1
|
Kinfe B, Abate HM, Mankelkl G. Determinants of self-reported sexually transmitted infections among reproductive age women in Senegal: evidenced by Senegal demographic and health survey. Contracept Reprod Med 2024; 9:53. [PMID: 39478592 PMCID: PMC11526574 DOI: 10.1186/s40834-024-00318-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2024] [Accepted: 10/22/2024] [Indexed: 11/02/2024] Open
Abstract
BACKGROUND Globally, access to sexual and reproductive health is a significant public health issue for women of the reproductive age group. Senegal is a low-income country with limited access to reproductive health services, such as in the prevention and treatment of STIs. The prevention and treatment of STIs is one of the goals set by the government to decrease reproductive health-related morbidity and mortality among women. So, the main objective of this research was to evaluate the prevalence's and determinant of self-reported sexually transmitted infections among reproductive-age women. METHODS Data from the 2023 Senegal Demographic and Health Survey datasets were used for secondary data analysis. A total of 16,583 women of reproductive age participated in the study. Bivariate analysis was employed in order to select the factors for multivariate analysis. In the multivariate analysis, variables with p < 0.05 significance levels were considered to be significant predictors of sexually transmitted infections among reproductive-age women. Finally, the percentage and odd ratio, together with their 95% confidence intervals, were reported. RESULTS The prevalence of sexually transmitted infection among women was 3.21% with a 95 CI. [2.95-3.49] in the last 12 months. Being between the age range of 20 and 44 years old; attending higher education [AOR: 2.70, 95% CI (1.74, 4.19); P = 0.0001]; women who were never in union [AOR: 0.09, 95% CI (0.046, 0.17); P = 0.001] were positively associated with sexually transmitted infections among women. In contrast to this, living in Louga [AOR: 0.41, 95% CI (0.23,0.69); P = 0.001]; Fatick [AOR: 0.33, 95% CI (0.18,0.61); P = 0.0001]; Kolda [AOR: 0.23, 95% CI (0.11,0.49); P = 0.0001]; Kedougou [AOR: 0.34, 95% CI (0.17,0.68); P = 0.002]; and Sedhiou [AOR: 0.43, 95% CI (0.23,0.79); P = 0.007] and women who had history terminated pregnancy [AOR: 1.27, 95% CI (1.03,1.58); P = 0.023] were negatively associated with sexually transmitted infections among women. CONCLUSIONS AND RECOMMENDATIONS Women's sexually transmitted infection has been associated with sociodemographic and geographic determinants such as the age of the woman, region, educational status, marital status, and history of terminated pregnancy. Therefore, to prevent the spread of sexually transmitted infections among women, the governments of Senegal and other concerned stakeholders should give special attention to women by addressing sociodemographic and geographic determinants.
Collapse
Affiliation(s)
- Beletu Kinfe
- Department of occupational Health and safety, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia.
| | - Habtemariam Mulugeta Abate
- Department of Biomedical Sciences, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Gosa Mankelkl
- Department of Biomedical Sciences, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia.
| |
Collapse
|
2
|
Klein JMA, Runge I, Pannen AK, Wakuma T, Abera SF, Adissie A, Unverzagt S, Schmitt M, Waterboer T, Höfler D, Thomssen C, Kantelhardt EJ. Prevalence of bacterial vaginosis, sexually transmitted infections and their association with HPV infections in asymptomatic women attending antenatal care in Ethiopia. Ecancermedicalscience 2024; 18:1783. [PMID: 39430093 PMCID: PMC11489113 DOI: 10.3332/ecancer.2024.1783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Indexed: 10/22/2024] Open
Abstract
Sexually transmitted infections (STIs) and human papillomavirus (HPV) infections are common among women of reproductive age and can lead to infertility, adverse pregnancy outcomes, neonatal infections and cervical cancer. In countries with limited medical coverage, untreated infections contribute to high morbidity. This study aimed to expand the current knowledge on the prevalence of bacterial vaginosis (BV) and STIs in pregnant Ethiopian women and assess the association of these conditions with HPV infections. Socio-demographic data and vaginal lavage samples were collected from 779 asymptomatic women aged 18 to 45 years (median age, 25.9 years) attending antenatal care in seven centres across Ethiopia. Multiplex polymerase chain reaction was used to test for BV, Chlamydia trachomatis, Trichomonas vaginalis, Neisseria gonorrhoeae, herpes simplex virus types 1 and 2 (HSV-1/2), Mycoplasma, Ureaplasma, Candida species and HPV. Overall, 26.8% (95% confidence interval (CI): 23.7-29.9) of women tested positive for BV or one of the following STIs: C. trachomatis, T. vaginalis, N. gonorrhoeae, Mycoplasma genitalium, HSV-1/2 or Ureaplasma urealyticum. Additionally, 22.1% tested positive for at least one high-risk HPV type. Chlamydia trachomatis and HSV-2 were significantly more common among women who were positive for HPV and high-risk HPV. This study reveals a high prevalence of asymptomatic pregnant women who are positive for BV, STIs or HPV, putting them at risk of adverse pregnancy outcomes, secondary infertility or cervical cancer in a country with limited medical coverage. Screening and treating these women could be crucial in reducing morbidity.
