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Lara-Escandell M, Gamberini C, Juliana NC, Al-Nasiry S, Morré SA, Ambrosino E. The association between non-viral sexually transmitted infections and pregnancy outcome in Latin America and the Caribbean: A systematic review. Heliyon 2024; 10:e23338. [PMID: 38187347 PMCID: PMC10767377 DOI: 10.1016/j.heliyon.2023.e23338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 11/30/2023] [Accepted: 12/01/2023] [Indexed: 01/09/2024] Open
Abstract
Introduction Non-viral sexually transmitted infections are known to be associated with adverse pregnancy outcomes. For these pathogens, standard antenatal screening is not broadly performed in Latin America and the Caribbean. The aim of this study was to comprehensively review the association of non-viral sexually transmitted infections and neonatal outcomes among pregnant women in the region. Methods Four databases (PubMed, Embase, SciELO and LILACS) were examined to identify eligible studies published up to September 2022. English or Spanish cross-sectional, case-control and cohort studies assessing the association of non-viral sexually transmitted infections and adverse pregnancy outcomes were evaluated. Articles were firstly screened by means of title and abstract. Potential articles were fully read and assessed for inclusion according to the eligibility criteria. Snowballing search was performed by screening of bibliographies of the chosen potentially relevant papers. Risk of bias within studies was assessed using the Joanna Briggs Institute reviewer's manual. Results A selection of 10 out of 9772 search records from five Latin America and the Caribbean countries were included. Six studies associated Treponema pallidum infection with preterm birth (1/6), history of previous spontaneous abortion (2/6), fetal and infant death (1/6), low birth weight (1/6) and funisitis of the umbilical cord (1/6). Three studies associated Chlamydia trachomatis infection with preterm birth (2/3), ectopic pregnancy (1/3) and respiratory symptoms on the newborn (1/3). One study associated Mycoplasma genitalium infection with preterm birth. Conclusion This review provides evidence on the association of non-viral sexually transmitted infections with adverse pregnancy outcomes. Further investigation is needed to establish more associations between non-viral sexually transmitted infections and pregnancy outcome, especially for Mycoplasma genitalium, Trichomonas vaginalis and Neisseria gonorrhoeae. Overall, this review calls for more research for public health interventions to promote screening of non-viral sexually transmitted infections during pregnancy, among high-risk population groups of pregnant women living in the region.
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Affiliation(s)
- Maria Lara-Escandell
- Institute for Public Health Genomics (IPHG), Department of Genetics and Cell Biology, Research School GROW for Oncology and Reproduction, Faculty of Health, Medicine & Life Sciences, University of Maastricht, 6229 ER Maastricht, the Netherlands
| | - Carlotta Gamberini
- Institute for Public Health Genomics (IPHG), Department of Genetics and Cell Biology, Research School GROW for Oncology and Reproduction, Faculty of Health, Medicine & Life Sciences, University of Maastricht, 6229 ER Maastricht, the Netherlands
| | - Naomi C.A. Juliana
- Institute for Public Health Genomics (IPHG), Department of Genetics and Cell Biology, Research School GROW for Oncology and Reproduction, Faculty of Health, Medicine & Life Sciences, University of Maastricht, 6229 ER Maastricht, the Netherlands
| | - Salwan Al-Nasiry
- Institute for Public Health Genomics (IPHG), Department of Genetics and Cell Biology, Research School GROW for Oncology and Reproduction, Faculty of Health, Medicine & Life Sciences, University of Maastricht, 6229 ER Maastricht, the Netherlands
- Department of Obstetrics and Gynecology, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Servaas A. Morré
- Institute for Public Health Genomics (IPHG), Department of Genetics and Cell Biology, Research School GROW for Oncology and Reproduction, Faculty of Health, Medicine & Life Sciences, University of Maastricht, 6229 ER Maastricht, the Netherlands
