Abstract
Background. Sexually transmitted infections (STIs) continue to be a significant public health problem especially among women of reproductive age in Africa. Methods. A total of 2236 women that had enrolled in the MDP301 vaginal microbicide trial were tested for the presence of Chlamydia trachomatis (CT), Neisseria gonorrhea (NG), Treponema pallidum, and Trichomonas vaginalis (TV). Results. CT was identified as the most prevalent STI (11%) followed by TV (10%), NG, and Syphilis (3%). The highest prevalence of coinfection was reported between T. pallidum and TV (19.67%, P = 0.004), followed by CT and TV (13.52%, P ≤ 0.001). Risk factors that were significantly associated with STI acquisition were women of 23 years of age or younger (HR: 1.50, 95% CI 1.17, 1.93), baseline STI with CT (HR: 1.77, 95% CI 1.32, 2.35), TV (HR: 1.58, 95% CI, 1.20, 2.10), and T. pallidum (HR: 5.13, 95% CI 3.65, 7.22), and a low education level (HR: 1.30, 95% CI 1.02, 1.66). Conclusion. Young women with lower education and a history of STIs are at high risk of multiple STIs. Prevention programs should consider target approach to STI prevention among young women. This trial is registered with ISRCTN64716212.
Highlights
According to the World Health Organization (WHO) 2008 estimates, the total global number of new cases of four of the curable sexually transmitted infections (STIs), Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Treponema pallidum (Syphilis), and Trichomonas vaginalis (TV), was nearly 500 million cases in adults aged 15 to 49 years (WHO) [1]
Risk factors that were significantly associated with STI acquisition were women of 23 years of age or younger (HR: 1.50, 95% CI 1.17, 1.93), baseline STI with CT (HR: 1.77, 95% CI 1.32, 2.35), TV (HR: 1.58, 95% CI, 1.20, 2.10), and T. pallidum (HR: 5.13, 95% CI 3.65, 7.22), and a low education level (HR: 1.30, 95% CI 1.02, 1.66)
The most prevalent STI in this cohort was CT which was detected in a total of 244/2236 (11%) followed by TV in 200/2236 (10%), NG in 71/2236 (3%), and T. pallidum in 56/2236 (3%)
Summary
According to the World Health Organization (WHO) 2008 estimates, the total global number of new cases of four of the curable sexually transmitted infections (STIs), Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Treponema pallidum (Syphilis), and Trichomonas vaginalis (TV), was nearly 500 million cases in adults aged 15 to 49 years (WHO) [1]. STIs continue to be a significant public health problem with an increased burden on women of reproductive age [3, 4]. They have been associated with a wide spectrum of complications such as urethritis and epididymitis in men and cervicitis in women [5, 6]; the more ascending cervical infections may cause pelvic inflammatory disease and untimely tubal pathology, which increases the risk of ectopic pregnancy, tubal infertility, and chronic abdominal pain [7, 8]. Transmitted infections (STIs) continue to be a significant public health problem especially among women of reproductive age in Africa.
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