Collapse
Affiliation(s)
- Johanna M. A. Klein
- Department of Gynaecology, Martin Luther University Halle-Wittenberg, Halle (Saale) 06097, Germany
- Global Health Working Group, Martin Luther University Halle-Wittenberg, Halle (Saale) 06097, Germany
| | - Isabel Runge
- Department of Gynaecology, Martin Luther University Halle-Wittenberg, Halle (Saale) 06097, Germany
- Global Health Working Group, Martin Luther University Halle-Wittenberg, Halle (Saale) 06097, Germany
| | - Ann-Katrin Pannen
- Department of Gynaecology, Martin Luther University Halle-Wittenberg, Halle (Saale) 06097, Germany
- Global Health Working Group, Martin Luther University Halle-Wittenberg, Halle (Saale) 06097, Germany
| | - Tariku Wakuma
- Global Health Working Group, Martin Luther University Halle-Wittenberg, Halle (Saale) 06097, Germany
- Aira Hospital, Aira, Ethiopia
| | - Semaw Ferede Abera
- Department of Radiation Oncology, Faculty of Medicine, Martin Luther University Halle-Wittenberg, Halle (Saale) 06097, Germany
- School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Adamu Adissie
- Global Health Working Group, Martin Luther University Halle-Wittenberg, Halle (Saale) 06097, Germany
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa 1000, Ethiopia
| | - Susanne Unverzagt
- Institute of General Practice and Family Medicine, Center of Health Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale) 06097, Germany
| | - Markus Schmitt
- Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg 69120, Germany
| | - Tim Waterboer
- Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg 69120, Germany
| | - Daniela Höfler
- Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg 69120, Germany
| | - Christoph Thomssen
- Department of Gynaecology, Martin Luther University Halle-Wittenberg, Halle (Saale) 06097, Germany
- Global Health Working Group, Martin Luther University Halle-Wittenberg, Halle (Saale) 06097, Germany
| | - Eva Johanna Kantelhardt
- Department of Gynaecology, Martin Luther University Halle-Wittenberg, Halle (Saale) 06097, Germany
- Global Health Working Group, Martin Luther University Halle-Wittenberg, Halle (Saale) 06097, Germany
| |
Collapse
|
3
|
Manjate A, Sergon G, Kenga D, Golparian D, Tyulenev Y, Loquilha O, Mausse F, Guschin A, Langa JC, Passanduca A, Sacarlal J, Unemo M. Prevalence of sexually transmitted infections (STIs), associations with sociodemographic and behavioural factors, and assessment of the syndromic management of vaginal discharge in women with urogenital complaints in Mozambique. FRONTIERS IN REPRODUCTIVE HEALTH 2024; 6:1323926. [PMID: 38706519 PMCID: PMC11067503 DOI: 10.3389/frph.2024.1323926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 04/04/2024] [Indexed: 05/07/2024] Open
Abstract
In Mozambique, sexually transmitted infections (STIs) are estimated to be prevalent, but diagnosis and treatment of curable STIs rely only on syndromic management. We examined the prevalence of four non-viral STIs and HIV-1/2, based on etiological diagnosis, associations with sociodemographic and behavioural factors, and the STI diagnostic accuracy of the vaginal discharge syndromic management in women with urogenital complaints in Maputo, Mozambique. A cross-sectional study was performed in Maputo, Mozambique, February 2018-January 2019, enrolling 924 women of reproductive age with urogenital complaints. Endocervical/vaginal swabs were sampled and chlamydia, gonorrhoea, trichomoniasis and Mycoplasma genitalium infections were diagnosed using a multiplex real-time PCR (AmpliSens; InterLabServices). Serological testing was performed for HIV-1/2. A structured questionnaire collected metadata. All data were analyzed in STATA/IC 12.1 using descriptive statistics, chi-square tests and logistic regression model. About 40% of the women were less than 24 years old, 50.8% were single, 62.1% had their sexual debut between 12 and 17 years of age, and the main complaint was vaginal discharge syndrome (85%). The prevalence of chlamydia was 15.5%, trichomoniasis 12.1%, gonorrhoea 4.0%, M. genitalium 2.1%, and HIV-1/2 22.3%. The vaginal discharge syndrome flowchart had a sensitivity of 73.0%-82.5% and a specificity of 14%-15% for the detection of any individual non-viral STI in women with urogenital complaints. In total, 19.2% of the symptomatic women with chlamydia, trichomoniasis or gonorrhoea would not be detected and accordingly treated using the vaginal discharge syndromic management (missed treatment) and 70.0% of the women would be treated despite not being infected with any of these three STIs (overtreatment). In conclusion, a high prevalence of especially chlamydia, trichomoniasis, and HIV-1/2 was found in women of childbearing age with urogenital complaints in Maputo, Mozambique. Syndromic management of vaginal discharge revealed low accuracy in the detection of STIs in symptomatic women, especially low specificity, which resulted in under-treatment of STI-positive cases and incorrect or over-treatment of women with urogenital complaints, many of whom were negative for all the non-viral STIs. Etiological diagnosis is imperative for effective management of STIs in symptomatic and asymptomatic women.