- Department of Molecular and Cellular Engineering, Jacob Institute of Biotechnology and Bioengineering, Sam Higginbottom University of Agriculture, Technology and Sciences, Allahabad 211007, UP, India
- Dutch Chlamydia Trachomatis Reference Laboratory on Behalf of the Epidemiology and Surveillance Unit, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, 3721 MA Bilthoven, the Netherlands
| | - Elena Ambrosino
- Institute for Public Health Genomics (IPHG), Department of Genetics and Cell Biology, Research School GROW for Oncology and Reproduction, Faculty of Health, Medicine & Life Sciences, University of Maastricht, 6229 ER Maastricht, the Netherlands
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Filho AC, Marcos CRSA, Colnago JM, Miranda AEB, Duarte JN, Peruchi LS. Sexually transmitted infections with Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, and Trichomonas vaginalis in pregnant women as detected by molecular testing. Indian J Sex Transm Dis AIDS 2023; 44:139-142. [PMID: 38223143 PMCID: PMC10785113 DOI: 10.4103/ijstd.ijstd_119_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 02/13/2023] [Accepted: 08/16/2023] [Indexed: 01/16/2024] Open
Abstract
Context During pregnancy, sexually transmitted infections can be transmitted vertically to the fetus, leading to an increase in morbidity and mortality for both mother and child. Aims This study aimed to determine the profile of cervical and vaginal infections in pregnant women receiving prenatal care in a single institute. Settings and Design The study was conducted in a tertiary hospital. Molecular testing was used to detect Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, and Trichomonas vaginalis. Materials and Methods Samples of vaginal secretions were collected from pregnant women using the Aptima® Multitest Swab Specimen Collection kit to test for the pathogens. The inclusion criteria consisted of pregnant women of 15-45 years of age receiving prenatal care at the institute, irrespective of gestational age, who agreed to provide vaginal swab. The exclusion criterion was the use of antibiotics in the preceding 3 months. Statistical Analysis Frequencies and percentages were calculated for the pathogens detected in the samples evaluated. Results Overall, 200 samples were tested. Of the pathogens detected, there was a predominance of T. vaginalis (15.5% of the samples) and C. trachomatis (14.5%), followed by M. genitalium (10.0%) and N. gonorrhoeae (0.5%). Conclusion Identifying the microorganisms present in the microbiota of pregnant women is of the utmost importance in assuring the appropriate treatment for each pathogen, thus avoiding complications both for the woman and for her fetus. These results should serve to stimulate the debate on implementing these tests as routine during prenatal care.
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Affiliation(s)
- Antônio Chambô Filho
- Department of Gynecology and Obstetrics at Promatre Teaching Maternity Hospital, Vitória, Espírito Santo, Brazil
- Department of Gynecology and Obstetrics at Holy House of Mercy Hospital, Vitória, Espírito Santo, Brazil
| | - Cinthia Rafaela Santos Assis Marcos
- Department of Gynecology and Obstetrics at Promatre Teaching Maternity Hospital, Vitória, Espírito Santo, Brazil
- Department of Gynecology and Obstetrics at Holy House of Mercy Hospital, Vitória, Espírito Santo, Brazil
| | - Jéssica Maria Colnago
- Department of Gynecology and Obstetrics at Promatre Teaching Maternity Hospital, Vitória, Espírito Santo, Brazil
- Department of Gynecology and Obstetrics at Holy House of Mercy Hospital, Vitória, Espírito Santo, Brazil
| | - Angélica Espinosa Barbosa Miranda
- Department of Gynecology and Obstetrics at Promatre Teaching Maternity Hospital, Vitória, Espírito Santo, Brazil
- Department of Gynecology and Obstetrics at Holy House of Mercy Hospital, Vitória, Espírito Santo, Brazil
| | - Júlia Nascimento Duarte
- Department of Gynecology and Obstetrics at Promatre Teaching Maternity Hospital, Vitória, Espírito Santo, Brazil
- Department of Gynecology and Obstetrics at Holy House of Mercy Hospital, Vitória, Espírito Santo, Brazil
