Genital tract infections in women attending sexually transmitted infection clinics in Mwanza, north-west Tanzania

Abstract

Lack of diagnostic methods to determine a specific aetiology can contribute to an increase in genital tract infections (GTIs) in women. We determined the aetiology of, and risk factors associated with, GTIs in women with genital symptoms. After obtaining informed consent, genital swabs to detect Neisseria gonorrhoeae, Trichomonas vaginalis, vaginal candidiasis, bacterial vaginosis and Chlamydia trachomatis, were collected from women who attended sexually transmitted infection (STI) clinics in Mwanza in 2010. Demographic data were also gathered. A total of 320 women, with a mean age 26.5 ± 6.9 years, were recruited for the study. The percentages of GTIs in women with genital discharge syndromes were 25.9% for bacterial vaginosis, 25.6% for vaginal candidiasis, 14% for C. trachomatis, 8.7% for T. vaginalis and 8.4% for N. gonorrhoeae. Gonococcal infections were detected more by N. gonorrhoeae PCR than by culture methods (p-value 2 infections of bacterial vaginosis, C. trachomatis and N. gonorrhoeae. Women who were reported to have engaged in sexual intercourse before the age of 18 years and those who had > 2 sexual partners were more likely to be infected by C. trachomatis vs. N. gonorrhoeae and T. vaginalis. Following a sensitivity test, 21 out of 27 (77.7%) of gonococcal isolates were quinolone-resistant N. gonorrhoeae. One isolate was resistant to ciprofloxacin, azithromycin and cefixime, but not ceftriaxone. A high prevalence of bacterial vaginosis, gonorrhoea, trichomoniasis, chlamydia and vaginal candidiasis in women who attended the STI clinics in Mwanza was observed. Drug resistance of N. gonorrhoeae to ciprofloxacin is very high. This calls for an immediate review of the guidelines on its use as a first-line treatment for STIs in Tanzania.