Abstract
ABSTRACT Introduction: Sexually transmitted infections (STI) remain a major public health problem and surveillance is crucial for prevention and control strategies. Objective: Our aim was to assess the prevalence of STI in a reference center for gynecology in Rio de Janeiro, Brazil. Materials and methods: It is a cross-sectional study conducted between August 2016 and June 2017. Whole blood and cervical cells were collected from 62 women and tested for human papillomavirus (HPV), human immunodeficiency virus (HIV), syphilis, chlamydia, gonorrhea and herpes simples virus 1 and 2 (HSV-1/2). Cervical lesions were diagnosed by cytopathology and in some patients by colposcopy (79%). Other STI were evaluated during clinical examination. Results: Cervical lesions were detected by cytopathology examinations in 46.8% of patients; those with a history of four sexual partners were at higher risk of developing them. There was moderate agreement between the cytopathology e colposcopy results (Kappa = 0.69). The prevalence of HSV (96.7%), syphilis (6.4%) and HIV (3.2%) were higher than that described in the literature, while the prevalence of chlamydia (6.4%) and gonorrhea (1.6%) were similar. HPV was detected in 53.2% of women, 32.3% of which were infected by HPV 16. In the context of co-infections, 38 women (61.3%) presented more than one STI. Conclusion: Since most of the women analyzed were affected by more than one STI, our results suggest that routine screening for these infections at health centers would help in early detection, treatment and prevention of these infections. These measures would also impact on patients’ cervical cancer control.
Highlights
Transmitted infections (STI) remain a major public health problem and surveillance is crucial for prevention and control strategies
Sexually transmitted infections (STI) are associated with significant morbidity and mortality; according to their causative agents they are grouped in bacterial, parasitic or viral STI [human immunodeficiency virus (HIV), human papillomavirus (HPV), herpes simplex virus (HSV) and hepatitis B virus (HBV)](1)
They were categorized into five groups according to the cytopathological exam: 33 presented no lesions; six presented atypical squamous cells of undetermined significance (ASC-US) (n = 5) or atypical squamous cells that cannot exclude high-grade squamous intraepithelial lesion (ASC-H) (n = 1); seven were classified as low-grade squamous intraepithelial lesion (LSIL); 13 were HSIL; and three presented tumors
Summary
Transmitted infections (STI) remain a major public health problem and surveillance is crucial for prevention and control strategies. Conclusion: Since most of the women analyzed were affected by more than one STI, our results suggest that routine screening for these infections at health centers would help in early detection, treatment and prevention of these infections. These measures would impact on patients’ cervical cancer control. The estimated global prevalence of chlamydia, gonorrhea, trichomoniasis and syphilis (curable STI) among women aged 1549 years, was 4.2%, 0.8%, 5%, and 0.5%, respectively, in 2012 These infections account for more than 190 million cases worldwide[2]. HPV affects 11.7% of the world population[5] and depending on its potential to cause cancer, this virus can be epidemiologically classified as low risk (LR) and high-risk (HR)(6) – the latter is detected in about 95% of cervical cancers[7]
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