Collapse
Affiliation(s)
- Alice Manjate
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Departament de Microbiologia, Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique
| | - Gladys Sergon
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Darlenne Kenga
- Departament de Microbiologia, Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique
| | - Daniel Golparian
- WHO Collaborating Centre for Gonorrhoea and Other Sexually Transmitted Infections, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Yuriy Tyulenev
- Department of Healthcare, Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology, Moscow, Russia
| | - Osvaldo Loquilha
- Departamento de Matemática e Informática, Faculdade de Ciências, Universidade Eduardo Mondlane, Maputo, Mozambique
| | - Fabião Mausse
- Departament de Microbiologia, Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique
| | - Alexander Guschin
- Department of Healthcare, Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology, Moscow, Russia
| | - José Carlos Langa
- Departament de Microbiologia, Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique
| | - Alfeu Passanduca
- Departament de Microbiologia, Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique
| | - Jahit Sacarlal
- Departament de Microbiologia, Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique
| | - Magnus Unemo
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- WHO Collaborating Centre for Gonorrhoea and Other Sexually Transmitted Infections, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Institute for Global Health, University College London (UCL), London, United Kingdom
| |
Collapse
|
4
|
Gobezie MY, Tesfaye NA, Solomon T, Demessie MB, Kassa TD, Wendie TF, Alemayehu E, Hassen M. Neisseria gonorrhea in Ethiopia, prevalence among STI suspected patients and its antimicrobial susceptibility: a systematic review and meta-analysis. Front Microbiol 2024; 15:1390001. [PMID: 38694795 PMCID: PMC11062254 DOI: 10.3389/fmicb.2024.1390001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 04/04/2024] [Indexed: 05/04/2024] Open
Abstract
Introduction Neisseria gonorrhea (N. gonorrhea) represents a significant causative agent of sexually transmitted infections (STIs), posing considerable global health challenges. Despite the presence of diagnostic tools and empirically guided therapies, the escalating AMR of N. gonorrhea continues to pose a threat. This study aims to assess the prevalence of N. gonorrhea among STI suspected patients in Ethiopia and explore the patterns of AMR to common antimicrobials. Methods Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a systematic review and meta-analysis. A thorough search of electronic databases from July 11 to July 24, 2023, identified 10 eligible studies. Data were extracted and analyzed using a random-effects model. Heterogeneity was assessed using the I2 statistic, and publication bias was evaluated through Egger's regression test and funnel plots. Results The overall pooled prevalence of N. gonorrhea among STI suspected patients in Ethiopia was 20% (95% confidence interval (CI): 8-30, I2 = 99.0%; p-value <0.001). Substantial regional variations were observed, with the highest prevalence in Addis Ababa (55, 95% CI: 45-65) and the lowest in the Southern Nations, Nationalities, and Peoples' Region (SNNPR) (4, 95% CI: 2-8). The pooled prevalence of AMR to ciprofloxacin, ceftriaxone, azithromycin, benzylpenicillin, tetracycline, and spectinomycin was 37, 9, 10, 79, 93, and 2%, respectively. Significant heterogeneity existed between studies (I2 = 99.0%; p value <0.001). Publication bias, identified through funnel plot examination and Egger's regression test (p < 0.001), execution of trim and fill analysis resulted in an adjusted pooled prevalence of (6.2, 95% CI: -6.8 to 19.3). Conclusion The prevalence of N. gonorrhea among STI suspected patients in Ethiopia is alarming, particularly in specific regions. The elevated AMR to ciprofloxacin underscores the immediate need for alternative treatment options and enhanced surveillance systems. Future initiatives should prioritize strengthening laboratory capacities and implementing targeted interventions to curtail N. gonorrhea transmission and prevent the emergence of AMR. Systematic Review Registration https://www.crd.york.ac.uk/prospero, identifier CRD42023459698.
Collapse
Affiliation(s)
- Mengistie Yirsaw Gobezie
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Nuhamin Alemayehu Tesfaye
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Tewodros Solomon
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Mulat Belete Demessie
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Tesfaye Dessale Kassa
- Department of Clinical Pharmacy, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Teklehaimanot Fentie Wendie
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Ermiyas Alemayehu
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Minimize Hassen
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| |
Collapse
|
5
|
Demissie E, Amare A, Birhanu M, Gizachew M. Neisseria gonorrhoeae antimicrobial resistance patterns and associated risk factors in women of childbearing potential in northwestern Ethiopia. BMC Womens Health 2024; 24:82. [PMID: 38297305 PMCID: PMC10829321 DOI: 10.1186/s12905-024-02898-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 01/11/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUNDS Neisseria gonorrhoeae causes gonorrhea and poses public health problems, including antimicrobial resistance. Current data on gonorrhea in prenatal participants in the study area are required. Thus, we aimed to identify gonorrhea prevalence, antimicrobial resistance, and risk factors among antenatal care clinic visitors in northwestern Ethiopia. METHODS A cross-sectional study was conducted from March to August 2022 at the University of Gondar Comprehensive Specialized Hospital. We recruited 278 study participants using convenient sampling techniques. Sociodemographic, clinical and behavioral risk factors were recorded using pre-tested questionnaires. Endocervical swabs were collected by a physician, transported to the microbiology laboratory, immediately inoculated into modified Thayer-Martin medium, and it was incubated at 37 °C for 24-48 hours. Gram staining and biochemical tests were used to identify the organism. AMR testing was performed using disc diffusion and E-test methods. Data were entered in EPI-info version 7 and exported and analyzed in SPSS version 26. A p-value ≤0.05 was considered as statistically significant. Results were presented in words, tables and figure. RESULTS Of 278 subjects enrolled, majority (44.6%) were 26-35 years, with a mean age of 29.9 (SD = ±7.2) years, 69.4% were urban residents, and 70.5% were married. Twenty-one (7.6%) participants had gonorrhea. Overall antimicrobial resistance ranged from 19 to 100%. High resistant to tetracycline (100%) and penicillin (85.7%) were observed by both tests. Ciprofloxacin resistance was 52.4% by disc diffusion and 85.7% by E-test. By E-test, all isolates were sensitive to ceftriaxone, cefixime, azithromycin and spectinomycin; however, 7 (33.3%), 9 (42.9%), 9 (42.9%) and 5 (23.8%) isolates showed resistant to these antibiotics with disk method. Prevalence of beta-lactamase producing Neisseria gonorrhoeae was 85.7%. Alcohol consumption (p = 0.032), condom-free sexual practice (p = 0.010), multiple sexual partners (p < 0.001), pelvic pain (p = 0.018), and dysuria (p = 0.021) revealed increased risk of infection. CONCLUSIONS Compared with many previous studies in Ethiopia, we found high prevalence, antimicrobial resistance, and beta-lactamase-positive isolates. Multiple sexual partners, alcohol consumption, not using condom, pelvic pain and dysuria were predictors of this infection. Continuous large-scale monitoring of pathogen is essential for its prevention and control.
