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Nguyen BH, Pham QM, Hoang L, Sansone A, Jannini EA, Tran CM. Investigating the microbial pathogens of sexually transmitted infections among heterosexual Vietnamese men with symptomatic urethritis. Aging Male 2022; 25:125-133. [PMID: 35416126 DOI: 10.1080/13685538.2022.2063272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
OBJECTIVE To explore the microbial etiology of urethritis in Vietnamese men and the association with patients' characteristics, especially their sexual behaviors. METHODS This study was conducted on 349 men who presented with symptomatic urethritis and evidence of STIs (determined by multiplex PCR tests) at the Department of Andrology and Sexual Medicine-Hanoi Medical University Hospital. All information regarding medical history, sexual activities, and symptoms of urethritis was documented. RESULTS C. trachomatis and N. gonorrhoea remained the two most common causative pathogens, followed by an unexpectedly high prevalence of Mycoplasma and Ureaplasma species. Coinfection was significant with a rate of 40.7%. Men who had sex with female sex workers (FSWs) were more likely to be positive with N. gonorrhoea but less likely to be positive with C. trachomatis and M. genitalium than those having sex with only one romantic partner. CONCLUSIONS Our findings suggested the important role of other microorganisms, especially M. genitalium, in the etiology of urethritis in men besides the previously well-known causes of STIs. Since the coinfection rate is quite high, targeted treatment with clear microbial evidence should be considered rather than empiric antimicrobial therapy.
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Affiliation(s)
- Bac Hoai Nguyen
- Department of Andrology and Sexual Medicine, Hanoi Medical University's Hospital, Hanoi, Vietnam
| | - Quan Minh Pham
- Department of Andrology and Sexual Medicine, Hanoi Medical University's Hospital, Hanoi, Vietnam
| | - Long Hoang
- Department of Urology, Hanoi Medical University's Hospital, Hanoi, Vietnam
| | - Andrea Sansone
- Endocrinology and Sexual Medicine (ENDOSEX), University of Rome Tor Vergata, Rome, Italy
| | - Emmanuele A Jannini
- Endocrinology and Sexual Medicine (ENDOSEX), University of Rome Tor Vergata, Rome, Italy
| | - Chau Minh Tran
- Department of Microbiology and Parasitology, Hanoi Medical University's Hospital, Hanoi, Vietnam
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Liu J, Zeng M, Yang L, Mao Y, He Y, Li M, Chen Q, Zhou W, Chen L, Zhu Q. Prevalence of reproductive tract infections among women preparing to conceive in Chongqing, China: trends and risk factors. Reprod Health 2022; 19:197. [PMID: 36192676 PMCID: PMC9531418 DOI: 10.1186/s12978-022-01502-x] [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: 09/17/2020] [Accepted: 09/14/2022] [Indexed: 11/10/2022] Open
Abstract
Background Reproductive tract infection has become a major public health issue all over the world for its high and growing prevalence. It can cause adverse pregnancy outcomes in pregnant women and their foetuses. This study aimed to investigate the trends and risk factors of the prevalence of reproductive tract infections among women who prepared to conceive in the Chongqing Municipality (China) from 2012 to 2016. Methods A multi-center cross-sectional study was conducted between January 2012 and December 2016. Women aged 20–49 years who intended to get pregnant were recruited for this study. All participants underwent preconception examination, which included testing for Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, syphilis, bacterial vaginosis and candidiasis according to the national diagnostic standard. A total of 439,372 women with testing results for all six types of reproductive tract infections were included in our final analyses. Logistic regression and factor analysis were used to determine the possible sociodemographic factors associated with prevalence trends. Results In our study, the overall positive rate of RTIs among the 439,372 women of reproductive age was 5.03%. Candidiasis was the most common infection in our population (2.47%), followed by bacterial vaginosis (1.28%), syphilis (0.73%), T. vaginalis (0.49%), C. trachomatis (0.20%) and N. gonorrhoeae (0.06%). The prevalence of reproductive tract infections was highest among women aged 35 years and above, with a primary or lower education level, history of pregnancy, delivery, induced abortion, or spontaneous abortion. From 2012 to 2016, the trend of the overall prevalence of reproductive tract infections was V-shaped, decreasing steadily from 2012 to 2015, with a slight rise in 2016. Our results suggest that the distribution change of age, education level, gravidity, parity, and history of induced abortion influenced this trend. Conclusion Since the number of high-risk women who intend to become pregnant is growing in the Chongqing Municipality, pre-conception positive preventions including health education, regular screening, and timely treatment of reproductive tract infections are needed to prevent the impact of reproductive tract infections on maternal health and infant safety. Supplementary Information The online version contains supplementary material available at 10.1186/s12978-022-01502-x. Reproductive tract infections (RTIs) can cause serious health problems, such as spontaneous abortion and congenital diseases in pregnant women and their foetuses. However, there is a lack of studies focusing on the prevalence of RTIs and their trends among women who intend to conceive. This cross-sectional study examined data collected from 439,372 women during their preconception care to investigate the trend and related risk factors of the prevalence of RTIs, thereby providing essential data for their prevention. Participants were women from all 39 counties in the Chongqing Municipality of China, and data were collected between 2012 and 2016. We found that the overall prevalence of the six types of RTIs among these women was 5.03%, which was relatively lower than that in other populations in previous studies. Age, education level, history of pregnancy or delivery, and history of abortion were all associated with the prevalence of RTIs. The prevalence trend from 2012 to 2016 was V-shaped decreased steadily from 2012 until 2015 and rose slightly in 2016. Our data suggested that this trend might be influenced by changes in the proportion of ‘high-risk’ women, that is, women with higher age, lower education level, and a history of pregnancy or induced abortion. This study suggests that health education and regular screening are necessary to face new challenges experienced by older women or women with previous pregnancies who intended to get pregnant in recent years in China.
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Affiliation(s)
- Jun Liu
- NHC Key Laboratory of Birth Defects and Reproductive Health (Chongqing Population and Family Planning Science and Technology Research Institute), Chongqing, 400020, China
| | - Mengyao Zeng
- NHC Key Lab. of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Fudan University, Shanghai, 200237, China.,School of Public Health, Fudan University, Shanghai, China
| | - Liu Yang
- NHC Key Laboratory of Birth Defects and Reproductive Health (Chongqing Population and Family Planning Science and Technology Research Institute), Chongqing, 400020, China
| | - Yanyan Mao
- NHC Key Lab. of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Fudan University, Shanghai, 200237, China
| | - Yang He
- NHC Key Laboratory of Birth Defects and Reproductive Health (Chongqing Population and Family Planning Science and Technology Research Institute), Chongqing, 400020, China
| | - Min Li
- NHC Key Lab. of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Fudan University, Shanghai, 200237, China
| | - Qing Chen
- NHC Key Laboratory of Birth Defects and Reproductive Health (Chongqing Population and Family Planning Science and Technology Research Institute), Chongqing, 400020, China.,West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, China
| | - Weijin Zhou
- NHC Key Laboratory of Birth Defects and Reproductive Health (Chongqing Population and Family Planning Science and Technology Research Institute), Chongqing, 400020, China.,NHC Key Lab. of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Fudan University, Shanghai, 200237, China
| | - Liang Chen
- NHC Key Laboratory of Birth Defects and Reproductive Health (Chongqing Population and Family Planning Science and Technology Research Institute), Chongqing, 400020, China.
| | - Qianxi Zhu
- NHC Key Lab. of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Fudan University, Shanghai, 200237, China.
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Zhao T, Xiao X, Xiao L, Wu XM, Yuan T. Bacterial vaginosis, vulvovaginal candidiasis, and trichomonal vaginitis in reproductive-age women in Yunnan, China: a descriptive study. J OBSTET GYNAECOL 2022; 42:3187-3192. [PMID: 35947028 DOI: 10.1080/01443615.2022.2109134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
This study aimed to determine the prevalence of and risk factors associated with BV(bacterial vaginosis, BV), VVC (vulvovaginal candidiasis, VVC) and TV (trichomonal vaginitis, TV) among non-pregnant women. Among 770 women included in analyses, surveyed using a questionnaire and subsequently diagnosed with BV, VVC and TV via Gram staining and vaginal swab microscopy. Vaginal infections were prevalent in 31.30%, with BV being the most prevalent (21.35%). Single-variable analysis revealed that an age of 20-29 years (odds ratio [OR] = 2.31, 95% CI: 1.24-4.29; p = .007) and lack of education (OR = 0.50, 95% CI: 0.28-0.89; p = .018) were significantly associated with BV. However, an age of 30-39 years was significantly associated with VVC (OR = 2.12, 95% CI: 1.03-4.38; p = .038). Multivariable analysis confirmed that miscarriage was an independent predictor of BV and VVC. Miscarriage was significantly associated with the incidence of BV and VVC (OR = 1.680, 95% CI: 1.146-2.462; p = .011 and OR = 2.04, 95% CI: 1.30-3.20; p = .002, respectively). In conclusion, BV appears to be the predominant cause of vaginitis, risk factors for vaginitis include age and level of education and miscarriage.IMPACT STATEMENTWhat is already known on this subject? Inflammation of the vagina, or vaginitis, is caused by various infectious and non-infectious factors. The most common causes of infectious vaginitis are BV, VVC and TV. Kunming located at the southwestern border of China, However, there is still no systematic research investigating the status of vaginitis infection in Yunnan Province. Therefore, the present study aimed to determine the prevalence of these vaginal infections; BV, VVC, and TV, among women of childbearing age, and to assess the prevalence of vaginal infections and the associated risk factors.What do the results of this study add? In our study we found that vaginal infections were prevalent in 31.30% of reproductive-age women, with BV being the most prevalent (21.35%). We believe that our study makes a significant contribution to the literature because we report that BV appears to be the predominant cause of vaginitis, followed by VVC and TV. Risk factors for vaginitis include age, miscarriage and level of education.What are the implications of these findings for clinical practice and/or further research? This study aimed to determine the prevalence of these vaginal infections, BV, VVC and TV, and to assess the prevalence of vaginal infections and the associated risk factors. Health education interventions are recommended to raise women's awareness of vaginitis and its prevention.