| | - Luiza Spinassé Peruchi
- Department of Gynecology and Obstetrics at Promatre Teaching Maternity Hospital, Vitória, Espírito Santo, Brazil
- Department of Gynecology and Obstetrics at Holy House of Mercy Hospital, Vitória, Espírito Santo, Brazil
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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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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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Sexually transmitted infections in pregnancy - An update on Chlamydia trachomatis and Neisseria gonorrhoeae. Eur J Obstet Gynecol Reprod Biol 2020; 255:1-12. [PMID: 33059307 DOI: 10.1016/j.ejogrb.2020.10.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 10/02/2020] [Accepted: 10/05/2020] [Indexed: 12/14/2022]
Abstract
Routine screening for Chlamydia and gonococcal infection in pregnancy is not widespread, especially in low- and middle-income countries (LMICs), despite their potential adverse consequences on pregnancy outcome. We conducted a systematic literature search of three major databases to review current literature surrounding Chlamydia trachomatis and Neisseria gonorrhoeae infections in pregnancy. We discuss the epidemiology and burden of both infections, detection methods, potential adverse feto-maternal and infant outcomes and provide an overview of treatment options. A total of 67 articles met the inclusion criteria. The prevalence of C. trachomatis and N. gonorrhoeae across all trimesters ranged between 1.0%-36.8% and 0-14.2% worldwide, respectively. The most common diagnostic method is the Nucleic acid amplification test (NAAT). In pregnancy, chlamydia is associated with preterm birth, spontaneous miscarriage, stillbirth and neonatal conjunctivitis, while gonorrhoea is mainly associated with preterm birth and stillbirth. Amoxicillin, erythromycin and azithromycin showed similar efficacy in the treatment of chlamydia in pregnancy, while ceftriaxone and cefixime were effective in treating gonorrhoea in pregnancy. Being largely asymptomatic infections in women, we opine that detection strategies with locally appropriate tools should be combined with the syndromic approach in LMICs, where there is a high burden of disease.
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Ahmadi SJ, Farhadifar F, Sharami SRY, Zare S, Rezaei M, Soofizadeh N, Babaei E, Moradi G, Ahmadi A. The role of Chlamydia trachomatis in preterm delivery: a case-control study in Besat Hospital, Sanandaj, Iran (2018-2019). IRANIAN JOURNAL OF MICROBIOLOGY 2020; 12:325-330. [PMID: 32994904 PMCID: PMC7502151 DOI: 10.18502/ijm.v12i4.3936] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Background and Objectives: Preterm delivery is an important subject in gynecology, obstetrics and pediatrics. It is defined as regular uterine contractions every five to eight minutes or less, lasting for 30 seconds. It is associated with progressive changes in the cervix, resulting in delivery after 22 weeks and before 37 weeks of gestation. This study aimed to evaluate the role of Chlamydia trachomatis infection in women with preterm delivery. Materials and Methods: This case-control study was performed on 75 women with preterm delivery (case group) and 75 women with term delivery (control group). The research tools included a questionnaire, polymerase chain reaction (PCR) assay of cervical swab samples and ELISA assay of umbilical cord blood samples. Fisher’s exact test and t test were also performed to compare qualitative variables between the two groups. Results: In this study, the mean age of subjects was 26.55 ± 0.53 years in the control group and 26.76 ± 0.56 years in the case group. The prevalence of C. trachomatis in the cervical swab samples was 7 (9.33%) in the control group and 2 (2.67%) in the case group. There was no C. trachomatis IgM antibody in either of the groups, while there was 1 (1.33%) C. trachomatis IgG antibody in both groups. Conclusion: The results of the present study showed that there was no significant relationship between C. trachomatis infection and preterm delivery.
