Abstract
Introduction We have previously determined the prevalence of human papillomavirus (HPV) infection among women in rural Nepal. In the current study, we also wanted to examine the prevalence of and risk factors for other sexually transmitted infections (STIs) in the same population. Methods Population-based study of nonpregnant women ≥ 15 years who were married or had a history of marriage in the past, residing in five rural villages in Nepal. Data on sociodemographic characteristics, reproductive history, and genitourinary symptoms were collected, and a gynecological examination was conducted. Cervical samples were analyzed by real-time PCR for Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis and HPV, and a serum sample was analyzed for syphilis, hepatitis B virus (HBV) and HIV infection by serology. Results Of 2416 eligible women, 62% participated. Trichomoniasis, Chlamydia trachomatis infection, HPV and HBV infection, and syphilis were detected in 5.4%, 0.8%, 14.3%, 0.3%, and 0.2% of the women. None had gonorrhea or HIV infection. Of those with genitourinary symptoms, 6.3% had a curable STI. Vaginal discharge classified as abnormal by gynecological examination, but not self-reported discharge, was significantly associated with laboratory diagnosis of a curable STI. Risk factors for trichomoniasis were reproductive age and high cast/ethnicity. Due to low prevalence, risk factors for other STIs could not be disclosed. Conclusion We observed high prevalence of HPV infection followed by trichomoniasis, while other STIs were rare among women in rural Nepal. There was no association between genitourinary symptoms and laboratory-confirmed STIs.
Highlights
We have previously determined the prevalence of human papillomavirus (HPV) infection among women in rural Nepal
We aimed to examine the prevalence of HPV and other sexually transmitted infections (STIs) in the same population for comparison, namely, the curable STIs gonorrhea, Chlamydia trachomatis infection, syphilis, and trichomoniasis, as well as viral STIs caused by hepatitis B virus (HBV), human immunodeficiency virus (HIV), and herpes simplex virus (HSV)
1498 (62%) of 2416 eligible women were recruited and completed the questionnaire (Figure 1). Among those who did not participate in the study, 250 were pregnant, whereas data were lacking on the remaining nonparticipants
Summary
We have previously determined the prevalence of human papillomavirus (HPV) infection among women in rural Nepal. We wanted to examine the prevalence of and risk factors for other sexually transmitted infections (STIs) in the same population. Trichomoniasis, Chlamydia trachomatis infection, HPV and HBV infection, and syphilis were detected in 5.4%, 0.8%, 14.3%, 0.3%, and 0.2% of the women. Of those with genitourinary symptoms, 6.3% had a curable STI. We observed high prevalence of HPV infection followed by trichomoniasis, while other STIs were rare among women in rural Nepal. There was no association between genitourinary symptoms and laboratory-confirmed STIs. Sexually transmitted infections (STIs) cause considerable morbidity worldwide, especially among women of reproductive age. All STIs are preventable, while only gonorrhea (Neisseria gonorrhoeae), Chlamydia trachomatis infection, syphilis, and trichomoniasis (Trichomonas vaginalis) are curable [1, 2].
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