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Affiliation(s)
- Ting Zhao
- Department of Gynecology, The First People's Hospital of Yunnan Province, Kunming, China.,Department of Gynecology, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Xiao Xiao
- Department of Gynecology, The First People's Hospital of Yunnan Province, Kunming, China.,Department of Gynecology, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Li Xiao
- Department of Gynecology, The First People's Hospital of Yunnan Province, Kunming, China.,Department of Gynecology, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Xiao-Mei Wu
- Department of Gynecology, The First People's Hospital of Yunnan Province, Kunming, China.,Department of Gynecology, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Tao Yuan
- Department of Gynecology, The First People's Hospital of Yunnan Province, Kunming, China.,Department of Gynecology, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
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Tsega NT, Abebe B, Ebabu T, Asmare T, Kassa M, Haile TT, Seyoum AT, Endalew M, Wondie KY. Sexually transmitted infections and associated factors during pregnancy in Gondar city, Northwest Ethiopia, 2021: A multicenter study. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2022. [DOI: 10.1016/j.cegh.2022.101096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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5
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Steiner RJ, Pampati S, Kortsmit KM, Liddon N, Swartzendruber A, Pazol K. Long-Acting Reversible Contraception, Condom Use, and Sexually Transmitted Infections: A Systematic Review and Meta-analysis. Am J Prev Med 2021; 61:750-760. [PMID: 34686301 PMCID: PMC9125421 DOI: 10.1016/j.amepre.2021.04.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 04/14/2021] [Accepted: 04/21/2021] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Given mixed findings regarding the relationship between long-acting reversible contraception and condom use, this systematic review and meta-analysis synthesizes studies comparing sexually transmitted infection‒related outcomes between users of long-acting reversible contraception (intrauterine devices, implants) and users of moderately effective contraceptive methods (oral contraceptives, injectables, patches, rings). METHODS MEDLINE, Embase, PsycINFO, Global Health, CINAHL, Cochrane Library, and Scopus were searched for articles published between January 1990 and July 2018. Eligible studies included those that (1) were published in the English language, (2) were published in a peer-reviewed journal, (3) reported empirical, quantitative analyses, and (4) compared at least 1 outcome of interest (condom use, sexual behaviors other than condom use, sexually transmitted infection‒related service receipt, or sexually transmitted infections/HIV) between users of long-acting reversible contraception and users of moderately effective methods. In 2020, pooled ORs were calculated for condom use, chlamydia/gonorrhea infection, and trichomoniasis infection; findings for other outcomes were synthesized qualitatively. The protocol is registered on the International Prospective Register of Systematic Reviews (CRD42018109489). RESULTS A total of 33 studies were included. Long-acting reversible contraception users had decreased odds of using condoms compared with oral contraceptive users (OR=0.43, 95% CI=0.30, 0.63) and injectable, patch, or ring users (OR=0.58, 95% CI=0.48, 0.71); this association remained when limited to adolescents and young adults only. Findings related to multiple sex partners were mixed, and only 2 studies examined sexually transmitted infection testing, reporting mainly null findings. Pooled estimates for chlamydia and/or gonorrhea were null, but long-acting reversible contraception users had increased odds of trichomoniasis infection compared with oral contraceptive users (OR=2.01, 95% CI=1.11, 3.62). DISCUSSION Promoting condom use specifically for sexually transmitted infection prevention may be particularly important among long-acting reversible contraception users at risk for sexually transmitted infections, including adolescents and young adults.
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Affiliation(s)
- Riley J Steiner
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Sanjana Pampati
- Oak Ridge Institute for Science and Education, Atlanta, Georgia
| | - Katherine M Kortsmit
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Nicole Liddon
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Andrea Swartzendruber
- Department of Epidemiology & Biostatistics, University of Georgia College of Public Health, Athens, Georgia
| | - Karen Pazol
- Division of Human Development and Disability, Centers for Disease Control and Prevention, Atlanta, Georgia
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Kassa ZY, Hussen S, Hadra N, Moges Y, Bonja F. Prevalence of Neisseria gonorrhoeae infection among women of reproductive age in sub-Saharan Africa: a systematic review and meta-analysis. EUR J CONTRACEP REPR 2020; 25:365-371. [PMID: 32845194 DOI: 10.1080/13625187.2020.1779688] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Neisseria gonorrhoeae infection is a global, major public health problem. It is the second leading bacterial sexually transmitted infection (STI) in sub-Saharan Africa and worldwide. As study findings on the topic are inconsistent, we conducted a systematic review and meta-analysis to determine the pooled prevalence of N. gonorrhoeae infection in sub-Saharan Africa among reproductive-aged women. METHODS Published studies were systematically retrieved from PubMed, Embase, CINHAL and Science Direct. Their quality was measured using the Joanna Briggs Institute critical appraisal checklist for studies reporting prevalence data, and the score of each included study had to meet at least 4.5 out of 9 indicators of quality. RESULTS The meta-analysis of 35 studies showed that the pooled prevalence of N. gonorrhoeae infection among reproductive-aged women in sub-Saharan Africa was 3.28% (95% confidence interval 2.61%, 3.94%). CONCLUSION The prevalence of N. gonorrhoeae infection was higher than that found in other studies carried out in the region. The results suggest that greater attention should be paid to the primary prevention of N. gonorrhoeae. We recommend the implementation of STI education for reproductive-aged women and the use of specific and rapid diagnostic testing for N. gonorrhoeae infection in STI clinics. N. gonorrhoeae screening and treatment should be integrated into in- and outpatient clinics to reduce infection among reproductive-aged women.
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Affiliation(s)
- Zemenu Yohannes Kassa
- Department of Midwifery, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Siraj Hussen
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Nebiha Hadra
- Department of Midwifery, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Yohannes Moges
- Department of Midwifery, Institute of Medicine and Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| | - Fisseha Bonja
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
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Huai P, Li F, Chu T, Liu D, Liu J, Zhang F. Prevalence of genital Chlamydia trachomatis infection in the general population: a meta-analysis. BMC Infect Dis 2020; 20:589. [PMID: 32770958 PMCID: PMC7414538 DOI: 10.1186/s12879-020-05307-w] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 07/28/2020] [Indexed: 12/11/2022] Open
Abstract
Background Estimating prevalence of Chlamydia trachomatis (CT) worldwide is necessary in designing control programs and allocating health resources. We performed a meta-analysis to calculate the prevalence of CT in the general population. Methods The Pubmed and Embase databases were searched for eligible population-based studies from its inception through June 5, 2019. Q test and I2 statistic were used to calculate the heterogeneity between studies. Random effects models were used to pool the prevalence of CT. Meta regression was performed to explore the possible sources of heterogeneity. Publication bias was evaluated using a funnel plot and “trim and fill” method. Results Twenty nine studies that reported prevalence of CT infection from 24 countries were identified, including a total population of 89,886 persons. The pooled prevalence of CT among the general population was 2.9% (95% CI, 2.4–3.5%), and females had a higher CT prevalence (3.1, 95% CI, 2.5–3.8%) than males (2.6, 95% CI, 2.0–3.2%) (χ2 = 10.38, P < 0.01). Prevalence of CT was highest in region of America (4.5, 95% CI, 3.1–5.9%), especially in Latin America (6.7, 95% CI, 5.0–8.4%), followed by females in region of Africa (3.8, 95% CI, 0.7–6.9%), while South-East Asia had a lowest CT prevalence 0.8% (95% CI, 0.3–1.3%). Conclusions This study provided the updated prevalence of CT among general population worldwide. General population from Latin America, especially females, and women in Africa should be given priority by WHO when design and delivery CT control programs.
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Affiliation(s)
- Pengcheng Huai
- Shandong Provincial Hospital for Skin Disease, Shandong First Medical University, Jinan, China.,Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, China
| | - Furong Li
- Shandong Provincial Hospital for Skin Disease, Shandong First Medical University, Jinan, China.,Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, China
| | - Tongsheng Chu
- Shandong Provincial Hospital for Skin Disease, Shandong First Medical University, Jinan, China.,Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, China
| | - Dianchang Liu
- Shandong Provincial Hospital for Skin Disease, Shandong First Medical University, Jinan, China.,Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, China
| | - Jian Liu
- Shandong Provincial Hospital for Skin Disease, Shandong First Medical University, Jinan, China.,Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, China
| | - Furen Zhang
- Shandong Provincial Hospital for Skin Disease, Shandong First Medical University, Jinan, China. .,Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, China.
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Abdul-Aziz M, Mahdy MAK, Abdul-Ghani R, Alhilali NA, Al-Mujahed LKA, Alabsi SA, Al-Shawish FAM, Alsarari NJM, Bamashmos W, Abdulwali SJH, Al Karawani M, Almikhlafy AA. Bacterial vaginosis, vulvovaginal candidiasis and trichomonal vaginitis among reproductive-aged women seeking primary healthcare in Sana'a city, Yemen. BMC Infect Dis 2019; 19:879. [PMID: 31640583 PMCID: PMC6805389 DOI: 10.1186/s12879-019-4549-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 10/09/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND In Yemen, the underlying causes of infectious vaginitis have been neglected. Therefore, this study aimed to determine the prevalence and risk factors associated with bacterial vaginosis (BV), vulvovaginal candidiasis (VVC) and trichomonal vaginitis (TV) among non-pregnant reproductive-aged women. METHODS A cross-sectional study was conducted among 347 non-pregnant reproductive-aged women seeking primary healthcare in Sana'a city, Yemen. Data about sociodemographic characteristics, lifestyle-related behaviors, routine hygienic practices, menstrual care and history and type of contraceptive intake were collected using a structured questionnaire. Vaginal discharge samples were collected and examined for discharge characteristics and pH by a gynecologist. Then, samples were examined for BV, VVC and TV. Data were analyzed using suitable statistical tests. RESULTS Vaginal infections were prevalent among 37.6% of reproductive-aged women, where BV was the most prevalent (27.2%). VVC was significantly higher among symptomatic women and significantly associated with itching (P = 0.005). Using bivariate analysis, the age of < 25 years (odds ratio [OR] = 1.9, 95% confidence interval [CI]: 1.16-3.10; P = 0.010) and using intrauterine contraceptive devices (IUCDs) (OR = 1.8, 95% CI: 1.09-2.89; P = 0.020) were significantly associated with BV, while history of miscarriage was significantly associated with a lower risk of BV (OR = 0.5, 95% CI: 0.31-0.85, P = 0.009). However, polygyny was significantly associated with VVC (OR = 3.4, 95% CI: 1.33-8.66; P = 0.007). Multivariable analysis confirmed that age of < 25 years and using IUCD were the independent predictors of BV, while history of miscarriage was an independent protective factor against BV. On the other hand, marriage to a polygamous husband was the independent predictor of VVC. CONCLUSIONS More than a third of non-pregnant reproductive-aged women seeking PHC in Sana'a have single or mixed infections with BV, VVC or TV. BV is the most frequent cause of vaginitis and is significantly associated with the age of < 25 years and using IUCDs, while VVC is significantly higher among women with polygamous husbands. Health education of polygamous husbands and their wives, regular monitoring of BV among IUCD users and screening women for vaginitis before treatment are recommended.