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Affiliation(s)
- Seyedeh Jahan Ahmadi
- Department of Obstetrics & Gynecology, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Fariba Farhadifar
- Department of Obstetrics & Gynecology, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.,Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | | | - Shamsi Zare
- Department of Obstetrics & Gynecology, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Masomeh Rezaei
- Department of Obstetrics & Gynecology, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Nasrin Soofizadeh
- Department of Obstetrics & Gynecology, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Erfan Babaei
- Department of Immunology, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Ghobad Moradi
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Amjad Ahmadi
- Department of Microbiology, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.,Cellular and Molecular Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
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7
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Nsereko E, Uwase A, Mukabutera A, Muvunyi CM, Rulisa S, Ntirushwa D, Moreland P, Corwin EJ, Santos N, Nzayirambaho M, Wojcicki JM. Maternal genitourinary infections and poor nutritional status increase risk of preterm birth in Gasabo District, Rwanda: a prospective, longitudinal, cohort study. BMC Pregnancy Childbirth 2020; 20:345. [PMID: 32493304 PMCID: PMC7268654 DOI: 10.1186/s12884-020-03037-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Accepted: 05/27/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Preterm birth (PTB) is a leading cause of early childhood mortality and morbidity, including long-term physical and mental impairment. The risk factors for PTB are complex and include maternal nutritional status and infections. This study aimed to identify potentially modifiable risk factors for targeted interventions to reduce the occurrence of PTB in Rwanda. METHODS We conducted a prospective, longitudinal cohort study of healthy pregnant women aged 18 to 49 years. Women at 9-15 gestational weeks were recruited from 10 health centers in Gasabo District, Kigali Province between September and October 2017. Pregnancy age was estimated using ultrasonography and date of last menstruation. Anthropometric and laboratory measurements were performed using standard procedures for both mothers and newborns. Surveys were administered to assess demographic and health histories. Categorical and continuous variables were depicted as proportions and means, respectively. Variables with p < 0.25 in bivariate analyses were included in multivariable logistic regression models to determine independent predictors of PTB. The results were reported as odds ratios (ORs) and 95% confidence intervals (CI), with statistical significance set at p < 0.05. RESULTS Among 367 participants who delivered at a mean of 38.0 ± 2.2 gestational weeks, the overall PTB rate was 10.1%. After adjusting for potential confounders, we identified the following independent risk factors for PTB: anemia (hemoglobin < 11 g/dl) (OR: 4.27; 95%CI: 1.85-9.85), urinary tract infection (UTI) (OR:9.82; 95%CI: 3.88-24.83), chlamydia infection (OR: 2.79; 95%CI: 1.17-6.63), inadequate minimum dietary diversity for women (MDD-W) score (OR:3.94; CI: 1.57-9.91) and low mid-upper arm circumference (MUAC) < 23 cm (OR: 3.12, 95%CI; 1.31-7.43). indicators of nutritional inadequacy (low MDD-W and MUAC) predicted risk for low birth weight (LBW) but only UTI was associated with LBW in contrast with PTB. CONCLUSION Targeted interventions are needed to improve the nutritional status of pregnant women, such as maternal education on dietary diversity and prevention of anemia pre-pregnancy. Additionally, prevention and treatment of maternal infections, especially sexually transmitted infections and UTIs should be reinforced during standard antenatal care screening which currently only includes HIV and syphilis testing.
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Affiliation(s)
- Etienne Nsereko
- University of Rwanda College of Medicine and Health Sciences School of Health Sciences, P.O. Box: 3538, Kigali, Rwanda
| | - Aline Uwase
- University of Rwanda College of Medicine and Health Sciences School of Health Sciences, P.O. Box: 3538, Kigali, Rwanda
| | - Assumpta Mukabutera
- University of Rwanda College of Medicine and Health Sciences School of Public Health, P.O. Box: 3538, Kigali, Rwanda
| | - Claude Mambo Muvunyi
- University of Rwanda College of Medicine and Health Sciences school of Medicine and Pharmacy, P.O. Box: 3538, Kigali, Rwanda
| | - Stephen Rulisa
- University of Rwanda College of Medicine and Health Sciences school of Medicine and Pharmacy, P.O. Box: 3538, Kigali, Rwanda
| | - David Ntirushwa
- University of Rwanda College of Medicine and Health Sciences school of Medicine and Pharmacy, P.O. Box: 3538, Kigali, Rwanda
| | - Patricia Moreland
- Lillian Carter Center for Global Health and Social Responsibility, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA USA
| | | | - Nicole Santos
- University of California San Francisco, Institute for Global Health Sciences, San Francisco, USA
| | - Manasse Nzayirambaho
