Sexually transmitted diseases during pregnancy: a synthesis of particularities

Prevalence of sexually transmitted infections, and its associated factors among students in Ethiopia: a systematic review and meta-analysis study

BACKGROUND

Sexually transmitted infections (STIs) are illnesses mainly spread through unprotected sexual activity. There is a scarcity of aggregate evidence in Ethiopia. The aim of this review was to assess the pooled prevalence of STI, and its associated factors among students in Ethiopia to fill the aforementioned gap.

METHODS

We extensively searched the bibliographic databases of PubMed, Scopus, and Google Scholar to obtain eligible studies. Further screening for a reference list of articles was also done. The Microsoft Excel Spreadsheet was used to extract data, and Stata 17 was used for analysis. The PRISMA-guidline and Newcastle-Ottawa quality assessment scale were used for quality appraisal. To check heterogeneity, the Higgs I2 and Cochran's Q tests were employed. Sensitivity and subgroup analysis were implemented. To detect publication bias, Egger's test and funnel plots were used.

RESULTS

The pooled prevalence of STI among students in Ethiopia was 13.6% with a 95% CI (10.2, 17). Findings from sub group analysis based on student category shows that the pooled prevalence of STI were 14.5% among University students, 14.2% among college students and 10.6% among high school students. Having multiple sexual partners (AOR 3.31; 95% CI: 2.40-4.57), not using condoms during sexual intercourse (AOR 2.56; 95% CI: 1.72-3.81), and having poor knowledge about sexually transmitted infections were 3.08 times (AOR 3.08; 95% CI: 1.84-5.15) significantly associated with STI.

CONCLUSION

The pooled prevalence of STIs among students in Ethiopia was high, and factors like having multiple sexual partners, not using condoms during sexual intercourse, and having poor knowledge about sexually transmitted infections were significantly associated with STIs. Hence, reduce STIs among students, strengthening sexual and reproductive health services, raising awareness about transmission and prevention, and promoting consistent condom use through health information dissemination is crucial. Further qualitative studies are suggested to explore the barriers and facilitators of STI prevention.

Donovanosis

Donovanosis is a chronic, progressive, and indolent bacterial disease that affects the skin and mucous membranes of the genital and perigenital regions, often associated with sexual transmission, and with low infectivity. The malignant transformation of donovanosis lesions occurs exceptionally, as is usually seen in long-term ulcerations.

High prevalence of Chlamydia trachomatis in pregnant women attended at Primary Health Care services in Amazon, Brazil

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.

Donovanosis in a child victim of sexual abuse: response to doxycycline treatment

Donovanosis is a chronic infectious disease caused by the Gram-negative bacteria Klebsiella granulomatis, which mainly affects the skin and mucous membranes of the genital, perigenital, and inguinal regions. Also known as venereal granuloma or granuloma inguinale, it is endemic in tropical and subtropical regions of the globe and often associated with sexual transmission. We report the case of an 11-year-old female victim of chronic sexual abuse, who was diagnosed with donovanosis and presented a good therapeutic response to doxycycline.

The prevalence and risk factors of preterm small-for-gestational-age infants: a population-based retrospective cohort study in rural Chinese population

Background

Preterm birth and small for gestational age (SGA) are strong indicators of neonatal adverse outcomes. With the growing importance of preterm SGA infants, we aim to evaluate the prevalence and risk factors for preterm SGA in China.

Method

We analyzed the data of parents and infants from a population-based cohort research of the free National Pre-pregnancy Checkups Project (NPCP) in rural China. Only singleton live births that occurred between 24 weeks +0 days and 36 weeks +6 days of pregnancy were included in this study. SGA was defined as birth weight less than the 10th percentile of the reference birth-weight-for-gestational-age population. A multiple logistic regression model was built using the statistically significant variables from the 371 variables in the questionnaire.

Results

A total of 11,474 singleton, preterm, live-birth infants were included. Of the total infants, 317 (2.77%) were preterm SGA infants. A higher risk of preterm SGA infants was observed among mothers who were on oral contraceptives (OR: 8.162, 95% CI: 1.622–41.072), mothers who had syphilis (OR: 12.800, 95% CI: 1.250–131.041), and mothers with a high eosinophil percentage (OR: 13.292, 95% CI: 1.282–135.796). Maternal intake of folic acid at least 3 months before pregnancy (OR: 0.284, 95% CI:0.124–0.654) and paternal intake of egg and meat (OR: 0.097,95% CI:0.030–0.315) were protective factors. Compared with North China, the incidence of preterm SGA infants was higher in South China.

Conclusion

Preterm SGA infants were associated with both maternal and paternal factors.

Uma abordagem sobre o uso de medicamentos nos livros didáticos de biologia como estratégia de promoção de saúde

O uso inadequado de medicamentos constitui uma grande ameaça à saúde pública e os medicamentos ocupam a primeira posição dentre os agentes causadores de intoxicação no Brasil, à frente de venenos para roedores e insetos, drogas ilícitas, agrotóxicos, produtos de limpeza e alimentos estragados. Os Parâmetros Curriculares Nacionais do Ensino Médio (PCN+) dão grande ênfase à saúde, uma vez que encontramos o tema Medicamentos mencionado repetidas vezes em seus conteúdos. O objetivo da pesquisa foi estudar as abordagens sobre o uso de medicamentos nos livros didáticos. Foram analisados onze livros didáticos de biologia, sendo seis constituídos de volumes únicos e cinco com três volumes cada, num total de vinte e um volumes. O uso racional de medicamentos deve ser considerado um tópico importante da promoção da saúde que atinge todos os setores da sociedade, devendo ser enfatizado na educação básica. Diante disso, e com base nos presentes resultados, sugerimos que os livros didáticos analisados sejam adequados às novas legislações e que os conteúdos o URM, atendendo assim as recomendações dos PCN+. Para tanto, os livros poderiam tratar de forma concisa os temas: automedicação, adesão ao tratamento medicamentoso, propagandas e reportagens sobre medicamentos entre outros.

Hypertrophic donavanosis in a young pregnant woman

BACKGROUND

Donovanosis is a chronic bacterial illness, progressive and indolent, which normally attacks the skin and mucous membranes in the genital and perigenital regions.

CASE

An 18-year-old pregnant female presented with large, hypertrophic lesions in the ano-genital region. HIV serology was negative. Pap smear revealed a CIN 1 associated with HPV infection. Biopsy yielded macrophages laden with Gram-negative Donovan bodies.

SUMMARY AND CONCLUSION

A diagnosis of vulvar and perianal donovanosis was reached; the patient decided to terminate the pregnancy and was treated with azithromycin, which led to clinical resolution.