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Affiliation(s)
- Maha Abdul-Aziz
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Science and Technology, Sana'a, Yemen
| | - Mohammed A K Mahdy
- Tropical Disease Research Center, Faculty of Medicine, University of Science and Technology, Sana'a, Yemen. .,Department of Parasitology, Faculty of Medicine, Sana'a University, Sana'a, Yemen.
| | - Rashad Abdul-Ghani
- Tropical Disease Research Center, Faculty of Medicine, University of Science and Technology, Sana'a, Yemen.,Department of Parasitology, Faculty of Medicine, Sana'a University, Sana'a, Yemen
| | - Nuha A Alhilali
- Medical Laboratory Sciences Program, Faculty of Medicine, University of Science and Technology, Sana'a, Yemen
| | - Leena K A Al-Mujahed
- Medical Laboratory Sciences Program, Faculty of Medicine, University of Science and Technology, Sana'a, Yemen
| | - Salma A Alabsi
- Medical Laboratory Sciences Program, Faculty of Medicine, University of Science and Technology, Sana'a, Yemen
| | - Fatima A M Al-Shawish
- Medical Laboratory Sciences Program, Faculty of Medicine, University of Science and Technology, Sana'a, Yemen
| | - Noura J M Alsarari
- Medical Laboratory Sciences Program, Faculty of Medicine, University of Science and Technology, Sana'a, Yemen
| | - Wala Bamashmos
- Medical Laboratory Sciences Program, Faculty of Medicine, University of Science and Technology, Sana'a, Yemen
| | - Shahad J H Abdulwali
- Medical Laboratory Sciences Program, Faculty of Medicine, University of Science and Technology, Sana'a, Yemen
| | - Mahdi Al Karawani
- Department of Community Medicine, Faculty of Medicine, University of Science and Technology, Sana'a, Yemen
| | - Abdullah A Almikhlafy
- Department of Community Medicine, Faculty of Medicine, University of Science and Technology, Sana'a, Yemen
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Xu S, Yu C, Zhou Y, Wu J, Bai T, Zhang J, Li Y. The Prevalence of Reproductive Tract Infections in a Chinese Internal Migrant Population, and Its Correlation with Knowledge, Attitude, and Practices: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16040655. [PMID: 30813340 PMCID: PMC6406905 DOI: 10.3390/ijerph16040655] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 02/18/2019] [Accepted: 02/18/2019] [Indexed: 11/16/2022]
Abstract
Objective: This study was designed to assess the prevalence of reproductive tract infections (RTIs) among an internal-migrant population of reproductive age in China. We also analyzed the knowledge, attitude, and practices related to these infections. Methods: A cross-sectional study using the quota-sampling method was conducted in three cities from March 2016 to February 2017. A total of 3320 participants (40.7% men and 59.3% women) were enrolled in the study, of whom, 1124, 1015, and 1181 were from Yinchuan, Urumchi, and Shanghai, respectively. Data on the included subjects were collected using a self-administered questionnaire. Results: We found that 3.2% and 22.6% of all subjects lacked knowledge regarding the identification and prevention of RTIs, respectively. More than 80% of the participants approved of developing RTI surveillance and taking RTI-related courses. While 45.1% of the respondents changed their underwear every 2⁻3 days, 49.0% cleaned their genitals daily, and 34.9% reported taking a bath daily. Among contraceptive users, 47.4% and 29.7% used condoms and IUDs (intrauterine devices), respectively. Overall, 48.2% of the participants had laboratory-confirmed sexually transmitted infections, and 19.7% of the female participants had endogenous infections. After controlling the socio-demographic variables, participants who cleaned their genitals and took a bath less frequently, as well as used condoms or pills had a lower prevalence of sexually transmitted infections, while those who were unwilling to take RTI-related courses and changed their underwear less frequently were more likely to contract sexually transmitted infections. While women who were unwilling to take RTI-related courses had a lower prevalence of endogenous infections, those with more children had a higher prevalence. Conclusion: The status of RTIs among the internal-migrant population of reproductive-age is not optimistic and is related to multiple factors. We believe this study will contribute to improving the knowledge, attitude, and practices related to RTIs.
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Affiliation(s)
- Shuangfei Xu
- Key Lab of Reproduction Regulation of National Population and Family Planning Commission, Shanghai Institute of Planned Parenthood Research, Institute of Reproductive Development, Fudan University, Shanghai 210035, China.
- School of Public Health, Fudan University, Shanghai 200032, China.
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China.
| | - Chuanning Yu
- Longhua District Center for Chronic Disease Control (Mental Health Center), Shenzhen 518110, China.
| | - Ying Zhou
- Key Lab of Reproduction Regulation of National Population and Family Planning Commission, Shanghai Institute of Planned Parenthood Research, Institute of Reproductive Development, Fudan University, Shanghai 210035, China.
- School of Public Health, Fudan University, Shanghai 200032, China.
| | - Junqing Wu
- Key Lab of Reproduction Regulation of National Population and Family Planning Commission, Shanghai Institute of Planned Parenthood Research, Institute of Reproductive Development, Fudan University, Shanghai 210035, China.
- School of Public Health, Fudan University, Shanghai 200032, China.
| | - Tieling Bai
- Family Planning and Reproductive Health Instructing Center of Ningxia Hui Autonomous Region, Yinchuan 750000, China.
| | - Junxian Zhang
- Family Planning Publicity and Education Technical Advising Center of Urumchi, Urumchi 830092, China.
| | - Yuyan Li
- Key Lab of Reproduction Regulation of National Population and Family Planning Commission, Shanghai Institute of Planned Parenthood Research, Institute of Reproductive Development, Fudan University, Shanghai 210035, China.
- School of Public Health, Fudan University, Shanghai 200032, China.
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10
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Borhani Zarandi M, Nourollahi Fard SR, Parastouei K, Ahmadi A. Causative Agents of Vaginitis in Women of Kerman Province, Iran. JOURNAL OF MEDICAL MICROBIOLOGY AND INFECTIOUS DISEASES 2019. [DOI: 10.29252/jommid.7.1.2.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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11
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Feng RM, Z Wang M, Smith JS, Dong L, Chen F, Pan QJ, Zhang X, Qiao YL, Zhao FH. Risk of high-risk human papillomavirus infection and cervical precancerous lesions with past or current trichomonas infection: a pooled analysis of 25,054 women in rural China. J Clin Virol 2017; 99-100:84-90. [PMID: 29396352 DOI: 10.1016/j.jcv.2017.12.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 12/06/2017] [Accepted: 12/29/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Trichomonas vaginitis (TV) infection has obviously been implicated in gynecological morbidity but still unclear in cervical lesions. OBJECTIVE To evaluate the risk of hr-HPV infection and cervical intraepithelial neoplasia grade 2 or worse (CIN2 + ) by TV infection. STUDY DESIGN The pooled study was conducted among 12 population-based, cervical cancer screening studies throughout China (N = 24,054). HPV was detected by Hybrid Capture®2 (HC2) test. Past TV infection was measured by self-reporting, current TV infection was diagnosed by liquid-based cytology (LBC), cervical lesions was diagnosed by histopathology. RESULTS Respective prevalence of hr-HPV and CIN2+ were 17.4% and 3.3%. Out of 24,054 women, 14.6% reported past TV infection, and out of 11,853 women, 9.9% had current TV infection. Current TV-positive women had an increased risk for hr-HPV (OR 1.31, 95%CI: 1.11-1.56). The risk of CIN2+ decreased for hr-HPV positive women with current TV infection (adjusted OR 0.50, 95% CI: 0.30-0.84) and past TV infection (adjusted OR 0.68, 95% CI: 0.54-0.86). Among hr-HPV negative women, no significant associations were observed between past or current TV infection and risk of CIN2+. CONCLUSIONS Women infected with HPV are more likely to be infected by other types of sexually transmitted diseases. Current TV-positive women had an increased risk for hr-HPV infection compared to currently TV-negative women. Both past and current TV-positive women had a decreased risk for CIN2+, especially among high-risk HPV positive women. More direct investigation into the interaction between TV, HPV, inflammatory signals, and risk of carcinogenesis are further needed.
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Affiliation(s)
- Rui-Mei Feng
- Department of Epidemiology, National Cancer Center, Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College (PUMC), Beijing, China; Department of Cancer Prevention center, Sun Yat-Sen University Cancer Center, Guangzhou, China; State Key Laboratory of Oncology in South China,Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Margaret Z Wang
- Pritzker School of Medicine, University of Chicago, Chicago, Illinois, USA; UJMT Fogarty Consortium, NIH Fogarty International Center, Bethesda, MD, USA
| | - Jennifer S Smith
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA; UNC Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA
| | - Li Dong
- Department of Epidemiology, National Cancer Center, Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College (PUMC), Beijing, China; Institutes of Biomedical Sciences, Shanxi University, Taiyuan, China
| | - Feng Chen
- Department of Epidemiology, National Cancer Center, Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College (PUMC), Beijing, China
| | - Qin-Jing Pan
- Department of Epidemiology, National Cancer Center, Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College (PUMC), Beijing, China
| | - Xun Zhang
- Department of Pathology, National Cancer Center, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - You-Lin Qiao
- Department of Epidemiology, National Cancer Center, Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College (PUMC), Beijing, China
| | - Fang-Hui Zhao
- Department of Epidemiology, National Cancer Center, Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College (PUMC), Beijing, China.