- University of Rwanda College of Medicine and Health Sciences School of Public Health, P.O. Box: 3538, Kigali, Rwanda
| | - Janet M. Wojcicki
- University of California San Francisco, Institute for Global Health Sciences, San Francisco, USA
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Lee JM, Mayall JR, Chevalier A, McCarthy H, Van Helden D, Hansbro PM, Horvat JC, Jobling P. Chlamydia muridarum infection differentially alters smooth muscle function in mouse uterine horn and cervix. Am J Physiol Endocrinol Metab 2020; 318:E981-E994. [PMID: 32315215 DOI: 10.1152/ajpendo.00513.2019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Chlamydia trachomatis infection is a primary cause of reproductive tract diseases including infertility. Previous studies showed that this infection alters physiological activities in mouse oviducts. Whether this occurs in the uterus and cervix has never been investigated. This study characterized the physiological activities of the uterine horn and the cervix in a Chlamydia muridarum (Cmu)-infected mouse model at three infection time points of 7, 14, and 21 days postinfection (dpi). Cmu infection significantly decreased contractile force of spontaneous contraction in the cervix (7 and 14 dpi; P < 0.001 and P < 0.05, respectively), but this effect was not observed in the uterine horn. The responses of the uterine horn and cervix to oxytocin were significantly altered by Cmu infection at 7 dpi (P < 0.0001), but such responses were attenuated at 14 and 21 dpi. Cmu infection increased contractile force to prostaglandin (PGF2α) by 53-83% in the uterine horn. This corresponded with the increased messenger ribonucleic acid (mRNA) expression of Ptgfr that encodes for its receptor. However, Cmu infection did not affect contractions of the uterine horn and cervix to PGE2 and histamine. The mRNA expression of Otr and Ptger4 was inversely correlated with the mRNA expression of Il1b, Il6 in the uterine horn of Cmu-inoculated mice (P < 0.01 to P < 0.001), suggesting that the changes in the Otr and Ptger4 mRNA expression might be linked to the changes in inflammatory cytokines. Lastly, this study also showed a novel physiological finding of the differential response to PGE2 in mouse uterine horn and cervix.
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Affiliation(s)
- Jia Ming Lee
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Jemma R Mayall
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
- Priority Research Centre for Healthy Lungs, University of Newcastle, Newcastle, New South Wales, Australia
| | - Anne Chevalier
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
- Priority Research Centre for Healthy Lungs, University of Newcastle, Newcastle, New South Wales, Australia
| | - Huw McCarthy
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
- Priority Research Centre for Healthy Lungs, University of Newcastle, Newcastle, New South Wales, Australia
| | - Dirk Van Helden
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Philip M Hansbro
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
- Priority Research Centre for Healthy Lungs, University of Newcastle, Newcastle, New South Wales, Australia
- Centenary Institute and the University of Technology Sydney, Sydney, New South Wales, Australia
| | - Jay C Horvat
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
- Priority Research Centre for Healthy Lungs, University of Newcastle, Newcastle, New South Wales, Australia
| | - Phillip Jobling
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
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Silveira MF, Bruni MP, Stauffert D, Golparian D, Unemo M. Prevalence and risk factors associated with Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycoplasma genitalium among women in Pelotas, Southern Brazil. Int J STD AIDS 2020; 31:432-439. [PMID: 32192370 DOI: 10.1177/0956462419898982] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The frequently asymptomatic sexually transmitted infections (STIs) caused by Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Mycoplasma genitalium (MG) are poorly diagnosed in Brazil and can lead to severe complications/sequelae without timely detection and treatment. We investigated prevalence of CT, NG, and MG infections and associated demographic, behavioral, and clinical factors in consecutive women attending a gynecology and obstetrics outpatient clinic in Pelotas, Southern Brazil. Vaginal swab samples were prospectively obtained from asymptomatic and symptomatic women (n = 498) from August 2015 to December 2016 and tested with Aptima Combo2 and Aptima M. genitalium assays (Hologic). The prevalence of CT, NG, and MG was 6.8% (34/498), 1.0% (5/498), and 4.2% (21/498), respectively. Three (0.6%) cases of CT and NG co-infection and one (0.2%) case of CT and MG co-infection were identified. The risk factors associated with these bacterial STIs were youth (<30 years), no steady sexual partner, infection with additional STI, and lack of income. Bacterial STIs, particularly CT and MG, were prevalent among women, including pregnant women (60% of positive cases), in Pelotas, Brazil. Sensitive and specific diagnostic testing and early treatment are essential to control STIs, limit transmission chains, avoid future complications/sequelae, and reduce health and cost burdens on the population.
