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. 1999 Sep;10(9):609-14.
doi: 10.1258/0956462991914753.

Sexually transmitted infections in young pregnant women in Bangui, Central African Republic

D Blankhart  1 , O Müller, G Gresenguet, P Weis
Affiliations

Sexually transmitted infections in young pregnant women in Bangui, Central African Republic

D Blankhart et al. Int J STD AIDS. 1999 Sep.

Abstract

In early 1996, 481 women visiting the antenatal services of the 3 major governmental health centres in the capital city of the Central African Republic (CAR) were included in the study. All study participants underwent the health centre's routine gynaecological examination, including laboratory diagnosis of trichomoniasis, candidiasis, gonorrhoea, syphilis and bacterial vaginosis. Cervical secretions and blood samples from study participants were sent to the National STD Reference Centre for diagnosis of Chlamydia trachomatis, Neisseria gonorrhoeae, Candida albicans, Treponema pallidum, and HIV. Overall, 34% of the study women were diagnosed with at least one sexually transmitted infection (STI) (3.1% N. gonorrhoeae, 6.2% C. trachomatis, 9.9% T. vaginalis, 6.7% T. pallidum, 12.2% HIV-1). In addition, 29.1% of women were diagnosed with bacterial vaginosis and 46.6% with candidiasis. Only a small proportion of these women had sought treatment during the weeks before, despite the recognition of genital symptoms. Self-reported and health worker-recognized symptoms, signs and laboratory results exhibited only low sensitivities, specificities, and positive predictive values in the diagnosis of STIs. These findings confirm the high vulnerability of young African women to STIs and emphasize the need for specific control interventions which should include affordable and user-friendly services. Moreover, these results call for more effective quality control in case of laboratory-based STI control strategies and question the validity of syndromic STI management strategies in women attending antenatal care services in Africa.

PIP: This study reports on the prevalence of sexually transmitted infections (STIs) among pregnant women in Bangui, Central African Republic. A total of 481 pregnant women visiting the antenatal services of the 3 major governmental health centers were included in the study. All these women were interviewed and underwent gynecological examination, including laboratory diagnosis of trichomoniasis, candidiasis, gonorrhea, syphilis and bacterial vaginosis. The results revealed that 34% of the women were diagnosed with at least one STI. Gonorrhea accounted for 3.1%, chlamydiasis for 6.2%, trichomoniasis for 9.9%, syphilis for 6.7%, and HIV-1 for 12.2%. In addition, 29.1% of women were diagnosed with bacterial vaginosis and 46.6% with candidiasis. The majority of the women diagnosed with an STI reported specific clinical symptoms during the week before they entered into the study, but only a minority of them actively sought treatment, and only half of those consulted the formal health sector. Self-reported and health worker-recognized symptoms, signs and laboratory results manifested only low sensitivities, specificities, and positive predictive values in STI diagnosis. These results confirmed the high susceptibility of young African women to STIs. Therefore, specific control interventions should be carried out which incorporate affordable and user-friendly services.

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