Collapse
Affiliation(s)
- Engdawork Demissie
- Department of Medical Laboratory Sciences, School of Medicine and Health Sciences, Jigjiga University, Jijiga, Ethiopia
| | - Azanaw Amare
- Department of Medical Microbiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Muluken Birhanu
- Department of Medical Microbiology, Immunology and Parasitology, Addis Ababa University, and Assosa University, Addis Ababa, Ethiopia
| | - Mucheye Gizachew
- Department of Medical Microbiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| |
Collapse
|
6
|
Husen O, Aliyo A, Boru K, Gemechu T, Dedecha W, Ashenafi G. Trichomonas vaginalis and Associated Factors among Pregnant Women Attending Antenatal Care at Bule Hora University Teaching Hospital, Oromia Region, Southern Ethiopia. J Parasitol Res 2023; 2023:4913058. [PMID: 38130894 PMCID: PMC10735719 DOI: 10.1155/2023/4913058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 10/28/2023] [Accepted: 11/30/2023] [Indexed: 12/23/2023] Open
Abstract
Trichomoniasis is caused by a flagellated protozoan parasite called Trichomonas vaginalis. It is one of the most common, curable nonsexually transmitted infections globally. In Ethiopia, complications associated with genital infection in pregnant women are a common problem. Despite the burden of the disease, epidemiological data related to this disease is currently rare in Africa, particularly in Ethiopia. Objective. This research is aimed at assessing the prevalence of Trichomonas vaginalis and associated factors among pregnant women attending antenatal care at Bule Hora University Teaching Hospital. Methods. An institutional-based cross-sectional study was conducted among 196 pregnant women attending ANC at Bule Hora University Teaching Hospital. Structured questionnaires were used to collect sociodemographic and associated factor data. The consecutive sampling technique was used to include study participants. The two vaginal swabs were collected by brushing the vagina with a sterile cotton swab and tested by using direct wet mount and the Giemsa staining. The data were analyzed using SPSS version 26 for logistic regression analysis. A p value < 0.05 with 95% CI was used to declare it statistically significant. Result. An overall prevalence of T. vaginalis among pregnant women was 7.7% (95% with confidence interval (CI), 0.043-0.123). The highest prevalence was observed among the 35-39-year-old age group with 18.2% and among widowed women with 25%. This study revealed that the number of sexual partners (AOR: 3.215, 95% CI: 1.062-9.731) was a significant associated factor of T. vaginalis.Conclusion. The prevalence of T. vaginalis was considerably high among pregnant women in this study. This finding emphasizes the need for routine screening and treatment of pregnant women in the first antenatal care and enhances the need for regular health education for pregnant women at antenatal clinics to make them aware of their health, and avoidance of the risk of trichomoniasis is advised.
