Prevalence of sexually transmitted infections among pregnant women attending antenatal clinics in West Coast Region of The Gambia

Health Status of Tsimihety Women: Sexually Transmitted Infections and Schistosomiasis, Northern Madagascar

Background: Madagascar is one of the lowest-income countries in Africa, and it has a poorly developed healthcare system. Malagasy women face limited access to sexual and reproductive health services, which is a serious risk factor facilitating the spread of sexually transmitted infections (STIs). The aim of the present study was to assess the prevalence of STIs (Trichomonas vaginalis, Neisseria gonorrhoeae, Treponema pallidum, and HIV-1/HIV-2) and urogenital schistosomiasis, as well as to evaluate hematological parameters and nutritional status, in a group of women from northern Madagascar. Methods: The study was conducted in April 2024 at the Clinique Médicale Beyzym in Manerinerina, Ambatoboeny District. Samples, which included overnight urine, venous blood, and vaginal swabs, were collected from 159 women aged 15-80 years. The urine samples were examined for the presence of Schistosoma haematobium eggs by light microscopy, the vaginal swabs were tested for the presence of Trichomonas vaginalis and Neisseria gonorrhoeae infections (by light microscopy), and venous blood samples were collected into VACUTAINER SEC collection tubes without anticoagulant and were tested for HIV-1/HIV-2 and Treponema pallidum infections using test cassettes. Results: The prevalence of STIs in the study group was found to be 31.5%, while S. haematobium infections were found in 17.6% of the tested women. Cases of gonorrhea (20.1%), trichomoniasis (8.8%), syphilis (7.6%), and one case of HIV infection were identified. Conclusions: The study found a high prevalence of STIs and S. haematobium cases in Tsimihety women. In order to improve the quality of healthcare in Madagascar, it is necessary to improve accessibility to maternal, sexual, and reproductive health services.

Sexually transmitted pathogens in asymptomatic women at Rethabile clinic, Limpopo, South Africa

Background

Health care for sexually transmitted infections (STIs) is often inadequate, especially for women, because of the asymptomatic nature of many STIs, which can lead to a false sense of health. Thus, there is limited data on the prevalence of STIs in pregnant women in low and middle-income countries.

Objectives

The study aimed to determine the prevalence of STIs in asymptomatic pregnant women attending antenatal Rethabile Community Health Centre, Limpopo, South Africa.

Method

A cross-sectional analysis of asymptomatic pregnant women at Rethabile Community Health Centre between March 2023 and November 2023 was conducted to determine the prevalence of seven STIs, detected from self-collected vaginal swab specimens using HAIN fluoroType STI-multiplex Polymerase Chain Reaction (PCR) test for nine targets covering seven major STIs.

Results

The study found that Ureaplasma urealyticum was the most prevalent pathogen (43%) followed by Chlamydia trachomatis (41%), and Trichomonas vaginalis (10%). The less common pathogens detected were Mycoplasma Genitalium (5%) and Neisseria gonorrhoeae (2%).

Conclusion

High STI prevalence among asymptomatic pregnant women at Rethabile Community Health Centre necessitates diagnostic screening over syndromic management because of a lack of reporting for symptoms.

Contribution

The paper examines the epidemiology of STIs in Limpopo, South Africa, focusing on healthy, asymptomatic populations. It emphasises the need for laboratory screening, particularly in pregnant women, over empiric treatment because of high chances of missing infections.

Determinants of self-reported sexually transmitted infections among reproductive age women in Senegal: evidenced by Senegal demographic and health survey

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.

Neisseria gonorrhoeae antimicrobial resistance patterns and associated risk factors in women of childbearing potential in northwestern Ethiopia

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.

Systematic review and meta-analysis of seroprevalence of human immunodeficiency virus serological markers among pregnant women in Africa, 1984-2020

BACKGROUND

Human immunodeficiency virus (HIV) is a major public health concern, particularly in Africa where HIV rates remain substantial. Pregnant women are at an increased risk of acquiring HIV, which has a significant impact on both maternal and child health.

AIM

To review summarizes HIV seroprevalence among pregnant women in Africa. It also identifies regional and clinical characteristics that contribute to study-specific estimates variation.

METHODS

The study included pregnant women from any African country or region, irrespective of their symptoms, and any study design conducted in any setting. Using electronic literature searches, articles published until February 2023 were reviewed. The quality of the included studies was evaluated. The DerSimonian and Laird random-effects model was applied to determine HIV pooled seroprevalence among pregnant women in Africa. Subgroup and sensitivity analyses were conducted to identify potential sources of heterogeneity. Heterogeneity was assessed with Cochran's Q test and I2 statistics, and publication bias was assessed with Egger's test.

RESULTS

A total of 248 studies conducted between 1984 and 2020 were included in the quantitative synthesis (meta-analysis). Out of the total studies, 146 (58.9%) had a low risk of bias and 102 (41.1%) had a moderate risk of bias. No HIV-positive pregnant women died in the included studies. The overall HIV seroprevalence in pregnant women was estimated to be 9.3% [95% confidence interval (CI): 8.3-10.3]. The subgroup analysis showed statistically significant heterogeneity across subgroups (P < 0.001), with the highest seroprevalence observed in Southern Africa (29.4%, 95%CI: 26.5-32.4) and the lowest seroprevalence observed in Northern Africa (0.7%, 95%CI: 0.3-1.3).

