; 95% CI: 0.24-0.89, respectively). CONCLUSIONS The prevalence of CT infection in these Samoan women is very high. Further studies, including investigating the prevalence of CT infection in men, and strategies for sustainable control are needed.
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Affiliation(s)
- Michael S Walsh
- Centre for International Health, University of Otago, Dunedin, New Zealand
| | - Eseta Hope
- Faculty of Applied Science, National University of Samoa, Samoa
| | | | | | | | | | | | - Leveti Auvaa
- Faculty of Applied Science, National University of Samoa, Samoa
| | | | | | - Ciaran Edwards
- Centre for International Health, University of Otago, Dunedin, New Zealand
| | - Maya Wernick
- Centre for International Health, University of Otago, Dunedin, New Zealand
| | | | | | - Philip C Hill
- Centre for International Health, University of Otago, Dunedin, New Zealand
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Peuchant O, Le Roy C, Desveaux C, Paris A, Asselineau J, Maldonado C, Chêne G, Horovitz J, Dallay D, de Barbeyrac B, Bébéar C. Screening for Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycoplasma genitalium should it be integrated into routine pregnancy care in French young pregnant women? Diagn Microbiol Infect Dis 2015; 82:14-9. [PMID: 25753079 DOI: 10.1016/j.diagmicrobio.2015.01.014] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 01/23/2015] [Accepted: 01/27/2015] [Indexed: 12/17/2022]
Abstract
Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycoplasma genitalium screening during pregnancy is not performed routinely in France. We conducted the first prospective study in 1004 women attending for routine antenatal care to determine the prevalence and risk factors for these bacterial infections. The overall prevalence of C. trachomatis, N. gonorrhoeae, and M. genitalium infections was 2.5%, 0%, and 0.8%, respectively. In patients aged 18-24 years, the prevalence increased to 7.9% for C. trachomatis and to 2.4% for M. genitalium. C. trachomatis infection was associated with age ≤24 years or being single or having more than 5 sexual partners in a lifetime. M. genitalium infection was more frequent in patients aged ≤24 years or who had a history of abortion or their first sexual intercourse after 20 years of age. The high prevalence of C. trachomatis in pregnant women aged ≤24 years, mostly asymptomatic, suggests that systematic screening could be beneficial.
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Affiliation(s)
- O Peuchant
- Univ. Bordeaux, USC EA 3671 Mycoplasmal and Chlamydial Infections in Humans, 33076 Bordeaux, France; INRA, USC EA 3671 Mycoplasmal and Chlamydial Infections in Humans, 33076 Bordeaux, France; Centre Hospitalier Universitaire de Bordeaux, Laboratoire de Bactériologie, 33076 Bordeaux, France.
| | - C Le Roy
- Univ. Bordeaux, USC EA 3671 Mycoplasmal and Chlamydial Infections in Humans, 33076 Bordeaux, France; INRA, USC EA 3671 Mycoplasmal and Chlamydial Infections in Humans, 33076 Bordeaux, France
| | - C Desveaux
- Centre Hospitalier Universitaire de Bordeaux, Service de Gynécologie Obstétrique, 33076 Bordeaux, France
| | - A Paris
- Centre Hospitalier Universitaire de Bordeaux, Service de Gynécologie Obstétrique, 33076 Bordeaux, France
| | - J Asselineau
- Centre Hospitalier Universitaire de Bordeaux, Unité de Soutien Méthodologique à la Recherche Clinique et Epidémiologique, 33076 Bordeaux, France
| | - C Maldonado
- Centre Hospitalier Universitaire de Bordeaux, Unité de Soutien Méthodologique à la Recherche Clinique et Epidémiologique, 33076 Bordeaux, France
| | - G Chêne
- Centre Hospitalier Universitaire de Bordeaux, Unité de Soutien Méthodologique à la Recherche Clinique et Epidémiologique, 33076 Bordeaux, France
| | - J Horovitz
- Centre Hospitalier Universitaire de Bordeaux, Service de Gynécologie Obstétrique, 33076 Bordeaux, France
| | - D Dallay
- Centre Hospitalier Universitaire de Bordeaux, Service de Gynécologie Obstétrique, 33076 Bordeaux, France
| | - B de Barbeyrac
