Treponema pallidum infection predicts sexually transmitted viral infections (hepatitis B virus, herpes simplex virus-2, and human immunodeficiency virus) among pregnant women from rural areas of Mwanza region, Tanzania

Gilbert Ng’Wamkai,Clotilda Chuma,Stephen E Mshana,Betrand Msemwa,Mariam M Mirambo,Frank Mgaya,Damas Chengula,Mtebe Majigo,Vitus Silago,Kalista V Msigwa

doi:10.1186/s12884-019-2567-1

Abstract

BackgroundSexually transmitted infections (STIs) is a global health problem with increased risk and morbidities during pregnancy. This study investigated the magnitude of viral STIs among pregnant women from three rural hospitals/clinics providing antenatal care in Mwanza region, Tanzania.MethodsBetween February and May 2018, a total of 499 pregnant women were enrolled and tested for Human immunodeficiency virus (HIV), Herpes simplex virus-2 (HSV-2), Hepatitis B virus (HBV) and Hepatitis C virus (HCV) using rapid immunochromatographic tests and for syphilis using non-treponemal and treponemal antibody test.ResultsThe median age of enrolled women was 25 (IQR: 22–31) years. Seventy eight (15.6, 95% CI: 12–18) of women tested had at least one sexually transmitted viral infection. Specific prevalence of HIV, HBV, HCV, HSV-2 IgG and HSV-2 IgM were found to be 25(5.0%), 29(5.8%), 2(0.4%), 188(37.7%) and 24(4.8%), respectively. The odds of having viral infection was significantly high among women with positive T. pallidum serostatus (adjusted odd ratio (aOR): 3.24, 95%CI; 1.2–85). By multivariable logistic regression analysis, history of STIs predicted HSV-2 IgM seropositivity (aOR: 3.70, 95%CI: 1.43–9.62) while parity (aOR: 1.23, 95%CI: 1.04–1.46) predicted HBV infection and syphilis positive results (aOR: 8.63, 95%CI: 2.81–26.45) predicted HIV infection.ConclusionA significant proportion of pregnant women in rural areas of Mwanza region has at least one sexually transmitted viral infection which is independently predicted by positive T. pallidum serostatus. The strengthening and expansion of ANC screening package to include screening of STIs will ultimately reduce the viral STIs among pregnant women hence reduce associated morbidities and mortalities.

Highlights

Transmitted infections (STIs) is a global health problem with increased risk and morbidities during pregnancy
Prevalence and factors associated with Herpes simplex virus type 2 (HSV-2) seropositivity among pregnant women in rural areas of Mwanza region Overall seroprevalence of specific HSV-2 Immunoglobulin gamma (IgG) and IgM antibodies among pregnant women in this study was high, which is similar to a previous study among adolescent pregnant women in the same settings [21]
In conclusion, a significant proportion of pregnant women in rural settings of Mwanza region is infected with at least one sexually transmitted viral infection which is predicted by positive T. pallidum serostatus

Summary

Introduction

Transmitted infections (STIs) is a global health problem with increased risk and morbidities during pregnancy. Herpes simplex virus type 2 (HSV-2) is the main causative agent of genital ulcer diseases worldwide [3]. It can be transmitted vertically from mother to the fetus and it is highly prevalent in the sub-Saharan Africa whereby it has been found to cause severe illness to the neonates [4,5,6,7]. Hepatitis B virus (HBV) and hepatitis C viruses (HCV) are major public health concern worldwide with high prevalence in the sub-Saharan Africa and Asia [10, 11]. The World Health Organization (WHO) estimates that 3% of the world’s populations are chronically infected with HCV with high prevalence reported in the subSaharan Africa [13, 14]

Methods

Results

Discussion

Conclusion