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12
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Lokken EM, Balkus JE, Kiarie J, Hughes JP, Jaoko W, Totten PA, McClelland RS, Manhart LE. Association of Recent Bacterial Vaginosis With Acquisition of Mycoplasma genitalium. Am J Epidemiol 2017; 186:194-201. [PMID: 28472225 DOI: 10.1093/aje/kwx043] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 08/19/2016] [Indexed: 11/14/2022] Open
Abstract
We assessed the association between recent bacterial vaginosis (BV) and incident Mycoplasma genitalium, a sexually transmitted bacterium associated with adverse female reproductive health outcomes. Female sex workers in Mombasa, Kenya, completed a monthly sexual behavior interview and clinical examination. During February 2005-February 2006, vaginal fluid specimens collected from women every other month were tested for M. genitalium by nucleic acid amplification testing. Vaginal microbiota were assessed monthly and categorized by Nugent score (0-3 = normal microbiota, 4-6 = intermediate microbiota disruption, and 7-10 = BV). A discrete failure time analysis for multiple events using logistic regression was employed to estimate the odds of incident M. genitalium infection at follow-up visits among women with BV (vs. normal microbiota) at the preceding visit. Among the 280 women, 54.3% were positive for human immunodeficiency virus. At baseline, 16.1% had prevalent M. genitalium infection and 40.4% had prevalent BV. There were 59 incident M. genitalium infections among 50 women, for an incidence rate of 34.6 cases per 100 person-years. Following adjustment for age, human immunodeficiency virus status, and time, prior BV was associated with a 3.5-fold increase in odds of incident M. genitalium (adjusted odds ratio = 3.49, 95% confidence interval: 1.86, 6.56). This strong association suggests that BV may enhance susceptibility to M. genitalium infection.
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13
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Joo SY, Goo YK, Ryu JS, Lee SE, Lee WK, Chung DI, Hong Y. Epidemiology of Trichomoniasis in South Korea and Increasing Trend in Incidence, Health Insurance Review and Assessment 2009-2014. PLoS One 2016; 11:e0167938. [PMID: 27936227 PMCID: PMC5148063 DOI: 10.1371/journal.pone.0167938] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 11/22/2016] [Indexed: 11/17/2022] Open
Abstract
Trichomoniasis, which is caused by Trichomonas vaginalis, is one of the most common non-viral sexually transmitted infections; however, limited population-based data are available that describe patterns and trends of the disease. We summarized insurance claims of trichomoniasis cases reported during 2009-2014 to South Korea Health Insurance Review and Assessment Service. The average annual incidence in South Korea was 276.8 persons per 100,000 population, and a substantial sex-associated variation was observed. The incidence rate among female subjects trended upward over 6 years, that is, it increased from 501 in 2009 to 625.8 in 2014 per 100,000 female population, which indicates a 25% overall increase. This trend was sharpest in the ≥60 years group of female population. However, a 66% decrease in incidence rates was observed among male subjects (23.7 in 2009 to 15.7 in 2014 per 100,000 male population). Further, substantial decrease was observed in the ≥40 years groups of male population. The incidence of trichomoniasis varied across regions and was the highest in Jeju province of South Korea. Overall, as the incidence of trichomoniasis appears to have increased in South Korea during 2009-2014, the disease burden is increasing; hence, there is a need to better understand the disease transmission.
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Affiliation(s)
- So-Young Joo
- Department of Parasitology and Tropical Medicine, Kyungpook National University School of Medicine, Daegu, Republic of Korea
| | - Youn-Kyoung Goo
- Department of Parasitology and Tropical Medicine, Kyungpook National University School of Medicine, Daegu, Republic of Korea
| | - Jae-Sook Ryu
- Department of Environmental Biology and Medical Parasitology, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Sang-Eun Lee
- Division of Malaria and Parasitic Diseases, Korea National Institute of Health, Korea Centers for Diseases Control and Prevention, Osong, Republic of Korea
| | - Won Kee Lee
- Medical Research Collaboration Center in KNUH, Kyungpook National University School of Medicine, Daegu, Republic of Korea
| | - Dong-Il Chung
- Department of Parasitology and Tropical Medicine, Kyungpook National University School of Medicine, Daegu, Republic of Korea
| | - Yeonchul Hong
- Department of Parasitology and Tropical Medicine, Kyungpook National University School of Medicine, Daegu, Republic of Korea
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14
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Shahinfar S, Nemanpour B. The Relationship Between Contraceptive Methods and Common Vaginal Infections. WOMEN’S HEALTH BULLETIN 2016. [DOI: 10.17795/whb.40793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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15
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Wiesen E, Diorditsa S, Li X. Progress towards hepatitis B prevention through vaccination in the Western Pacific, 1990-2014. Vaccine 2016; 34:2855-62. [PMID: 27020710 DOI: 10.1016/j.vaccine.2016.03.060] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 03/14/2016] [Accepted: 03/18/2016] [Indexed: 12/17/2022]
Abstract
Hepatitis B infections are responsible for more than 300 thousand deaths per year in the Western Pacific Region. Because of this high burden, the countries and areas of the Region established a goal of reducing hepatitis B chronic infection prevalence among children to less than 1% by 2017. This study was conducted to measure the progress in hepatitis B prevention and assess the status of achievement of the 2017 Regional hepatitis B control goal. A literature review was conducted to identify studies of hepatitis B prevalence in the countries and areas of the region, both before and after vaccine introduction. A mathematical model was applied to assess infections and deaths prevented by hepatitis B vaccination and hepatitis B prevalence in countries without recent empirical data. The majority of countries and areas (22 out of 36) were estimated to have over 8% prevalence of chronic hepatitis B infection among persons born before vaccine introduction. After introduction of hepatitis B vaccine, most countries and areas (24 out of 36) had chronic infection prevalence of less than 1% among children born after vaccine introduction. It was estimated that in the past 25 years immunization programmes in the Western Pacific Region have averted 7,167,128 deaths that would have occurred in the lifetime of children born between 1990 and 2014 if hepatitis B vaccination programmes had not been established. Regional prevalence among children born in 2012 was estimated to be 0.93%, meaning that the Regional hepatitis B control goal was achieved. While additional efforts are needed to further reduce hepatitis B transmission in the region, this study demonstrates the great success of the hepatitis B vaccination efforts in the Western Pacific Region.
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Affiliation(s)
- Eric Wiesen
- World Health Organization Western Pacific Regional Office, Philippines
| | - Sergey Diorditsa
- World Health Organization Western Pacific Regional Office, Philippines
| | - Xi Li
- Consultant to World Health Organization Western Pacific Regional Office, Philippines.
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16
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Su S, Chow EPF, Muessig KE, Yuan L, Tucker JD, Zhang X, Ren J, Fairley CK, Jing J, Zhang L. Sustained high prevalence of viral hepatitis and sexually transmissible infections among female sex workers in China: a systematic review and meta-analysis. BMC Infect Dis 2016; 16:2. [PMID: 26732281 PMCID: PMC4702370 DOI: 10.1186/s12879-015-1322-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Accepted: 12/12/2015] [Indexed: 02/06/2023] Open
Abstract
Background The 1980’s economic boom has been associated with a rapid expansion of China’s sex industry over the past three decades. Consequently, the spread of sexually transmitted infections (STIs) and hepatitis infections among female sex workers (FSW) has become an important public health issue in China. This study identifies prevalence and risks of hepatitis and STIs in Chinese FSWs. Method Four electronic databases were searched for Chinese and English language peer-reviewed studies conducted between 01/2000-12/2011 that reported prevalence of hepatitis and STIs (excluding HIV) among Chinese FSW. Following the PRISMA guidelines, meta-analysis was used to estimate pooled prevalence and 95 % confidence intervals for each infection. Result Three hundred and thirty nine articles (34 in English and 305 in Chinese) investigating 603,647 FSWs in 29 Chinese provinces were included in this review. Over the period 2000–2011, the seroprevalence of active hepatitis B and hepatitis C among FSW were 10.7 % (7.3–15.5 %) and 1.0 % (0.7–1.3 %), respectively. The most prevalent STI was human papillomavirus (HPV, 27.0 % [10.1–55.1 %]), followed by herpes simplex virus-2 (HSV-2, 15.8 % [11.7–20.9 %]), chlamydia (13.7 % [12.1–15.4 %]), gonorrhoea (6.1 % [5.3–7.0 %]), syphilis (5.2 % [4.8–5.7 %]), genital warts (3.3 % [2.5–4.2 %]) and Trichomonas vaginitis (2.1 % [1.5–24.2 %]). Disease burden of both hepatitis and STI among FSW were concentrated in South Central and Southwest China. In particular, chlamydia and syphilis demonstrated a significant declining trend during the studied period (P < 0.05). Compared with the general Chinese population, FSW had significantly higher prevalence of all STIs except Trichomonas vaginitis. Further, compared to the general FSW population, HIV-positive FSW had significantly higher prevalence of syphilis, chlamydia, HSV-2 and Trichomonas vaginitis. Conclusion Prevalence of hepatitis and STIs remained high and mostly stable among Chinese FSW over the period of 2000–2011. Targeted STI and hepatitis surveillance and interventions should be strengthened among Chinese FSWs, especially those who are HIV-positive. Electronic supplementary material The online version of this article (doi:10.1186/s12879-015-1322-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Shu Su
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.
| | - Eric P F Chow
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia. .,Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.
| | - Kathryn E Muessig
- The University of North Carolina Project-China, Guangzhou, China. .,Department of Health Behaviour, Gillings School of Global Public Health at the University of North Carolina at Chapel Hill, Chapel Hill, USA.
| | - Lei Yuan
- The School of Sociology and Population Studies, Renmin University of China, Beijing, China.
| | - Joseph D Tucker
- The University of North Carolina Project-China, Guangzhou, China. .,London School of Hygiene and Tropical Medicine, London, UK.
| | - Xiaohu Zhang
- China Food and Drug Administration Institute of Executive Development, Beijing, China. .,Research Center for Public Health, School of Medicine, Tsinghua University, Beijing, China.
| | - Jiehui Ren
- The School of Sociology, Tsinghua University, Beijing, China.
| | - Christopher K Fairley
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia. .,Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.
| | - Jun Jing
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia. .,Research Center for Public Health, School of Medicine, Tsinghua University, Beijing, China.
| | - Lei Zhang
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia. .,Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia. .,Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia. .,Research Center for Public Health, School of Medicine, Tsinghua University, Beijing, China.