- Univ. Bordeaux, USC EA 3671 Mycoplasmal and Chlamydial Infections in Humans, 33076 Bordeaux, France; INRA, USC EA 3671 Mycoplasmal and Chlamydial Infections in Humans, 33076 Bordeaux, France; Centre Hospitalier Universitaire de Bordeaux, Laboratoire de Bactériologie, 33076 Bordeaux, France
| | - C Bébéar
- Univ. Bordeaux, USC EA 3671 Mycoplasmal and Chlamydial Infections in Humans, 33076 Bordeaux, France; INRA, USC EA 3671 Mycoplasmal and Chlamydial Infections in Humans, 33076 Bordeaux, France; Centre Hospitalier Universitaire de Bordeaux, Laboratoire de Bactériologie, 33076 Bordeaux, France
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Miranda AE, Pinto VM, Gaydos CA. Trichomonas vaginalis infection among young pregnant women in Brazil. Braz J Infect Dis 2014; 18:669-71. [PMID: 25181400 PMCID: PMC4378618 DOI: 10.1016/j.bjid.2014.07.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2014] [Revised: 07/08/2014] [Accepted: 07/16/2014] [Indexed: 11/29/2022] Open
Abstract
Our goal was to determine the prevalence of Trichomonas vaginalis and its associated risk factors in parturient women aged 15-24 years attending Brazilian public maternity units. Participants answered a demographic, behavioral, and clinical data questionnaire. A sample of urine was screened for T. vaginalis. A total 299 women participated in this study. The prevalence rate of T. vaginalis was 7.7% (95% CI: 4.7-10.7%). The factors associated with T. vaginalis were use of illicit drugs [OR=4.70 (95% CI: 1.63-13.56, p=0.004)] and not attending antenatal care [OR=5.15 (95% CI: 1.15-23.25, p=0.032)]. These data demonstrate that it is important to discuss how to include routine screening for T. vaginalis during antenatal care in Brazil.
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Affiliation(s)
- Angelica E Miranda
- Post-graduation Program in Infectious Diseases, Universidade Federal do Espírito Santo, Vitória, ES, Brazil.
| | - Valdir M Pinto
- Post-graduation Program in Infectious Diseases, Universidade Federal do Espírito Santo, Vitória, ES, Brazil
| | - Charlotte A Gaydos
- Division of Infectious Diseases, Johns Hopkins University, Baltimore, United States
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de Lima YAR, Turchi MD, Fonseca ZC, Garcia FLB, de Brito e Cardoso FA, da Guarda Reis MN, de Britto Guimarães EM, Alves RRF, Carvalho NR, de Fátima Costa Alves M. Sexually transmitted bacterial infections among young women in Central Western Brazil. Int J Infect Dis 2014; 25:16-21. [PMID: 24818991 DOI: 10.1016/j.ijid.2014.03.1389] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Revised: 03/23/2014] [Accepted: 03/27/2014] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Studies on sexually transmitted infections in Brazil are done mainly in large metropolises and screening is available for pregnant women only. We aimed to estimate the prevalence and risk factors for Chlamydia trachomatis, Neisseria gonorrhoeae, and Treponema pallidum infection among young non-pregnant women in non-clinical settings in middle-sized cities of Central Brazil. METHODS A cross-sectional community-based sample of 1072 participants was included. Sexually active women (64.9%) provided first-catch urine samples for PCR investigation of chlamydial and gonococcal infection. Syphilis was tested in serum. Univariate analysis investigated risk factors for chlamydial infection. Multivariate logistic regression included associations with a p-value <0.20. RESULTS The mean age of participants was 18 years; 73.2% reported unprotected intercourse, 37.6% were married/cohabiting, and 5% reported a previous STI. Prevalence rates of C. trachomatis, N. gonorrhoeae, and T. pallidum were 9.6% (95% confidence interval (CI) 7.4-12.4%), 0.7% (95% CI 0.2-1.9%), and 0.15% (95% CI 0.0-0.7%), respectively. After adjustments, being <20 years old (adjusted odds ratio (aOR) 1.90, 95% CI 1.07-3.37) and having three or more lifetime sexual partners (aOR 2.57, 95% CI 1.46-4.53) were associated with the risk for chlamydial infection. CONCLUSIONS We observed a high prevalence of chlamydial infection and sexual risk behaviors in this population. These findings are important to guide screening strategies in Brazil.
