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Gore-Langton, Georgia, Madanitsa, Mwayiwawo, Barsosio, Hellen C, Minja, Daniel T R, Mosha, Jacklin, Kavishe, Reginald A, Mtove, George, Gesase, Samwel, Msemo, Omari A, Kariuki, Simon, Otieno, Kephas, Phiri, Kamija S, Lusingu, John P A, Mukerebe, Crispin, Manjurano, Alphaxard, Ikigo, Pius, Saidi, Queen, Onyango, Eric, Schmiegelow, Christentze, Dodd, James, Hill, Jenny 
ORCID: https://orcid.org/0000-0003-1588-485X, Hansson, Helle, Alifrangis, Michael, Gutman, Julie, Hunter, Patricia Jean, Klein, Nigel, Ashorn, Ulla, Khalil, Asma, Cairns, Matt, terKuile, Feiko ORCID: https://orcid.org/0000-0003-3663-5617 and Chico, Matthew
(2024)
'Prevalence and risk factors of curable sexually transmitted and reproductive tract infections and malaria co-infection among pregnant women at antenatal care booking in Kenya, Malawi and Tanzania: a cross-sectional study of randomised controlled trial data'. BMJ Public Health, Vol 2, Issue 2, e000501.
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Abstract
Objectives Malaria and curable sexually transmitted and reproductive tract infections (STIs/RTIs) are associated with adverse pregnancy outcomes. This study reports the prevalence and risk factors of curable STIs/RTIs, STI/RTI co-infection and STI/RTI and malaria co-infection among HIV-negative pregnant women at their first antenatal care visit in Kenya, Malawi and Tanzania.
Methods HIV-negative pregnant women of all gravidae (n=4680) were screened for syphilis with point-of-care tests and treated if positive. Separately, women provided blood samples (n=4569) for rapid plasma reagin (RPR) testing; positive cases were confirmation by Treponema pallidum particle agglutination (TPPA). Women also provided dried blood spots for batch testing of malaria by retrospective polymerase chain reaction (PCR (n=4226) methods. A randomly selected subgroup of women provided vaginal swabs for chlamydia, gonorrhoea and trichomoniasis testing by retrospective PCR batch testing (n=1431), and bacterial vaginosis diagnosis by Nugent scoring (n=1402).
Results Malaria prevalence was 14.6% (95% CI 13.6 to 15.7), 45.9% (43.4 to 48.4) of women were positive for at least one curable STI/RTI and 6.7% (5.5 to 8.1) were co-infected with malaria and a curable STI/RTI. Prevalence of individual STIs/RTIs ranged from 28.5% (26.2 to 30.9) for bacterial vaginosis to 14.5% (12.7 to 16.4) for trichomoniasis, 13.8% (12.1 to 15.7) for chlamydia, 2.7% (1.9 to 3.6) for gonorrhoea and 1.7% (1.4 to 2.2) for RPR/TPPA-confirmed syphilis. The prevalence of STI/RTI co-infection was 10.1% (8.7 to 11.8). Paucigravidae, at highest risk of malaria, were also at greater risk of having chlamydia, gonorrhoea and bacterial vaginosis than multigravidae.
Conclusions Of women infected with malaria, 49.0% also had a curable STI/RTI and one in five women with at least one STI/RTI were co-infected with more than one STI/RTI. Current antenatal interventions that address malaria and curable STIs/RTIs remain suboptimal. New approaches to preventing and managing these infections in pregnancy are urgently needed.
| Item Type: | Article |
|---|---|
| Subjects: | WC Communicable Diseases > Sexually Transmitted Diseases > WC 140 Sexually transmitted diseases WC Communicable Diseases > Tropical and Parasitic Diseases > WC 750 Malaria WJ Urogenital System > WJ 151 Urinary tract infections WQ Obstetrics > Pregnancy Complications > WQ 240 Pregnancy complications (General) |
| Faculty: Department: | Clinical Sciences & International Health > Clinical Sciences Department |
| Digital Object Identifer (DOI): | https://doi.org/10.1136/bmjph-2023-000501 |
| SWORD Depositor: | JISC Pubrouter |
| Depositing User: | JISC Pubrouter |
| Date Deposited: | 08 Oct 2024 07:26 |
| Last Modified: | 08 Oct 2024 07:26 |
| URI: | https://archive.lstmed.ac.uk/id/eprint/25385 |
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