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17
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Kissinger P. Trichomonas vaginalis: a review of epidemiologic, clinical and treatment issues. BMC Infect Dis 2015; 15:307. [PMID: 26242185 PMCID: PMC4525749 DOI: 10.1186/s12879-015-1055-0] [Citation(s) in RCA: 185] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 07/22/2015] [Indexed: 12/28/2022] Open
Abstract
Trichomonas vaginalis (TV) is likely the most common non-viral sexually transmitted infection (STI) in the world. It is as an important source of reproductive morbidity, a facilitator of HIV transmission and acquisition, and thus it is an important public health problem. Despite its importance in human reproductive health and HIV transmission, it is not a reportable disease and surveillance is not generally done. This is problematic since most persons infected with TV are asymptomatic. Metronidazole (MTZ) has been the treatment of choice for women for decades, and single dose has been considered the first line of therapy. However, high rates of retest positive are found among TV infected persons after single dose MTZ treatment. This has not been explained by drug resistance since in vitro resistance is only 2-5 %. Treatment failure can range from 7-10 % and even higher among HIV+ women. Treatment efficacy may be influenced by vaginal ecology. The origins of repeat positives need further explanation and better treatment options are needed.
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Affiliation(s)
- Patricia Kissinger
- School of Public Health and Tropical Medicine, Tulane University, 1440 Canal Street Suite 2004, New Orleans, Louisiana, 70112, USA.
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18
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Li X, Wiesen E, Diorditsa S, Toda K, Duong TH, Nguyen LH, Nguyen VC, Nguyen TH. Impact of Adverse Events Following Immunization in Viet Nam in 2013 on chronic hepatitis B infection. Vaccine 2015; 34:869-73. [PMID: 26055296 PMCID: PMC5357724 DOI: 10.1016/j.vaccine.2015.05.067] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 05/13/2015] [Accepted: 05/26/2015] [Indexed: 12/17/2022]
Abstract
Adverse Events Following Immunization in Viet Nam in 2013 led to substantial reductions in hepatitis B vaccination coverage (both the birth dose and the three-dose series). In order to estimate the impact of the reduction in vaccination coverage on hepatitis B transmission and future mortality, a widely-used mathematical model was applied to the data from Viet Nam. Using the model, we estimated the number of chronic infections and deaths that are expected to occur in the birth cohort in 2013 and the number of excessive infections and deaths attributable to the drop in immunization coverage in 2013. An excess of 90,137 chronic infections and 17,456 future deaths were estimated to occur in the 2013 birth cohort due to the drop in vaccination coverage. This analysis highlights the importance of maintaining high vaccination coverage and swiftly responding to reported Adverse Events Following Immunization in order to regain consumer confidence in the hepatitis B vaccine.
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Affiliation(s)
- Xi Li
- Johns Hopkins University, Candidate for Master of Science in Public Health, 615 N. Wolfe St., Baltimore, MD 21205, United States
| | - Eric Wiesen
- Expanded Programme on Immunization Unit, World Health Organization, Western Pacific Regional Office, PO Box 2932, Manila, Philippines.
| | - Sergey Diorditsa
- Expanded Programme on Immunization Unit, World Health Organization, Western Pacific Regional Office, PO Box 2932, Manila, Philippines
| | - Kohei Toda
- Expanded Programme on Immunization Unit, World Health Organization Country Office, 63 Tran Hung Dao Street, Hoan Kiem District, Ha Noi, Viet Nam
| | - Thi Hong Duong
- National Institute of Hygiene and Epidemiology, 1 Yersin Street, Hai Ba Trung, Ha Noi 10000, Viet Nam
| | - Lien Huong Nguyen
- National Institute of Hygiene and Epidemiology, 1 Yersin Street, Hai Ba Trung, Ha Noi 10000, Viet Nam
| | - Van Cuong Nguyen
- National Institute of Hygiene and Epidemiology, 1 Yersin Street, Hai Ba Trung, Ha Noi 10000, Viet Nam
| | - Tran Hien Nguyen
- National Institute of Hygiene and Epidemiology, 1 Yersin Street, Hai Ba Trung, Ha Noi 10000, Viet Nam
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19
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Abstract
Trichomonas vaginalis is the most common nonviral sexually transmitted infection (STI) in the world. It was once thought to be a nuisance STI, but it is now being recognized as an important source of reproductive morbidity and a facilitator of HIV transmission and acquisition, and thus it is an important public health problem. The prevalence of T. vaginalis varies greatly by geography and risk group, but is more common among persons of African descent and appears to increase with age, though this may be a screening phenomenon. Wet mount and culture are simple diagnostics, but have lower sensitivity than nucleic acid amplification techniques presently approved for women only. Single dose (2 g) metronidazole (MTZ) for both the index patient and their sexual partners is the preferred treatment. High rates of retest positivity are found after single-dose treatment which are likely due to clinical resistance rather than re-infection and/or drug resistance.
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Affiliation(s)
- Patricia Kissinger
- School of Public Health and Tropical Medicine, Tulane University, 1440 Canal Street SL-18, New Orleans, LA, 70112, USA,
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20
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Lan PT, Phuc HD, Hoa NQ, Chuc NTK, Lundborg CS. Improved knowledge and reported practice regarding sexually transmitted infections among healthcare providers in rural Vietnam: a cluster randomised controlled educational intervention. BMC Infect Dis 2014; 14:646. [PMID: 25471366 PMCID: PMC4263008 DOI: 10.1186/s12879-014-0646-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 11/20/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Healthcare providers (HCPs) play a critical role in controlling the spread of sexually transmitted infections (STI) through early and accurate diagnosis, appropriate treatment and prevention counselling. This study aimed to assess the effectiveness of an educational intervention about STI on knowledge and reported practice among HCPs and to explore which determinants may influence the intervention's effects. METHODS A cluster randomized controlled educational intervention was carried out in a rural district, Vietnam. 32 communes of the district were randomized into two arms, with 160 HCPs in an STI intervention arm and 144 in a control arm. The STI intervention comprised interactive training with basic STI knowledge, case scenarios, and poster distribution. Questionnaires to evaluate knowledge and reported practice were completed three times: before, during and after the intervention. Correct answer was scored as 1; "do not know", incorrect answer was scored as 0. Univariate and multilevel multivariate analyses were applied. RESULTS Of the maximum 56 points, the mean knowledge score increased significantly in the STI intervention arm and in the control arm post-intervention (37.2 to 48.4, and 32.7 to 41.7, respectively). In multivariate regression analysis, knowledge improvement in the intervention arm was significantly higher than that in the control arm (regression coefficient = 2.97, p = 0.008). Other factors which positively influenced the increase in knowledge were being between 35 and 50 years old, having intermediate professional training, being a pharmacist or working at a village level (regression coefficient: 2.81, 4.43, 5.53 and 7.91, respectively). Post-intervention, the mean reported practice score increased significantly in the STI intervention arm (from 17.6 to 21.8) and insignificantly in the control arm (maximum 36 points). Factors which positively influenced the increase in reported practice were being between 35 and 50 years old, having intermediate professional training, or working at a pharmacy/drugstore (regression coefficient: 2.15, 3.33 and 3.22, respectively). CONCLUSIONS This study indicates that an educational intervention including interactive training and multi-faceted interventions may be effective in improving STI knowledge and reported practice of HCPs at grassroots level, particularly among pharmacists, HCPs who work in villages or pharmacies/drugstores, and who initially have low STI knowledge.
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Affiliation(s)
- Pham Thi Lan
- Hanoi Medical University, Hanoi, Vietnam. .,Global Health (IHCAR), Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
| | | | - Nguyen Quynh Hoa
- Global Health (IHCAR), Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden. .,National Cancer Hospital, Hanoi, Vietnam.
| | | | - Cecilia Stålsby Lundborg
- Global Health (IHCAR), Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
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21
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Abstract
There is some evidence that the risk of HIV infection per heterosexual act is higher in low-income countries than in high-income countries. We hypothesize that variations in per sex-act transmission probability of HIV may in part be attributed to differences in the composition and function of the vaginal microbiota between different populations. This paper presents data that are in support of this hypothesis. Experimental and clinical studies have provided evidence that the normal vaginal microbiota plays a protective role against acquisition of HIV and other sexually transmitted infections. Epidemiological studies have convincingly shown that disturbances of the vaginal microbiome, namely intermediate flora and bacterial vaginosis, increase the risk of acquisition of HIV infection. A review of the literature found large differences in prevalence of bacterial vaginosis between different populations, with the highest prevalence rates found in black populations. Possible explanations for these differences are presented including data suggesting that there are ethnic differences in the composition of the normal vaginal microbiota. Lastly, interventions are discussed to restore and maintain a healthy vaginal environment.
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22
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Nielsen A, Lan PT, Marrone G, Phuc HD, Chuc NTK, Stålsby Lundborg C. Reproductive Tract Infections in Rural Vietnam, Women's Knowledge, and Health-Seeking Behavior: A Cross-Sectional Study. Health Care Women Int 2014; 37:392-411. [PMID: 24850497 DOI: 10.1080/07399332.2014.920021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
We interviewed 1,805 women in a rural setting in Vietnam with the aim of investigating women's knowledge regarding reproductive tract infections (RTIs) and their health-seeking behavior. We found that women's overall knowledge was poor. Furthermore, only one-third of the symptomatic women sought health care. RTIs affect millions of women globally each year. Most vulnerable are women in low- and middle-income countries where poverty and gender inequities affect their access to health care services. Findings from our study can be used in similar rural settings worldwide to understand and manage the widespread problem of RTIs.