CONCLUSION

The review found that HIV seroprevalence among pregnant women in African countries remains significant, particularly in Southern African countries. This review can inform the development of targeted public health interventions to address high HIV seroprevalence in pregnant women in African countries.

Prevalence of five treatable sexually transmitted infections among women in Lower River region of The Gambia

BACKGROUND

The prevalence of sexually transmitted infections (STIs) in sub-Saharan Africa is poorly described. We aimed to determine the prevalence of five treatable STIs (Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Mycoplasma genitalium, Treponema pallidum) in a sample of Gambian women from the general population.

METHODS

Archived specimens from 420 women aged 15 - 69 years living in The Gambia enrolled in a clinical trial of human papilloma virus vaccine schedules were tested in this study. Urine samples were tested for C. trachomatis, N. gonorrhoeae, T. vaginalis and M. genitalium using a commercially available, open-platform multiplex PCR kit. A fragment of the ompA gene was amplified from C. trachomatis-positive samples and sequenced. Serum samples were tested for T. pallidum using the Chembio DPP Syphilis Screen and Confirm test.

RESULTS

Overall, 41/420 (9.8%) women tested positive for at least one STI. 32 (7.6%), 9 (2.1%), 1 (0.2%), 1 (0.2%) and 0 (0.0%) tested positive for T. vaginalis, C. trachomatis, N gonorrhoeae, M. genitalium and T. pallidum, respectively. ompA gene sequence was available from five C. trachomatis infections: four were genovar D,one was genovar G and one was genovar F.

CONCLUSIONS

STIs are endemic in The Gambia. Monitoring systems should be established.

Prevalence of Group B Streptococcus maternal colonization, serotype distribution, and antimicrobial resistance in Sub-Saharan Africa: A systematic review and meta-analysis

OBJECTIVE

Group B Streptococcus (GBS)-associated maternal, perinatal, and neonatal mortality and morbidity disproportionately affects Sub-Saharan Africa (SSA). This systematic review and meta-analysis aimed to address the estimated prevalence, antimicrobial susceptibility, and serotype distribution of GBS isolates in SSA.

METHODS

This study was done according to PRISMA guidelines. MEDLINE/PubMed, CINAHL (EBSCO), Embase, SCOPUS, Web of Sciences databases, and Google Scholar were used to retrieve both published and unpublished articles. STATA software version 17 was used for data analysis. Forest plots using the random-effect model were used to present the findings. Heterogeneity was assessed using Cochrane chi-square (I²) statistics, while the Egger intercept was used to assess publication bias.

RESULTS

Fifty-eight studies that fulfilled the eligibility criteria were included for meta-analysis. The pooled prevalence of maternal rectovaginal colonization and vertical transmission of GBS were 16.06, 95% CI [13.94, 18.30] and 43.31%, 95% CI [30.75, 56.32], respectively. The highest pooled proportion of antibiotic resistance to GBS was observed in gentamicin (45.58%, 95% CI [4.12%, 91.23]), followed by erythromycin, (25.11%, 95% CI [16.70, 34.49]). The lowest antibiotic resistance was observed in vancomycin (3.84%, 95% CI [0.48, 9.22]). Our findings indicate that serotypes Ia/Ib/II/ III/and V cover almost 88.6% of serotypes in SSA.

CONCLUSIONS

The estimated high prevalence and resistance to different antibiotic classes observed in GBS isolates from SSA suggests the need for implementation of effective intervention efforts.

Prevalence and Demographic, Socioeconomic, and Behavioral Risk Factors of Self-Reported Symptoms of Sexually Transmitted Infections (STIs) among Ever-Married Women: Evidence from Nationally Representative Surveys in Bangladesh

Sexually transmitted infections (STI) symptoms (e.g., abnormal genital discharge and genital sores/ulcers) are a major public health concern in Bangladesh because the symptoms can indicate an STI and cause sexual and reproductive health complications in women of reproductive age. To our knowledge, no study examined the prevalence and risk factors of STI symptoms using a nationally representative sample. This study investigates the prevalence of STI symptoms among ever-married women in Bangladesh and the associations of STI symptoms with various demographic, socioeconomic, and behavioral risk factors using the most recent available data (2007, 2011, and 2014) of the Bangladesh Demographic and Health Surveys (BDHS). The BDHS employs a two-stage stratified sampling technique. The analytic sample comprised 41,777 women of reproductive age (15-49 years). Outcome variables included STI symptoms: abnormal genital discharge and genital sores/ulcers. Multivariate logistic regression was employed to find the adjusted odds ratio with a 95% confidence interval to assess the associations of outcome measures with explanatory variables. The study found that the prevalence of abnormal genital discharge and genital sores/ulcers among ever-married women aged 15-49 years was 10% and 6%, respectively. Multivariable analysis revealed that for women aged 25-34 years, those who used contraceptives and married earlier had an increased likelihood of STI symptoms. Furthermore, women from the wealthiest wealth quintile and couple's joint decision-making were less likely to have STI symptoms. Findings have implications for interventions efforts aiming to improve women's sexual and reproductive health in Bangladesh.

Editorial: Infectious diseases and NCDs persist despite concerted effort

Nil.