Collapse
Affiliation(s)
- Oliyad Husen
- Department of Medical Laboratory Science, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
| | - Alqeer Aliyo
- Department of Medical Laboratory Science, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
| | - Kalicha Boru
- Department of Medical Laboratory Science, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
| | - Tibeso Gemechu
- Department of Medical Laboratory Science, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
| | - Wako Dedecha
- Department of Medical Laboratory Science, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
| | - Girma Ashenafi
- Department of Medical Laboratory Science, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
| |
Collapse
|
7
|
Msemwa B, Mushi MF, Kidenya B, Okamo B, Keenan K, Sabiiti W, Miyaye DN, Konje ET, Silago V, Mirambo MM, Mwanga JR, Gillespie S, Maldonado-Barragan A, Sandeman A, Holden M, Mshana SE. Urogenital pathogens in urine samples of clinically diagnosed urinary tract infected patients in Tanzania: A laboratory based cross-sectional study. IJID REGIONS 2023; 7:170-175. [PMID: 37069922 PMCID: PMC10105482 DOI: 10.1016/j.ijregi.2022.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 12/19/2022] [Accepted: 12/20/2022] [Indexed: 12/28/2022]
Abstract
Background Urogenital pathogens such as Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium and Trichomonas vaginalis have been reported to cause pyuria, however they are not routinely cultured from urine samples of patients clinically diagnosed to have urinary tract infections (UTI). In this study, pathogen specific PCR was done to identify the urogenital pathogens in the urine samples among clinically diagnosed UTI patients with negative routine urine culture. Methods A cross-sectional study was conducted involving 227 archived urine samples from clinically diagnosed UTI patients with positive leucocyte esterase but negative urine culture results. The urogenital pathogens were detected using pathogen specific singleplex PCR. Data were cleaned and analyzed using STATA version 15. Results The median age of patients was 31[IQR 23 - 51] years and the majority (174, 76.7%) were females. Two thirds of patients had history of antibiotic use two weeks prior to recruitment (154, 67.8%). A total of 62(27.3%) urine samples were positive for at least one urogenital pathogen. Of 62 positive samples, 9 had two urogenital pathogens and 1 had three urogenital pathogens. The most predominant urogenital pathogen detected was Neisseria gonorrhoeae 25(34.2%) and Trichomonas vaginalis 24(32.9%). Being female (aOR 2.4; 95% CI: 1.04 - 5.49; p-value 0.039) and having history of using antibiotics in the past two weeks (aOR 1.9; 95%CI: 1.04 - 3.60; p-value 0.036) was independently associated with the presence of urogenital pathogens. Conclusion More than a quarter of female patients with clinical symptoms of UTI and routine urine culture negative results were infected with urogenital pathogens mainly Neisseria gonorrhoeae and Trichomonas vaginalis. Further research with a larger sample set in a range of settings is required to understand the implications of these finding generally.
Collapse
Affiliation(s)
- Betrand Msemwa
- Department of Medical Laboratory Sciences, Catholic University of Health and Allied Sciences, Bugando, P. O. Box 1464 Mwanza
| | - Martha F Mushi
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Bugando, P. O. Box 1464 Mwanza
| | - Benson Kidenya
- Department of Biochemistry and Molecular biology, Catholic University of Health and Allied Sciences, Bugando, P. O. Box 1464 Mwanza
| | - Bernard Okamo
- Department of Biochemistry and Molecular biology, Catholic University of Health and Allied Sciences, Bugando, P. O. Box 1464 Mwanza
| | - Katherine Keenan
- Geography and Sustainable Development, University of St Andrews, St Andrews, UK
| | - Wilber Sabiiti
- School of Medicine, University of St Andrews, St Andrews, UK
| | - Donald N Miyaye
- National Institute for Medical Research, Mwanza Centre, P. O. Box 1462 Mwanza
| | - Eveline T Konje
- Department of Epidemiology and Biostatistics, and Behavioral Sciences, Catholic University of Health and Allied Sciences, Bugando, P. O. Box 1464 Mwanza
| | - Vitus Silago
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Bugando, P. O. Box 1464 Mwanza
| | - Mariam M Mirambo
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Bugando, P. O. Box 1464 Mwanza
| | - Joseph R Mwanga
- School of Public Health, Catholic University of Health and Allied Sciences, Bugando, P. O. Box 1464 Mwanza
| | | | | | - Alison Sandeman
- School of Medicine, University of St Andrews, St Andrews, UK
| | - Mathew Holden
- School of Medicine, University of St Andrews, St Andrews, UK
| | - Stephen E Mshana
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Bugando, P. O. Box 1464 Mwanza
| |
Collapse
|
8
|
Mabaso N, Ngobese B, Tinarwo P, Abbai N. Prevalence of Chlamydia trachomatis infection in pregnant women from Durban, South Africa. Int J STD AIDS 2022; 33:920-927. [PMID: 35971616 DOI: 10.1177/09564624221118721] [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: 11/15/2022]
Abstract
INTRODUCTION The Sub-Saharan African region has some of the world's highest prevalence of sexually transmitted infections (STIs). These infections are considered a major public health concern. Previous studies on the prevalence of C. trachomatis infection in Sub-Saharan Africa have reported rates ranging from 3.1% to 36.8% in pregnant women. This study investigated the prevalence and risk factors associated with C. trachomatis infection in pregnant women. METHODS This study included 735 stored clinical samples that were collected from pregnant women attending the antenatal clinic at King Edward VIII Hospital in Durban from 2018 -2021. C. trachomatis was detected using the Applied BiosystemsTM TaqMan® Assays from stored DNA samples. RESULTS A total of 81/735 (11%) samples tested positive for C. trachomatis infection. The overall median (Q1-Q3) age of the women was 29.0 years (24.0-35.0). The majority of the women who tested positive for C. trachomatis were younger, median (Q1-Q3) age 26.0 years (23.0-32.0) vs 30.0 years (25.0-35.0) for the negative women (p < .001). Of the positive women, 96.3% were unmarried (p=0.014). Older women were less likely to test positive for C. trachomatis infection (OR: 0.93; 95% CI 0.89-0.96 p = .001). Women who were married (OR: 0.25; 95% CI 0.06-0.70; p = .022), co-habiting with their partner (OR: 0.60; 95% CI 0.36-0.98; p = .048) and started having sex at older than 15 years (OR:0.26; 95% CI 0.09-0.87; p = .018) were less likely to test positive for C. trachomatis compared to their counterparts. CONCLUSION This study showed that behavioural and clinical factors were associated with prevalent infections. In order to reduce prevalent infections, stronger risk reduction counselling messages need to be provided from the educational and public health sector.