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Affiliation(s)
- Anna Nielsen
- a Division of Global Health (IHCAR), Department of Public Health Sciences, Karolinska Institutet , Stockholm , Sweden
| | - Pham Thi Lan
- a Division of Global Health (IHCAR), Department of Public Health Sciences, Karolinska Institutet , Stockholm , Sweden.,b Hanoi Medical University , Hanoi , Vietnam
| | - Gaetano Marrone
- a Division of Global Health (IHCAR), Department of Public Health Sciences, Karolinska Institutet , Stockholm , Sweden
| | - Ho Dang Phuc
- c Department of Probability and Mathematical Statistics , Institute of Mathematics, Vietnam Academy of Science and Technology , Hanoi , Vietnam
| | | | - Cecilia Stålsby Lundborg
- a Division of Global Health (IHCAR), Department of Public Health Sciences, Karolinska Institutet , Stockholm , Sweden
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23
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Kenyon C, Colebunders R, Crucitti T. The global epidemiology of bacterial vaginosis: a systematic review. Am J Obstet Gynecol 2013; 209:505-23. [PMID: 23659989 DOI: 10.1016/j.ajog.2013.05.006] [Citation(s) in RCA: 240] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Revised: 03/12/2013] [Accepted: 05/02/2013] [Indexed: 11/20/2022]
Abstract
Bacterial vaginosis (BV) enhances the acquisition and transmission of a range of sexually transmitted infections including human immunodeficiency virus. This has made it more important to uncover the reasons why some populations have very high BV prevalences and others not. This systematic review describes the global epidemiology of BV. It summarizes data from peer-reviewed publications detailing the population prevalence of BV as diagnosed by a standardized and reproducible methodology-Nugent scoring system. BV variations between countries, and between ethnic groups within countries, are described. We evaluated 1692 English- and non-English-language articles describing the prevalence of BV using MEDLINE and the Web of Science databases. A total of 86 articles met our inclusion criteria. BV prevalences were found to vary considerably between ethnic groups in North America, South America, Europe, the Middle East, and Asia. Although BV prevalence is, in general, highest in parts of Africa and lowest in much of Asia and Europe, some populations in Africa have very low BV prevalences and some in Asia and Europe have high rates.
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Affiliation(s)
- Chris Kenyon
- HIV/STD Unit, Institute of Tropical Medicine, Antwerp, Belgium; Division of Infectious Diseases and HIV Medicine, University of Cape Town, Cape Town, South Africa.
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Arthur S, Bangha M, Sankoh O. Review of contributions from HDSSs to research in sexual and reproductive health in low- and middle-income countries. Trop Med Int Health 2013; 18:1463-87. [DOI: 10.1111/tmi.12209] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | | | - Osman Sankoh
- INDEPTH Network; Accra Ghana
- School of Public Health; University of the Witwatersrand; Johannesburg South Africa
- Faculty of Public Health; Hanoi Medical University; Hanoi Vietnam
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Mujeres inmigrantes versus autóctonas. Diferencias en disfunciones sexuales, infecciones vaginales y lesiones cervicales. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2013. [DOI: 10.1016/j.gine.2012.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Hormonal contraception decreases bacterial vaginosis but oral contraception may increase candidiasis: implications for HIV transmission. AIDS 2013; 27:2141-53. [PMID: 23660575 DOI: 10.1097/qad.0b013e32836290b6] [Citation(s) in RCA: 103] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE A 2012 WHO consultation concluded that combined oral contraception (COC) does not increase HIV acquisition in women, but the evidence for depot medroxyprogesterone acetate (DMPA) is conflicting. We evaluated the effect of COC and DMPA use on the vaginal microbiome because current evidence suggests that any deviation from a 'healthy' vaginal microbiome increases women's susceptibility to HIV. METHODS We conducted a systematic review and reanalysed the Hormonal Contraception and HIV Acquisition (HC-HIV) study. Vaginal microbiome outcomes included bacterial vaginosis by Nugent scoring, vaginal candidiasis by culture or KOH wet mount and microbiome compositions as characterized by molecular techniques. RESULTS Our review of 36 eligible studies found that COC and DMPA use reduce bacterial vaginosis by 10-20 and 18-30%, respectively. The HC-HIV data showed that COC and DMPA use also reduce intermediate microbiota (Nugent score of 4-6) by 11% each. In contrast, COC use (but not DMPA use) may increase vaginal candidiasis. Molecular vaginal microbiome studies (n=4) confirm that high oestrogen levels favour a vaginal microbiome composition dominated by 'healthy' Lactobacillus species; the effects of progesterone are less clear and not well studied. CONCLUSION DMPA use does not increase HIV risk by increasing bacterial vaginosis or vaginal candidiasis. COC use may predispose for vaginal candidiasis, but is not believed to be associated with increased HIV acquisition. However, the potential role of Candida species, and vaginal microbiome imbalances other than bacterial vaginosis or Candida species, in HIV transmission cannot yet be ruled out. Further in-depth molecular studies are needed.
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Olsen B, Pham TL, Golparian D, Johansson E, Tran HK, Unemo M. Antimicrobial susceptibility and genetic characteristics of Neisseria gonorrhoeae isolates from Vietnam, 2011. BMC Infect Dis 2013; 13:40. [PMID: 23351067 PMCID: PMC3574855 DOI: 10.1186/1471-2334-13-40] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Accepted: 01/17/2013] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Antimicrobial resistance (AMR) in Neisseria gonorrhoeae is a major public health concern worldwide. In Vietnam, knowledge regarding N. gonorrhoeae prevalence and AMR is limited, and data concerning genetic characteristics of N. gonorrhoeae is totally lacking. Herein, we investigated the phenotypic AMR (previous, current and possible future treatment options), genetic resistance determinants for extended-spectrum cephalosporins (ESCs), and genotypic distribution of N. gonorrhoeae isolated in 2011 in Hanoi, Vietnam. METHODS N. gonorrhoeae isolates from Hanoi, Vietnam isolated in 2011 (n = 108) were examined using antibiograms (Etest for 10 antimicrobials), Neisseria gonorrhoeae multi-antigen sequence typing (NG-MAST), and sequencing of ESC resistance determinants (penA, mtrR and penB). RESULTS The levels of in vitro resistance were as follows: ciprofloxacin 98%, tetracycline 82%, penicillin G 48%, azithromycin 11%, ceftriaxone 5%, cefixime 1%, and spectinomycin 0%. The MICs of gentamicin (0.023-6 mg/L), ertapenem (0.002-0.125 mg/L) and solithromycin (<0.016-0.25 mg/L) were relatively low. No penA mosaic alleles were found, however, 78% of the isolates contained an alteration of amino acid A501 (A501V (44%) and A501T (34%)) in the encoded penicillin-binding protein 2. A single nucleotide (A) deletion in the inverted repeat of the promoter region of the mtrR gene and amino acid alterations in MtrR was observed in 91% and 94% of the isolates, respectively. penB resistance determinants were detected in 87% of the isolates. Seventy-five different NG-MAST STs were identified, of which 59 STs have not been previously described. CONCLUSIONS In Vietnam, the highly diversified gonococcal population displayed high in vitro resistance to antimicrobials previously recommended for gonorrhoea treatment (with exception of spectinomycin), but resistance also to the currently recommended ESCs were found. Nevertheless, the MICs of three potential future treatment options were low. It is essential to strengthen the diagnostics, case reporting, and epidemiologic surveillance of gonorrhoea in Vietnam. Furthermore, the surveillance of gonococcal AMR and gonorrhoea treatment failures is imperative to reinforce. Research regarding novel antimicrobial treatment strategies (e.g., combination therapy) and new antimicrobials is crucial for future treatment of gonorrhoea.
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Affiliation(s)
- Birgitta Olsen
- School of Health and Medical Sciences, Örebro University, Örebro, Sweden
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Patel H, Wagner M, Singhal P, Kothari S. Systematic review of the incidence and prevalence of genital warts. BMC Infect Dis 2013; 13:39. [PMID: 23347441 PMCID: PMC3618302 DOI: 10.1186/1471-2334-13-39] [Citation(s) in RCA: 211] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Accepted: 01/16/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Anogenital warts (AGWs) are a common, highly infectious disease caused by the human papillomavirus (HPV), whose high recurrence rates contribute to direct medical costs, productivity loss and increased psychosocial impact. Because of the lack of a systematic review of the epidemiology of AGWs in the literature, this study reviewed the published medical literature on the incidence and prevalence of AGWs. METHODS A comprehensive literature search was performed on the worldwide incidence and prevalence of AGWs between 2001 and 2012 using the PubMed and EMBASE databases. An additional screening of abstracts from relevant sexual health and infectious disease conferences from 2009 to 2011 was also conducted. Only original studies with general adult populations (i.e., at least including ages 20 through 40 years) were included. RESULTS The overall (females and males combined) reported annual incidence of any AGWs (including new and recurrent) ranged from 160 to 289 per 100,000, with a median of 194.5 per 100,000. New AGW incidence rates among males ranged from 103 to 168 per 100,000, with a median of 137 per 100,000 and among females from 76 to 191 per 100,000, with a median of 120.5 per 100,000 per annum. The reported incidence of recurrent AGWs was as high as 110 per 100,000 among females and 163 per 100,000 among males. Incidence peaked before 24 years of age in females and between 25 and 29 years of age among males. The overall prevalence of AGWs based on retrospective administrative databases or medical chart reviews or prospectively collected physician reports ranged from 0.13% to 0.56%, whereas it ranged from 0.2% to 5.1% based on genital examinations. CONCLUSIONS The literature suggests that AGWs are widespread and the prevalence depends on study methodology as suggested by higher rates reported from routine genital examinations versus those from treatment records. However, there remains a need for more population-based studies from certain regions including Africa, Latin America and Southern Asia to further elucidate the global epidemiology of this disease.