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Affiliation(s)
- M F Silveira
- Maternal and Child Department, School of Medicine, Federal University of Pelotas (UFPel), Pelotas, Brazil
| | - M P Bruni
- Post Graduate Program in Parasitology, Biology Institute, Federal University of Pelotas (UFPel), Pelotas, Brazil
| | - D Stauffert
- Maternal and Child Department, School of Medicine, Federal University of Pelotas (UFPel), Pelotas, Brazil
| | - D Golparian
- WHO Collaborating Centre for Gonorrhoea and other STIs, Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - M Unemo
- WHO Collaborating Centre for Gonorrhoea and other STIs, Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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10
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Kiguen AX, Marramá M, Ruiz S, Estofan P, Venezuela RF, Mosmann JP, Monetti MS, Rivero V, Cuffini CG. Prevalence, risk factors and molecular characterization of Chlamydia trachomatis in pregnant women from Córdoba, Argentina: A prospective study. PLoS One 2019; 14:e0217245. [PMID: 31150440 PMCID: PMC6544222 DOI: 10.1371/journal.pone.0217245] [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: 01/31/2019] [Accepted: 05/07/2019] [Indexed: 11/18/2022] Open
Abstract
Background Chlamydia trachomatis causes the most prevalent bacterial Sexual Transmitted Infection. In pregnant women, untreated chlamydial infections are associated with abortions, premature rupture of membranes, postpartum endometritis, low birth weight and transmission to the newborn. In Córdoba, Argentina, there is little knowledge about the prevalence of Chlamydia trachomatis in women in their third trimester of pregnancy, so, the aim of this study was to evaluate Chlamydia trachomatis prevalence and genotypes present in Cordovan pregnant women with different age and socioeconomic status. Methods and findings Design: prospective study. Settings: Women population from Cordoba city, Argentina. Population: Pregnant women having 35 to 37 weeks of gestation. Methods: Five hundred and nine cervical swabs were collected. Each sample was subjected to DNA extraction and PCR for Chlamydia trachomatis using primers NRO/NLO and CTP1/CTP2. Positives samples were sequenced to determine genotype. Main outcome measures: Demographic data of the patients were collected to detect a population at risk for this infection. Results A prevalence of 6.9% (35/509) for Chlamydia trachomatis infection was detected, with 32/295 and 3/214 from pregnant women with low or better economic resources respectively (p = 0,0001). Results showed a significantly increased rate of 11.6% (30/258) in women under 25 years compared with 2% (5/251) in patients over that age (p = 0,00003). Genotype E was the most prevalent. Conclusions With these results, we can say that pregnant women under 25 years old and low economic resources are one of the populations in which the screening programs of Chlamydia trachomatis should focus.
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Affiliation(s)
- Ana Ximena Kiguen
- Instituto de Virología Doctor José María Vanella, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- * E-mail:
| | - Marcela Marramá
- Dirección de Especialidades Médicas, Municipalidad de Córdoba, Córdoba, Argentina
| | - Susana Ruiz
- Laboratorios LACE Sociedad Anónima, Córdoba, Argentina
| | - Patricia Estofan
- Centro Integral de Ginecología, Obstetricia y Reproducción (CIGOR), Córdoba, Argentina
| | - Raúl Fernando Venezuela
- Instituto de Virología Doctor José María Vanella, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Jessica Paola Mosmann
- Instituto de Virología Doctor José María Vanella, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Marina Soledad Monetti
- Instituto de Virología Doctor José María Vanella, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Virginia Rivero
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI-CONICET), Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Cecilia Gabriela Cuffini
- Instituto de Virología Doctor José María Vanella, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
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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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