Prevalence of sexually transmitted infections (STIs), associations with sociodemographic and behavioural factors, and assessment of the syndromic management of vaginal discharge in women with urogenital complaints in Mozambique

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Prevalence of sexually transmitted infections (STIs), associations with sociodemographic and behavioural factors, and assessment of the syndromic management of vaginal discharge in women with urogenital complaints in Mozambique

Manjate, Alice, 1971- (author): Örebro universitet,Institutionen för medicinska vetenskaper,Departament de Microbiologia, Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique

Sergon, Gladys, 1984- (author): Örebro universitet,Institutionen för naturvetenskap och teknik,School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden

Kenga, Darlenne (author): Departament de Microbiologia, Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique

Golparian, Daniel, 1984- (author): Örebro universitet,Institutionen för medicinska vetenskaper,WHO Collaborating Centre for Gonorrhoea and Other Sexually Transmitted Infections, Faculty of Medicine and Health, Örebro University, Örebro, Sweden

Tyulenev, Yuriy (author): Department of Healthcare, Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology, Moscow, Russia

Loquilha, Osvaldo (author): Departamento de Matemática e Informática, Faculdade de Ciências, Universidade Eduardo Mondlane, Maputo, Mozambique

Mausse, Fabião (author): Departament de Microbiologia, Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique

Guschin, Alexander (author): Department of Healthcare, Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology, Moscow, Russia

Langa, José Carlos (author): Departament de Microbiologia, Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique

Passanduca, Alfeu (author): Departament de Microbiologia, Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique

Sacarlal, Jahit (author): Departament de Microbiologia, Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique

Unemo, Magnus, 1970- (author): Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,WHO Collaborating Centre for Gonorrhoea and Other Sexually Transmitted Infections, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; Institute for Global Health, University College London (UCL), London, United Kingdom

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Frontiers Media S.A. 2024
2024
English.
In: Frontiers in reproductive health. - : Frontiers Media S.A.. - 2673-3153. ; 6

Related links:: https://doi.org/10.3...; show more...; https://urn.kb.se/re...; https://doi.org/10.3...; show less...

Journal article (peer-reviewed)

Abstract Subject headings

In Mozambique, sexually transmitted infections (STIs) are estimated to be prevalent, but diagnosis and treatment of curable STIs rely only on syndromic management. We examined the prevalence of four non-viral STIs and HIV-1/2, based on etiological diagnosis, associations with sociodemographic and behavioural factors, and the STI diagnostic accuracy of the vaginal discharge syndromic management in women with urogenital complaints in Maputo, Mozambique. A cross-sectional study was performed in Maputo, Mozambique, February 2018-January 2019, enrolling 924 women of reproductive age with urogenital complaints. Endocervical/vaginal swabs were sampled and chlamydia, gonorrhoea, trichomoniasis and Mycoplasma genitalium infections were diagnosed using a multiplex real-time PCR (AmpliSens; InterLabServices). Serological testing was performed for HIV-1/2. A structured questionnaire collected metadata. All data were analyzed in STATA/IC 12.1 using descriptive statistics, chi-square tests and logistic regression model. About 40% of the women were less than 24 years old, 50.8% were single, 62.1% had their sexual debut between 12 and 17 years of age, and the main complaint was vaginal discharge syndrome (85%). The prevalence of chlamydia was 15.5%, trichomoniasis 12.1%, gonorrhoea 4.0%, M. genitalium 2.1%, and HIV-1/2 22.3%. The vaginal discharge syndrome flowchart had a sensitivity of 73.0%-82.5% and a specificity of 14%-15% for the detection of any individual non-viral STI in women with urogenital complaints. In total, 19.2% of the symptomatic women with chlamydia, trichomoniasis or gonorrhoea would not be detected and accordingly treated using the vaginal discharge syndromic management (missed treatment) and 70.0% of the women would be treated despite not being infected with any of these three STIs (overtreatment). In conclusion, a high prevalence of especially chlamydia, trichomoniasis, and HIV-1/2 was found in women of childbearing age with urogenital complaints in Maputo, Mozambique. Syndromic management of vaginal discharge revealed low accuracy in the detection of STIs in symptomatic women, especially low specificity, which resulted in under-treatment of STI-positive cases and incorrect or over-treatment of women with urogenital complaints, many of whom were negative for all the non-viral STIs. Etiological diagnosis is imperative for effective management of STIs in symptomatic and asymptomatic women.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Infektionsmedicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Infectious Medicine (hsv//eng)

Keyword

Mozambique
prevalence
sexually transmitted infections
syndromic management
vaginal discharge

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art (subject category)

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