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Affiliation(s)
- Harshila Patel
- LA-SER Analytics, 1405 TransCanada Highway, Suite 310, Montréal, Quebec H9P 2V9, Canada
| | - Monika Wagner
- LA-SER Analytics, 1405 TransCanada Highway, Suite 310, Montréal, Quebec H9P 2V9, Canada
| | - Puneet Singhal
- Merck & Co., Inc. Global Health Outcomes, Whitehouse Station, NJ, USA
| | - Smita Kothari
- Merck & Co., Inc. Global Health Outcomes, Whitehouse Station, NJ, USA
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Bahram A, Hamid B, Zohre T. Prevalence of bacterial vaginosis and impact of genital hygiene practices in non-pregnant women in zanjan, iran. Oman Med J 2012; 24:288-93. [PMID: 22216382 DOI: 10.5001/omj.2009.58] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2009] [Accepted: 08/09/2009] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Bacterial vaginosis is one of the most common causes of reproductive tract infection (RTI), it's prevalence is influenced by many factors. The aim of this study is to determine the prevalence of bacterial vaginosis and impact of sexual and genital hygienie practices and socio-demographic characteristics in non pregnant women of Zanjan province in Iran. METHODS 500 non-pregnant, married women were randomly selected for this study. This is a descriptive-analytic study conducted among non-pregnant referred to primry healthcare centres in Zanjan between May to August 2006. Following gynecological examination and vaginal sample collection by physicians, bacterial vaginosis was confirmed by Nugent criteria, tricomoniasis by direct microscopy and candidiasis by direct microscopic observation and evaluation of presenting clinical signs of vulvovaginitis. RESULTS The prevalence of RTI was 27.6%. Out of which 16.2% was devoted to bacterial vaginosis (BV), 6.6% to trichomoniasis and 4.8% to Vulvovaginal candidiasis (VVC). In contrast to coital hygiene, there was a significant correlation between menstrual and individual vaginal hygiene and BV (p<0.01 and p<0.001) respectively. There was a significant correlation between BV and education (p<0.025), number of pregnancy (p<0.05) and method of contraception (p<0.005). No significant correlation was observed between age, age of marriage and abortion. CONCLUSION The data obtained suggests that the prevalence rate of BV is relatively high and could be affected by hygiene behaviors and certain socio-demographic characteristics, which indicate the need for comprehensive, scheduled programs of healthcare educations, aimed at reducing BV prevalence.
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Evaluation of three adolescent sexual health programs in ha noi and khanh hoa province, Vietnam. AIDS Res Treat 2012; 2012:986978. [PMID: 22666565 PMCID: PMC3362850 DOI: 10.1155/2012/986978] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2012] [Accepted: 03/14/2012] [Indexed: 12/04/2022] Open
Abstract
With an increase in sexual activity among young adults in Vietnam and associated risks, there is a need for evidence-based sexual health interventions. This evaluation of three sexual health programs based on the Protection Motivation Theory (PMT) was conducted in 12 communes in Ha Noi, Nha Trang City, and Ninh Hoa District. Inclusion criteria included unmarried youth 15–20 years residing in selected communes. Communes were randomly allocated to an intervention, and participants were randomly selected within each commune. The intervention programs included Vietnamese Focus on Kids (VFOK), the gender-based program Exploring the World of Adolescents (EWA), and EWA plus parental and health provider education (EWA+). Programs were delivered over a ten-week period in the communities by locally trained facilitators. The gender-based EWA program with parental involvement (EWA+) compared to VFOK showed significantly greater increase in knowledge. EWA+ in comparison to VFOK also showed significant decrease at immediate postintervention for intention to have sex. Sustained changes are observed in all three interventions for self-efficacy condom use, self-efficacy abstinence, response efficacy for condoms, extrinsic rewards, and perceived vulnerability for HIV. These findings suggest that theory-based community programs contribute to sustained changes in knowledge and attitudes regarding sexual risk among Vietnamese adolescents.
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Abstract
OBJECTS Chlamydia (Chlamydia trachomatis) is a common sexually transmitted infection that places a heavy burden on women and neonatal health. To avoid severe sequelae such as female infertility, ectopic pregnancy, neonatal infection, such as ophthalmitis, and chronic pelvic pain prompt and appropriate antibiotic treatment seems the best policy in treating this group of patients. However, adequate treatment is not easy because many factors can interfere with an early and rapid identification of Chlamydia infection, including complicated mixed microflora of the vagina and cervix, a nonuser-friendly detection system, and the time required for identification, even with the combination of specific complaints and a high level of clinical alertness. When dealing with a female patient in a point-of-care (POC) clinic, we need to find the best strategy to provide the most efficient way to detect this infection. MATERIALS AND METHODS Totally five traditional methods and advanced technologies used for the diagnosis of Chlamydia infection in women were reviewed. A criterion proposed by World Health Organization with an acronym of ASSURED, representing affordable price, high sensitivity, high specificity, user-friendly design, rapid process, minimal equipment, and delivered-or-not, was used to reexamine these tools if they are the best tools. A multiplexed microchip-based immunoassay was evaluated as a potential tool. The ASSURED score was compared and a Chi-square test with a p value less than 0.05 was considered significant. RESULTS Traditional methods, such as symptoms approach, microscopic examination, and microorganism culture that have been broadly used once, are affordable, simple, and equipment-free but their relatively low sensitivity and specificity limit their use as a test of POC setting for these infected women. On the other hand, advanced technologies, such as antigen detection by immunoassay and nucleic acid amplification tests, have contributed to major progress in the diagnosis of Chlamydia because of its accuracy, convenience, and time saving. However, nucleic acid amplification tests are too expensive, so they cannot be accepted as a screening tool in a developing country. The only significant finding with p value less than 0.01 was achieved when a more sensitive immunoassay system developed successfully as a test of POC setting. CONCLUSIONS Eventually, advances in laboratory techniques will satisfy our needs to detect Chlamydia infection economically and instantly. Microarray chips might be a relatively rapid, easy, inexpensive, and sensitive tool to detect many pathogens, including Chlamydia, using a one-time vaginal sampling process, which might make a POC policy possible.
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Ngo AD, Hill PS. The use of reproductive healthcare at commune health stations in a changing health system in Vietnam. BMC Health Serv Res 2011; 11:237. [PMID: 21943073 PMCID: PMC3189878 DOI: 10.1186/1472-6963-11-237] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2010] [Accepted: 09/27/2011] [Indexed: 11/24/2022] Open
Abstract
Background With health sector reform in Vietnam moving towards greater pluralism, commune health stations (CHSs) have been subject to growing competition from private health services and increasing numbers of patients bypassing CHSs for higher-level health facilities. This study describes the pattern of reproductive health (RH) and family planning (FP) service utilization among women at CHSs and other health facilities, and explores socio-demographic determinants of RH service utilization at the CHS level. Methods This study was based on a cross-sectional survey conducted in Thua Thien Hue and Vinh Long provinces, using a multi-stage cluster sampling technique. Questionnaire-based interviews with 978 ever-married women at reproductive age provided data on socio-demographic characteristics, current use of FP methods, history of RH service use, and the health facility attended for their most recent services. Multiple logistic regression analyses were used to identify socio-demographic determinants of their use of CHS RH services. Results Eighty nine percent of ever-married women reported current use of birth control with 49% choosing intra-uterine device (IUD). Eighty nine percent of pregnant women attended facility-based antenatal care (ANC) with 62% having at least 3 check-ups during their latest pregnancy. Ninety one percent of mothers had their last delivery in a health facility. Seventy-one percent of respondents used CHS for IUD insertion, 55% for antenatal check-ups, and 77% gynecological examination. District and provincial/central hospitals dominated the provision of delivery service, used by 57% of mothers for their latest delivery. The percentage of women opting for private ANC services was reported at 35%, though the use of private delivery services was low (11%). Women who were farmers, earning a lower income, having more than 2 children, and living in a rural area were more likely than others to use ANC, delivery, and/or gynecological check-up services at the CHS. Conclusions Women choice of providers for FP and RH services that help them plan and protect their pregnancies is driven by socio-economic factors. While the CHS retains significant utilization rates, it is under challenge by preferences for hospital-based delivery and the growing use of private ANC services.
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Affiliation(s)
- Anh D Ngo
- Social Epidemiology and Evaluation Research Group, School of Health Sciences, University of South Australia, City East Campus, Adelaide, SA 5000, Australia.
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Abstract
Although it has been clear for more than 2 decades that bacterial vaginosis increases the risk for preterm birth in some women, it is not yet fully understood why this association exists or how best to modify the risk. Incomplete understanding of this polymicrobial condition and difficulties in classification contribute to the challenge. The relationship between altered vaginal microflora and preterm birth is likely mediated by host immune responses. Because treatment of bacterial vaginosis during pregnancy does not improve preterm birth rates, and may in fact increase them, screening and treatment of asymptomatic pregnant women is discouraged. Symptomatic women should be treated for symptom relief. This article reviews the pathophysiology of bacterial vaginosis and controversy surrounding management during pregnancy. Agents currently recommended for treatment of this condition are reviewed.
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Heng LS, Yatsuya H, Morita S, Sakamoto J. Vaginal douching in Cambodian women: its prevalence and association with vaginal candidiasis. J Epidemiol 2009; 20:70-6. [PMID: 20009371 PMCID: PMC3900782 DOI: 10.2188/jea.je20081046] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND We determined the prevalence of vaginal douching (cleansing of the vagina with liquid) in a sample of Cambodian women, and examined the associations of douching with genitourinary symptoms and infections, after controlling for potential confounding factors, including genitourinary symptoms and sociodemographic factors. METHODS A total of 451 adolescent and adult females aged 15 to 49 years who attended 17 maternal and child health (MCH) clinics in 7 provinces of Cambodia in 2001 were consecutively enrolled as a part of the Sexually Transmitted Infection Sentinel Survey. Sociodemographic factors, genitourinary symptoms, and frequency of douching were assessed by face-to-face interviews using a structured questionnaire. Vaginal infections were examined by using standard diagnostic procedures specific to each pathogen. RESULTS The proportion of participants who douched at least once a week was 76.7% (n = 346). Douching was significantly more prevalent in urban than in rural women (85.7%, n = 198 vs 67.3%, n = 148; P < 0.001). Frequency of douching was significantly associated with genitourinary symptoms, which were most prevalent in participants who douched from several times a week to once a day; genitourinary symptoms were less prevalent in those who douched more than once a day. Douching was significantly associated with vaginal candidiasis, but not with trichomoniasis or bacterial vaginosis, and this association persisted even after controlling for sociodemographic factors and genitourinary symptoms. CONCLUSIONS Vaginal douching was very common among Cambodian women visiting MCH clinics. Further investigations are warranted to elucidate the reasons for douching. In addition, women should be informed that douching may endanger their reproductive health.
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Affiliation(s)
- Lon Say Heng
- National Center for HIV/AIDS, Dermatology and STD, Ministry of Health, Phnom Penh, Cambodia.