Collapse
Affiliation(s)
- Nonkululeko Mabaso
- School of Clinical Medicine Laboratory, College of Health Sciences, 56394University of KwaZulu-Natal, Durban, South Africa
| | - Bongekile Ngobese
- School of Clinical Medicine Laboratory, College of Health Sciences, 56394University of KwaZulu-Natal, Durban, South Africa
| | - Partson Tinarwo
- Department of Biostatistics, Nelson R Mandela School of Medicine, 56394University of KwaZulu-Natal, Durban, South Africa
| | - Nathlee Abbai
- School of Clinical Medicine Laboratory, College of Health Sciences, 56394University of KwaZulu-Natal, Durban, South Africa
| |
Collapse
|
9
|
Significant Associations between Chlamydia trachomatis and Neisseria gonorrhoeae Infections in Human Immunodeficiency Virus-Infected Pregnant Women. Infect Dis Obstet Gynecol 2022; 2022:7930567. [PMID: 35754526 PMCID: PMC9232329 DOI: 10.1155/2022/7930567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 06/07/2022] [Indexed: 11/17/2022] Open
Abstract
There is a lack of data on the burden of Chlamydia trachomatis and Neisseria gonorrhoeae among human immunodeficiency virus- (HIV-) infected pregnant women in South Africa. We conducted a cross-sectional study which included 385 HIV-infected pregnant women attending antenatal clinic at the King Edward VIII Hospital in Durban, South Africa. The women provided vaginal swabs which were tested for C. trachomatis and N. gonorrhoeae. The prevalence of the individual STIs was as follows: C. trachomatis (47/385, 12.2%) and N. gonorrhoeae (16/385, 4.1%). Having a circumcised partner, testing positive for N. gonorrhoeae, and perceiving themselves of being at risk for infection were shown to increase the risk for C. trachomatis infection. Without controlling for the other factors, testing positive for N. gonorrhoeae increased the risk for C. trachomatis infection by 10-fold (OR: 10.17, 95% CI: 3.39-29.66, p < 0.001). Similarly, adjusting for the other factors, the risk for C. trachomatis infection in women who tested positive for N. gonorrhoeae was 9-fold (OR: 9.16, 95% CI: 2.19-40.18, p = 0.003). The following factors were associated with the increased risk of N. gonorrhoeae infection: not knowing their partner's HIV status, partner having other partners, and C. trachomatis infection status. Without controlling for the other factors, testing positive for C. trachomatis increased the risk for N. gonorrhoeae infection by 6-fold (OR: 6.52, 95% CI: 2.22-18.49, p < 0.001). Similarly, adjusting for the other factors, the risk for N. gonorrhoeae infection in women who tested positive for C. trachomatis was 6-fold (OR: 6.09, 95% CI: 1.73-22.03, p = 0.005). We found a significant association between C. trachomatis and N. gonorrhoeae in the pregnant women and the risk factors associated with these pathogens. Future studies are urgently required to investigate the impact of C. trachomatis/N. gonorrhoeae coinfections in HIV pregnant women since this data is lacking in our setting. In addition, etiological screening of C. trachomatis and N. gonorrhoeae during antenatal clinic is urgently required to prevent adverse pregnancy and birth outcomes associated with these infections.
Collapse
|
10
|
Feleke DG, Yemanebrhane N. Trichomonas vaginalis infection in Ethiopia: A systematic review and meta-analysis. Int J STD AIDS 2022; 33:232-241. [PMID: 35038945 DOI: 10.1177/09564624211060176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND An estimated 30 million new cases of Trichomonas vaginalis are recorded annually in sub-Saharan Africa. In Ethiopia, there is no study that systematically compiled the burden of T. vaginalis. Therefore, this study aimed to estimate the pooled prevalence of T. vaginalis in Ethiopia. METHODS Electronic databases such as PubMed/Medline, EMBASE, Science Direct, Scopus, HINARI, Google Scholar, and Cochrane Library were systematically searched, and studies with high-quality Newcastle Ottawa Scale scores were included. Analyses were performed using STATA version 14 software, and heterogeneity of studies was assessed using the Cochrane's Q test statistics and I2 test statistics. Sub-group, sensitivity analysis, and publication bias were performed. RESULTS Ten eligible studies consisting of 2979 study participants were included. The overall pooled prevalence of T. vaginalis infections in Ethiopia was 9.62%. Sub-group analysis showed that the overall pooled prevalence of T. vaginalis infections in pregnant women and other study groups was 6.68% and 12.86%, respectively. Publication bias was detected by funnel plots and Egger's tests. CONCLUSIONS This study showed that the overall pooled prevalence of T. vaginalis infections was relatively high. This study should trigger policy makers, governmental and non-governmental organizations, and healthcare providers to give attention for prevention and control of T. vaginalis infection.