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Affiliation(s)
- Yanna Andressa Ramos de Lima
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Rua 235, s/n, Setor Universitário, CEP 74605050, Goiânia, Goiás, Brazil.
| | - Marília Dalva Turchi
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Rua 235, s/n, Setor Universitário, CEP 74605050, Goiânia, Goiás, Brazil
| | - Zulmirene Cardoso Fonseca
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Rua 235, s/n, Setor Universitário, CEP 74605050, Goiânia, Goiás, Brazil
| | - Fernanda Lopes Brito Garcia
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Rua 235, s/n, Setor Universitário, CEP 74605050, Goiânia, Goiás, Brazil
| | - Fernanda Alves de Brito e Cardoso
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Rua 235, s/n, Setor Universitário, CEP 74605050, Goiânia, Goiás, Brazil
| | - Mônica Nogueira da Guarda Reis
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Rua 235, s/n, Setor Universitário, CEP 74605050, Goiânia, Goiás, Brazil
| | | | | | - Nígela Rodrigues Carvalho
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Rua 235, s/n, Setor Universitário, CEP 74605050, Goiânia, Goiás, Brazil
| | - Maria de Fátima Costa Alves
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Rua 235, s/n, Setor Universitário, CEP 74605050, Goiânia, Goiás, Brazil
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Silva LCF, Miranda AE, Batalha RS, Sabino CCD, Dib E, Costa CMD, Ramasawmy R, Talhari S. Chlamydia trachomatis infection among HIV-infected women attending an AIDS clinic in the city of Manaus, Brazil. Braz J Infect Dis 2013; 16:335-8. [PMID: 22846120 DOI: 10.1016/j.bjid.2012.06.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2012] [Accepted: 03/18/2012] [Indexed: 10/27/2022] Open
Abstract
This was a cross-sectional study aimed to determine the prevalence of and to identify risk factors for Chlamydia trachomatis (CT) among human immunodeficiency virus (HIV)-infected women attending the acquired immunodeficiency syndrome (AIDS) clinic in the city of Manaus, Brazil, in 2009-2010. Participants answered a questionnaire containing demographic, epidemiological, and clinical data. A genital specimen was collected during examination to detect CT-DNA by hybrid capture, and blood samples were taken to determine CD4(+)T and HIV viral load. There were 329 women included in the study. Median age was 32 years (IQR=27-38) and median schooling was nine years (IQR=4-11). The prevalence of CT was 4.3% (95%CI: 2.1-6.5). Logistic regression analysis showed that age between 18-29 years [OR=4.1(95%CI: 1.2-13.4)] and complaint of pelvic pain [OR=3.7 (95%CI: 1.2-12.8)] were independently associated with CT. The use of condom was inversely associated with CT [OR=0.39 (95%CI: 0.1-0.9)]. The results showed that younger women who did not use condoms are at a higher risk for CT. Screening for sexually transmitted infections must be done routinely and safe sexual practices should be promoted among this population.
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37
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Travassos AGÁ, Brites C, Netto EM, Fernandes SDA, Rutherford GW, Queiroz CM. Prevalence of sexually transmitted infections among HIV-infected women in Brazil. Braz J Infect Dis 2012; 16:581-5. [DOI: 10.1016/j.bjid.2012.08.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Accepted: 08/10/2012] [Indexed: 11/16/2022] Open
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Pinto VM, Tancredi MV, Golub JE, de Castro Coelho A, Tancredi Neto A, Miranda AE. Prior history of sexually transmitted diseases in women living with AIDS in São Paulo, Brazil. Braz J Infect Dis 2012. [DOI: 10.1016/s1413-8670(12)70315-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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