The Natural Course of Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, and Mycoplasma genitalium in Pregnant and Post-Delivery Women in Pemba Island, Tanzania.

Naomi C A Juliana,Elena Ambrosino,Sunil Sazawal,Nina B Uijldert,Fahad Aftab,Sander Ouburg,Jolein Pleijster,Servaas A Morré,Saikat Deb,Said M Ali,Abdulla Mbaruk Omar

doi:10.3390/microorganisms9061180

Abstract

This study aimed to determine the persistence of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Trichomonas vaginalis (TV) and Mycoplasma genitalium (MG) infections during pregnancy and after delivery in vaginal swabs of women from Pemba Island, Tanzania. In the context of an earlier biobanking effort, vaginal swabs were collected at two timepoints during pregnancy and once post-delivery. Detection of CT, NG, TV, and MG was performed by PCR using validated detection kits in samples from 441 pregnant women aged 16–48 years old. Among those, 202 samples were matched during pregnancy and 38 at the second timepoint of the pregnancy and post-delivery CT infection persistence during pregnancy was 100% (n = 11) after an average of eight weeks, that of TV infection 82% (n = 11) after ten weeks, and that of MG infection 75% (n = 4) after ten weeks. Post-delivery (after approximately 22 weeks) infection persistence was 100% for CT (n = 1) and 20% for TV (n = 5). NG was only detected at the last collection timepoint, its persistence rate could not be determined. These results show persistence and clearance of curable infections during and after pregnancy. Analysis of biobanked samples is a valuable approach in the investigation of the natural history of curable pathogens.

Highlights

All vaginal samples were retrospectively tested for the presence of C. trachomatis, N. gonorrhoeae, T. vaginalis and M. genitalium and the positive results were immediately shared with the stakeholders in Tanzania so the participants could be informed of their health status for further action
This study reports the persistence rate of C. trachomatis (100%), T. vaginalis (82%)
The detection and persistence of these curable genital infection stresses on the importance of screening all women during the pre and postnatal periods, where treatment will decrease sequelae

Summary

Introduction

Neisseria gonorrhoeae, Trichomonas vaginalis and Mycoplasma genitalium are common curable sexually transmitted infections (STIs) that are mostly asymptomatic and have a high burden in sub-Saharan Africa [1,2]. In 2016, the estimated prevalence among women between 15 and 49 years of age was 5% for C. trachomatis infection, 1.9% for N. gonorrhoeae infection and 12% for T. vaginalis infections in the African region [3]. For M. genitalium, no recent regional data for sub-Saharan Africa are available, but prevalence among reproductive-age women in South Africa has been reported between. 1.6 and 11% [4] These STIs can cause acute urogenital problems, such as inflammation of the cervix (cervicitis), but their often asymptomatic presentation

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