Collapse
Affiliation(s)
- Daniel Getacher Feleke
- Department of Microbiology, Immunology and Parasitology, College of Health Sciences, 37602Addis Ababa University, Addis Ababa, Ethiopia
| | | |
Collapse
|
11
|
Congenital Cytomegalovirus Infections Mother-Newborn Pair Study in Southern Ethiopia. CANADIAN JOURNAL OF INFECTIOUS DISEASES AND MEDICAL MICROBIOLOGY 2021; 2021:4646743. [PMID: 35003406 PMCID: PMC8739911 DOI: 10.1155/2021/4646743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 12/08/2021] [Accepted: 12/21/2021] [Indexed: 11/17/2022]
Abstract
Introduction. Congenital cytomegalovirus (cCMV) is a common cause of neurodevelopmental delays and sensorineural hearing loss of infants, yet the prevalence of cCMV and the associated factors in Ethiopia are not studied. Hence, this study was to assess the prevalence and associated factors of cCMV in Southern Ethiopia. Methodology. A mother-newborn pair cross-sectional study was conducted at Hawassa University Comprehensive and Specialized Hospital, Ethiopia. Newborn’s saliva sample was tested for cCMV using Alethia CMV molecular assay. Mothers’ serum was tested serologically for anti-CMV IgM and IgG by EUROIMMUN ELISA. Pregnant women responded to a questionnaire about their previous and current obstetric history and sociodemographic characteristics. The chi-square (χ2) test and independent-sample t-test were used to determine the associations between infections and possible risk factors; then, potential variables were screened for multivariable analysis. Results. A total of 593 mother-newborn pairs were assessed. CMV was detected in 14 of 593 newborn saliva swabs (2.4%; 95% CI 1.2–3.7). As assessed by CMV IgM-positive results, maternal CMV seropositivity was 8.3% (49/593); thus, the rate of mother-to-child transmission of CMV was 28% (14/49) among CMV IgM-positive women. Congenital CMV infection was significantly associated with maternal exposure through nursery school children in the household, women sharing a feeding cup with children, and any of the detected curable STIs during pregnancy. Birth weight was negatively associated with CMV infection. Maternal age, gravidity, level of education, and sharing of children feeding utensils were not associated with cCMV infection. Conclusion. A high rate of cCMV infection in the absence of awareness demands further in-depth investigation in Ethiopia. Thus, policymakers must take appropriate action through the antenatal care system for prevention strategies and put in place a constant health education and awareness creation of pregnant women about the causes of infection and hygienic measures.
Collapse
|
12
|
Yasin J, Ayalew G, Dagnaw M, Shiferaw G, Mekonnen F. Vulvovaginitis Prevalence Among Women in Gondar, Northwest Ethiopia: Special Emphasis on Aerobic Vaginitis Causing Bacterial Profile, Antimicrobial Susceptibility Pattern, and Associated Factors. Infect Drug Resist 2021; 14:4567-4580. [PMID: 34754204 PMCID: PMC8572045 DOI: 10.2147/idr.s337205] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 10/20/2021] [Indexed: 01/13/2023] Open
Abstract
Background Genital tract infections are posing a series of public health challenges for women in both developed and developing countries. Microbial infections of the vagina can lead to serious medical complications such as preterm labor, amniotic fluid infection, premature rupture of the fetal membranes, and low birth weight of the neonate, leading to high perinatal morbidity and mortality. In Ethiopia, limited information is found on the burden, antimicrobial susceptibility profile and associated factors for aerobic vaginitis. Thus, this study was aimed to determine the burden of AV, antimicrobial susceptibility profile of aerobic bacterial isolates and associated factors among women attending Gondar town health facilities, northwest Ethiopia. Methods A health facility-based cross-sectional study was conducted on 214 study participants from February 1 to May 31, 2019. For all consecutive women, demographic variables were collected using a structured questionnaire and two vaginal swabs for each were collected. The diagnosis of AV and BV was based on the composite score of Donders and Nugent criteria, respectively. All bacteria were isolated and characterized by conventional culture techniques. The antimicrobial susceptibility pattern was performed using the disc diffusion technique. Logistic regression, univariate and multivariate analysis were carried out. A p-value ≤ 0.05 at 95% CI was considered as statistically significant. Results The overall prevalence of vulvovaginitis among women was 50%. The identified aetiologies of vulvovaginitis were bacterial vaginosis (35.5%), candidiasis (23.8%), aerobic vaginitis (22.9%) and trichomoniasis (3.3%). Aerobic bacteria, especially Enterococcus faecalis and Escherichia coli, were predominantly isolated in the vaginal samples. The prevalence of the multidrug resistance rate was 38.98%. The isolated Gram positive bacteria were sensitive to antibiotics like vancomycin, cefoxitin, ciprofloxacin, clindamycin, and gentamicin, whereas the Gram negative bacteria isolates were sensitive to ciprofloxacin, gentamicin and meropenem. Conclusion The high burden of bacterial vaginosis and aerobic vaginitis was reported. Therefore, regular screening of women using microbiological diagnosis should be promoted. The common bacteria isolated were Enterococcus faecalis and Escherichia coli. Additionally, antibiotics like vancomycin, cefoxitin, ciprofloxacin, clindamycin, gentamicin, and meropenem were shown to have good action against the majority of bacteria isolates.
