Skip to main content
PMC home page
Bulletin of the World Health Organization logoLink to Bulletin of the World Health Organization
. 1995;73(5):621–630.

Risk assessment and other screening options for gonorrhoea and chlamydial infections in women attending rural Tanzanian antenatal clinics.

P Mayaud 1, H Grosskurth 1, J Changalucha 1, J Todd 1, B West 1, R Gabone 1, K Senkoro 1, M Rusizoka 1, M Laga 1, R Hayes 1, et al.
PMCID: PMC2486828  PMID: 8846488

Abstract

Sexually transmitted diseases (STDs) are a major cause of morbidity and mortality in developing countries and may play a key role in enhancing the heterosexual transmission of human immunodeficiency virus (HIV). Treatment of STDs is one of the most cost-effective of all health interventions in developing countries; however, STDs among women in rural populations have received little attention. In this study, we report that prevalences of STDs among 964 women attending antenatal clinics in a rural area of the United Republic of Tanzania. A total of 378 (39%) of these women were infected with at least one STD pathogen, 97 (10%) had syphilis, and 81 (8%) has Neisseria gonorrhoeae (NG) and/or Chlamydia trachomatis (CT) infection. The recommended syndromic approach to screening for NG/CT infection, based on reported genital symptoms, had a low sensitivity (43%) and failed to discriminate between infected and uninfected women. A risk score approach that we developed, based on sociodemographic and other factors associated with NG/CT infection, had a higher sensitivity and lower cost per true case treated than other approaches, although its positive predictive value was only about 20%.

Full text

PDF
628

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Arya O. P., Lawson J. B. Sexually transmitted diseases in the tropics. Epidemiological, diagnostic, therapeutic, and control aspects. Trop Doct. 1977 Apr;7(2):51–56. doi: 10.1177/004947557700700203. [DOI] [PubMed] [Google Scholar]
  2. Arya O. P., Nsanzumuhire H., Taber S. R. Clinical, cultural, and demographic aspects of gonorrhoea in a rural community in Uganda. Bull World Health Organ. 1973;49(6):587–595. [PMC free article] [PubMed] [Google Scholar]
  3. Barongo L. R., Borgdorff M. W., Mosha F. F., Nicoll A., Grosskurth H., Senkoro K. P., Newell J. N., Changalucha J., Klokke A. H., Killewo J. Z. The epidemiology of HIV-1 infection in urban areas, roadside settlements and rural villages in Mwanza Region, Tanzania. AIDS. 1992 Dec;6(12):1521–1528. doi: 10.1097/00002030-199212000-00016. [DOI] [PubMed] [Google Scholar]
  4. Beem M. O., Saxon E. M. Respiratory-tract colonization and a distinctive pneumonia syndrome in infants infected with Chlamydia trachomatis. N Engl J Med. 1977 Feb 10;296(6):306–310. doi: 10.1056/NEJM197702102960604. [DOI] [PubMed] [Google Scholar]
  5. Braddick M. R., Ndinya-Achola J. O., Mirza N. B., Plummer F. A., Irungu G., Sinei S. K., Piot P. Towards developing a diagnostic algorithm for Chlamydia trachomatis and Neisseria gonorrhoeae cervicitis in pregnancy. Genitourin Med. 1990 Apr;66(2):62–65. doi: 10.1136/sti.66.2.62. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Cameron D. W., Simonsen J. N., D'Costa L. J., Ronald A. R., Maitha G. M., Gakinya M. N., Cheang M., Ndinya-Achola J. O., Piot P., Brunham R. C. Female to male transmission of human immunodeficiency virus type 1: risk factors for seroconversion in men. Lancet. 1989 Aug 19;2(8660):403–407. doi: 10.1016/s0140-6736(89)90589-8. [DOI] [PubMed] [Google Scholar]
  7. De Schryver A., Meheus A. Epidemiology of sexually transmitted diseases: the global picture. Bull World Health Organ. 1990;68(5):639–654. [PMC free article] [PubMed] [Google Scholar]
  8. Handsfield H. H., Jasman L. L., Roberts P. L., Hanson V. W., Kothenbeutel R. L., Stamm W. E. Criteria for selective screening for Chlamydia trachomatis infection in women attending family planning clinics. JAMA. 1986 Apr 4;255(13):1730–1734. [PubMed] [Google Scholar]
  9. Laga M., Manoka A., Kivuvu M., Malele B., Tuliza M., Nzila N., Goeman J., Behets F., Batter V., Alary M. Non-ulcerative sexually transmitted diseases as risk factors for HIV-1 transmission in women: results from a cohort study. AIDS. 1993 Jan;7(1):95–102. doi: 10.1097/00002030-199301000-00015. [DOI] [PubMed] [Google Scholar]
  10. Laga M., Plummer F. A., Nzanze H., Namaara W., Brunham R. C., Ndinya-Achola J. O., Maitha G., Ronald A. R., D'Costa L. J., Bhullar V. B. Epidemiology of ophthalmia neonatorum in Kenya. Lancet. 1986 Nov 15;2(8516):1145–1149. doi: 10.1016/s0140-6736(86)90544-1. [DOI] [PubMed] [Google Scholar]
  11. Matondo P. Antenatal interventions against sexually transmitted disease in Africa. Lancet. 1993 Jun 19;341(8860):1565–1566. doi: 10.1016/0140-6736(93)90701-h. [DOI] [PubMed] [Google Scholar]
  12. Muir D. G., Belsey M. A. Pelvic inflammatory disease and its consequences in the developing world. Am J Obstet Gynecol. 1980 Dec 1;138(7 Pt 2):913–928. doi: 10.1016/0002-9378(80)91082-0. [DOI] [PubMed] [Google Scholar]
  13. Plummer F. A., Laga M., Brunham R. C., Piot P., Ronald A. R., Bhullar V., Mati J. Y., Ndinya-Achola J. O., Cheang M., Nsanze H. Postpartum upper genital tract infections in Nairobi, Kenya: epidemiology, etiology, and risk factors. J Infect Dis. 1987 Jul;156(1):92–98. doi: 10.1093/infdis/156.1.92. [DOI] [PubMed] [Google Scholar]
  14. Plummer F. A., Simonsen J. N., Cameron D. W., Ndinya-Achola J. O., Kreiss J. K., Gakinya M. N., Waiyaki P., Cheang M., Piot P., Ronald A. R. Cofactors in male-female sexual transmission of human immunodeficiency virus type 1. J Infect Dis. 1991 Feb;163(2):233–239. doi: 10.1093/infdis/163.2.233. [DOI] [PubMed] [Google Scholar]
  15. Schulz K. F., Cates W., Jr, O'Mara P. R. Pregnancy loss, infant death, and suffering: legacy of syphilis and gonorrhoea in Africa. Genitourin Med. 1987 Oct;63(5):320–325. doi: 10.1136/sti.63.5.320. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Temmerman M., Laga M., Ndinya-Achola J. O., Paraskevas M., Brunham R. C., Plummer F. A., Piot P. Microbial aetiology and diagnostic criteria of postpartum endometritis in Nairobi, Kenya. Genitourin Med. 1988 Jun;64(3):172–175. doi: 10.1136/sti.64.3.172. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Bulletin of the World Health Organization are provided here courtesy of World Health Organization

RESOURCES