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Symptoms of Reproductive Tract Infections and Mental Distress among Women in Low-Income Urban Neighborhoods of Beirut, Lebanon. J Womens Health (Larchmt) 2009; 18:1701-8. [DOI: 10.1089/jwh.2008.0962] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Knowledge and practice among healthcare providers in rural Vietnam regarding sexually transmitted infections. Sex Transm Dis 2009; 36:452-8. [PMID: 19556937 DOI: 10.1097/olq.0b013e31819fe9ae] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To assess knowledge and reported practice regarding sexually transmitted infections (STI) among healthcare providers in rural Vietnam and to examine background characteristics possibly associated with knowledge and practice. METHODS A cross-sectional study using a self-completed questionnaire was carried out in 2006 among 465 healthcare providers in rural Vietnam. The questionnaire included questions on providers' characteristics, STI knowledge, and case scenarios of 4 common STI syndromes. Correct answer was scored 1, "do not know" or incorrect answer was scored 0. Linear and logistic regressions were applied. RESULTS Diseases considered as STI were gonorrhea and syphilis by 83% of the respondents, 70% believed partner treatment necessary for bacterial vaginosis or candidiasis cases. Sharing clothes/food or kissing was commonly mentioned as transmission routes (60%). Median scores of knowledge and reported practice were 29 (range: 0-50) and 2 (range: 0-20), respectively. Among the respondents, 34% had a knowledge score of less than 25 and 78% had a practice score of less than 10. Characteristics predicting higher level of knowledge were being a medical doctor, assistant medical doctor, midwife, or serving STI patients. Characteristics predicting higher level of practice were serving STI patients, being a midwife or female provider, and having participated in STI or reproductive tract infection training courses. Respondents who reported treating STI patients had a higher level of knowledge and reported practice than the others.
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Nguyễn MH, Gammeltoft T, Christoffersen SV, Trần TT, Rasch V. Reproductive Tract Infections in Northern Vietnam: Health Providers' Diagnostic Dilemmas. Women Health 2009; 49:229-45. [DOI: 10.1080/03630240902963630] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- M[ytilde] Hu'o'ng Nguyễn
- a Institute for Population and Development Studies, General Office for Population and Family Planning, Ministry of Health , Hanoi, Vietnam
| | - Tine Gammeltoft
- b Department of Anthropology , University of Copenhagen , Copenhagen, Denmark
| | - Sarah Vigh Christoffersen
- c Department of International Health , Immunology & Microbiology, University of Copenhagen , Copenhagen, Denmark
| | - Thu Thuỷ Trần
- d Office for Population and Family Planning , Hai Phong, Vietnam
| | - Vibeke Rasch
- c Department of International Health , Immunology & Microbiology, University of Copenhagen , Copenhagen, Denmark
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Lan PT, Lundborg CS, Mogren I, Phuc HD, Chuc NTK. Lack of knowledge about sexually transmitted infections among women in North rural Vietnam. BMC Infect Dis 2009; 9:85. [PMID: 19500402 PMCID: PMC2701953 DOI: 10.1186/1471-2334-9-85] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2009] [Accepted: 06/06/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The serious long-term complications of sexually transmitted infections (STI) in women and newborns are well-documented. Particularly, STI imply considerable social consequences for women. Low STI knowledge has been shown to be associated with unsafe sex. In Vietnam, misconceptions regarding STI exist, and rural women delay seeking care for STI. The aim of the study was to investigate knowledge of STI among women aged 15 to 49 years in a rural district of Vietnam and to evaluate possible associations between socioeconomic factors and STI knowledge. METHODS A cross-sectional population-based study using face-to-face interviews was carried out between March and May 2006 in a demographic surveillance site in rural Vietnam. In total, 1805 women aged 15-49 years were randomly selected to participate in the study. The interviews were based on a structured questionnaire including questions on sociodemographic characteristics of the women and their knowledge about STI. Each correct answer was scored 1, incorrect or do not know answer was scored 0. Multivariate analyses were applied to examine associations between socio-economic conditions and STI knowledge. Intra-cluster correlation was calculated to examine similarities of STI knowledge within clusters. RESULTS Of the 1,805 respondents, 78% (73% married vs. 93% unmarried, p < 0.001) did not know any symptoms of STI, 50% could not identify any cause of STI, 59% (54% married vs. 76% unmarried, p < 0.001) did not know that STI can be prevented. Only 31% of the respondents (36% married vs. 14% unmarried, p < 0.001) answered that condom use could protect against STI, and 56% considered partner treatment necessary. Of 40 possible correct answers, the mean knowledge score was 6.5 (range 0-26, median 6). Young, unmarried women and women who lived in the highlands or mountainous areas demonstrated very low levels of STI knowledge (regression coefficients -1.3 and -2.5, respectively, p < 0.001). Experience of an induced abortion was significantly associated with a higher level of knowledge. CONCLUSION The low levels of STI knowledge found among women of reproductive age in a rural district of Vietnam indicate an urgent need of health education interventions, of which, young and unmarried women should be specifically targeted.
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Affiliation(s)
- Pham Thi Lan
- Division of Global Health (IHCAR), Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
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Kisa S, Taskin L. Validity of the symptomatic approach used by nurses in diagnosing vaginal infections. J Clin Nurs 2009; 18:1059-68. [DOI: 10.1111/j.1365-2702.2008.02702.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Highly effective contraception and acquisition of HIV and other sexually transmitted infections. Best Pract Res Clin Obstet Gynaecol 2009; 23:263-84. [DOI: 10.1016/j.bpobgyn.2008.11.004] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2008] [Revised: 11/13/2008] [Accepted: 11/14/2008] [Indexed: 11/22/2022]
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Olsen B, Lan PT, Stålsby Lundborg C, Khang TH, Unemo M. Population-based assessment of Mycoplasma genitalium in Vietnam--low prevalence among married women of reproductive age in a rural area. J Eur Acad Dermatol Venereol 2009; 23:533-7. [PMID: 19220645 DOI: 10.1111/j.1468-3083.2009.03117.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To analyse the prevalence of Mycoplasma genitalium infection in a population-based study among married women from a demographic surveillance site in a rural geographical area of Vietnam. MATERIALS AND METHODS Women, aged 18-49 years, were randomly selected to participate. DNA was isolated from endocervical swabs sampled from 990 participating women. The M. genitalium MgPa adhesion gene was detected using a real-time polymerase chain reaction with TaqMan probe. RESULTS Eight (0.8%; 95% confidence interval, 0.25-1.35%) of the included women were infected with M. genitalium. Two of these positive women reported clinical symptoms. One additional M. genitalium-positive but symptom-free woman, however, showed clinical signs of vaginitis. None of the M. genitalium-positive women was concomitantly infected with Chlamydia trachomatis, Neisseria gonorrhoeae, syphilis or human immunodeficiency virus (HIV). Furthermore, there was no obvious association between M. genitalium infection and vaginal douching, use of intrauterine device, or occurrence of bacterial vaginosis, candidiasis, or Trichomonas vaginalis. CONCLUSIONS The prevalence of M. genitalium among married women in Vietnam was relatively low. However, more large, well-designed and appropriately performed studies in other population groups including unmarried women and men, and in other geographical areas, rural as well as urban, are crucial in order to extract any evidence-based conclusions regarding the overall prevalence of sexually transmitted infections (STIs), including M. genitalium infections, in the Vietnamese society. The present study compiled with such future studies may form the basis for a national sexual health strategy for prevention, diagnosis, and surveillance of STIs, including M. genitalium infections, in Vietnam.
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Affiliation(s)
- B Olsen
- School of Health and Medical Sciences, Orebro University, Orebro, Sweden
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Mỹ Hương N, Kurtzhals J, Thủy ĐTT, Rasch V. Reproductive tract infections in women seeking abortion in Vietnam. BMC Womens Health 2009; 9:1. [PMID: 19178703 PMCID: PMC2652446 DOI: 10.1186/1472-6874-9-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2008] [Accepted: 01/29/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Women requesting abortion are at increased risk of developing RTI complications. However, RTI control in many resource-poor countries including Vietnam have been faced with logistical and methodological problems due to lack of standardized definitions of RTIs, lack of well-validated diagnostic criteria, lack of accurate laboratory tests, and lack of diagnostic equipment and skills. This article investigates the prevalence of RTIs among Vietnamese abortion-seeking women, to evaluate the available diagnostic techniques, and to assess antibiotic resistance among aetiological agents of RTI. METHOD The study was conducted in Phu-San hospital (PSH) from December 2003 through April 2004 among 748 abortion clients. A structured questionnaire was used to collect data on socio-economic and reproductive characteristics. Specimens were collected for laboratory analyses of chlamydia, gonorrhoea, trichomoniasis, vaginal candidiasis (VC), bacterial vaginosis (BV) and syphilis. To assess the validity of the obtained results, the study was repeated among 100 women and the duplicate samples were analysed at PSH and Copenhagen University Hospital (CUH). RESULTS In all 54% of the women were diagnosed as having an RTI, including 3.3% with sexually transmitted infections. Endogenous infections were most prevalent (VC 34% and BV 12%) followed by chlamydia (1.3%) and trichomoniasis (0.7%). The sensitivity of culture for VC and BV was 30% and 88%, respectively, when tests in PSH were measured against tests in CUH. Antibiotic resistance was common among bacterial isolates. CONCLUSION RTIs are common among women seeking abortion. The presence of RTIs is associated with an increased risk of developing iatrogenic infections, routine administration of prophylactic antibiotic to all women undergoing abortion should be considered. However, the choice of routine prophylactic antibiotics should be based on relevant surveillance data of antibiotic resistance. Moreover, since the accuracy of diagnosis is doubtful and to address the problem of under-diagnosed and treated RTIs new investment in diagnostic facilities with simple performed microscopy or improved rapid tests should also be taken into consideration.
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Affiliation(s)
- Nguyễn Mỹ Hương
- Institute of Population and Development Studies, General Office of Population and Family Planning, Ministry of Health, Vietnam
- Department of International Health, Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Jørgen Kurtzhals
- Center for Medical Parasitology, Department of Clinical Microbiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Vibeke Rasch
- Department of International Health, Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
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