Collapse
Affiliation(s)
- Jemal Yasin
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
| | - Getnet Ayalew
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
| | - Mulat Dagnaw
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
| | - Getachew Shiferaw
- Department of Gynecology and Obstetrics, School of Medicine, University of Gondar, Gondar, Ethiopia
| | - Feleke Mekonnen
- Department of Medical Laboratory Sciences, School of Health Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| |
Collapse
|
13
|
Zenebe MH, Mekonnen Z, Loha E, Padalko E. Seroprevalence and associated factors of maternal cytomegalovirus in Southern Ethiopia: a cross-sectional study. BMJ Open 2021; 11:e051390. [PMID: 34675017 PMCID: PMC8532544 DOI: 10.1136/bmjopen-2021-051390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES The aim of this study was to assess the seroprevalence and associated factors of cytomegalovirus (CMV) among pregnant women in Southern Ethiopia. DESIGN Cross-sectional study. SETTING The study was conducted in Hawassa University comprehensive and specialised hospital. Hawassa, Southern Ethiopia. PARTICIPANTS A total of 600 consecutive pregnant women attending the delivery ward were recruited for the study from August to October 2020. OUTCOME MEASURES The study assessed the rate of maternal anti-CMV IgG and IgM antibodies. The association of obstetric history, sociodemographic and behavioural characteristics with seropositivity of CMV was also evaluated based on the collected data using structured questioners. RESULTS Seropositivity for CMV IgM antibodies was 8.2% (49/600) (95% CI 6% to 10.5%), whereas the CMV IgG was 88.7% (532/600), (95% CI 89.5% to 94.0%). Seroprevalence of CMV IgM was higher in women of older age, currently unmarried, having nursery schooled children and with any of the detected curable sexually transmitted infections, while seroprevalence of CMV IgG was significantly associated only with women having nursery schooled children. Seroprevalence was not significantly associated with previous adverse pregnancy outcome, gravidity, being a child daycare occupant mother and newborn birth weight. CONCLUSION In the present study, we identified a high rate of CMV IgM and CMV IgG seroprevalence among pregnant women in Southern Ethiopia. Given that there is no existing CMV diagnosis, special attention should be designed to pregnant women in parallel to the existing antenatal care facility. Besides, training healthcare professionals will support awareness conception among pregnant women concerning the sequels of CMV infection during pregnancy.
Collapse
Affiliation(s)
- Mengistu Hailemariam Zenebe
- Medical Laboratory Sciences, Hawassa University College of Medicine and Health Sciences, Hawassa, South Ethiopia, Ethiopia
- Department of Diagnostic Sciences, Ghent University Faculty of Medicine and Health Sciences, Gent, Belgium
- Medical Laboratory Sciences, Jimma University Institute of Health, Jimma, Ethiopia
| | - Zeleke Mekonnen
- Medical Laboratory Sciences, Jimma University Institute of Health, Jimma, Ethiopia
| | - Eskindir Loha
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Chr Michelson Institute, Bergen, Norway
| | - Elizaveta Padalko
- Department of Diagnostic Sciences, Ghent University Hospital, Ghent, Belgium
| |
Collapse
|
14
|
Self-reported syndromes of sexually transmitted infections and its associated factors among reproductive (15-49 years) age women in Ethiopia. Heliyon 2021; 7:e07524. [PMID: 34401559 PMCID: PMC8353284 DOI: 10.1016/j.heliyon.2021.e07524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 06/05/2021] [Accepted: 07/06/2021] [Indexed: 11/22/2022] Open
Abstract
Background Sexually Transmitted Infections (STIs) are among the most important causes of maternal and neonatal morbidity and mortality. It remains a significant public health problem and disproportionately affects women posing a large public health burden in low and middle-income countries. However, there is little information on the magnitude of self-reported syndromes of STIs among reproductive-age women in Ethiopia. Aim This study aimed to determine the magnitude of self-reported syndromes of sexual transmitted infections and its associated factors among women of reproductive age in Ethiopia. Methods The study was based on the data from the Ethiopian Demographic Health Survey of 2016. The data on the status of self-reported STIs were extracted from the individual women dataset, and a total of 15,683 reproductive-age women were involved in the study. Since the data has a hierarchical and cluster nature sampling weight was applied for all analysis procedures to account for complex survey design. Rao-scot chi-square test that adjusts for complex sample design was used to examine the association of outcome and independent variables. In, multivariable analysis, the level of statistical significance was declared at P-value ≤ 0.05. Findings and conclusions The magnitude of self-reported STIs was 3.0 % (95% CI: 2.92–3.08). Among self-reported syndromes of STIs only, 33.3 % (158) seek care for sexually transmitted infections. Age (Adjusted Odds Ratio (AOR = 2.15; 95%CI:1.4, 3.4)), marital status (AOR = 1.72; 95%CI:1.02, 2.90), women attending higher education and above (AOR = 2.67; 95%CI:1.57,4.57), history of termination of pregnancy (AOR = 2.85; 95%CI:2.0,4.08), and risky sexual behavior (AOR = 1.72; 95%CI:1.02,2.90) were found to be associated with self-reported syndrome of sexually transmitted infections. The magnitude of self-reported syndromes of STI and health care seeking behaviors among reproductive-age women was found low. Therefore, the government should enhance the awareness of women for sexually transmitted syndromes, and increase accessibility of STI services. Moreover, qualitative studies should be done to identify the demand, supply, and barriers related to STI among women of reproductive age women in Ethiopia.
Collapse
|