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High Prevalence and Incidence of Asymptomatic Sexually Transmitted Infections During Pregnancy and Postdelivery in KwaZulu Natal, South Africa
Journal article   Open access   Peer reviewed

High Prevalence and Incidence of Asymptomatic Sexually Transmitted Infections During Pregnancy and Postdelivery in KwaZulu Natal, South Africa

Dhayendre Moodley, Prashini Moodley, Motshedisi Sebitloane, Deepak Soowamber, Heather Luz McNaughton-Reyes, Allison K. Groves and Suzanne Maman
Sexually transmitted diseases, v 42(1), pp 43-47
Jan 2015
PMID: 25504300
url
https://doi.org/10.1097/OLQ.0000000000000219View
Published, Version of Record (VoR) Open

Abstract

Infectious Diseases Life Sciences & Biomedicine Science & Technology
Background: We report the prevalence and incidence of 3 treatable sexually transmitted pathogens (Neiserria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis) in women who were HIV infected or at high risk for HIV infection, in pregnancy and postpartum, respectively. Method: Vulvovaginal specimens collected at the first antenatal visit and again at 14 weeks postpartum were tested for N. gonorrhoeae, C. trachomatis, and T. vaginalis in the laboratory. Women were routinely tested for HIV-1 with a point-of-care test. Results: Among 1480 women, 32.3% (95% confidence interval, 29.9-34.7) tested positive for any of the sexually transmitted infections (STIs) in pregnancy and 19.2%(95% confidence interval, 16.9-21.5) were positive when retested 14 weeks postpartum (incidence rate, 79.2 per 100 person-years). The prevalence of N. gonorrhoeae and T. vaginalis infections in pregnancy and the incidence rate of any STI at 14 weeks postpartum were significantly higher in HIV-1-infected women (P < 0.0001 amd P = 0.0079). More than 50% of N. gonorrhoeae, T. vaginalis, and C. trachomatis infections in pregnancy were asymptomatic. Conclusions: The high prevalence of asymptomatic STIs in pregnancy is compelling evidence that demands the development and validation of point-of-care tests for STIs be expedited. In addition, the high incidence of STIs 3 months postpartum suggests that women in this study setting resume unprotected sexual intercourse soon after delivery.

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Infectious Diseases
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