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. 1998 Jun;74(3):189–193. doi: 10.1136/sti.74.3.189

Rapid assessment of sexually transmitted diseases in a sentinel population in Thailand: prevalence of chlamydial infection, gonorrhoea, and syphilis among pregnant women--1996

P H Kilmarx, C M Black, K Limpakarnjanarat, N Shaffer, S Yanpaisarn, P Chaisilwattana, W Siriwasin, N L Young, C E Farshy, T D Mastro, L St
PMCID: PMC1758120  PMID: 9849554

Abstract

OBJECTIVE: To determine the prevalence of sexually transmitted diseases (STDs) among pregnant women in Thailand, where case reporting suggests a marked decrease in STDs following a campaign promoting condom use during commercial sex. DESIGN: Cross sectional study of women at their first visit to the study hospitals' antenatal clinics in Chiang Rai (n = 500) and Bangkok (n = 521). METHODS: First catch urine specimens were tested for Chlamydia trachomatis and Neisseria gonorrhoeae using the Amplicor CT/NG polymerase chain reaction assay. Syphilis and HIV serological testing were performed in the study hospitals' laboratories. RESULTS: The prevalence of chlamydial infection was 5.7%, gonorrhoea 0.2%, and syphilis 0.5% (all VDRL or RPR titres were < or = 1:4). The prevalence of HIV infection was 7.1% in Chiang Rai and 2.9% in Bangkok. In a multivariate logistic regression analysis, chlamydial infection was associated with younger age and with higher gestational age at first antenatal clinic visit, but was not associated with marital status, gravidity, city of enrollment, or HIV infection status. CONCLUSIONS: There was a low prevalence of gonorrhoea and syphilis among these pregnant women in Thailand. Chlamydial infection was detected at a higher prevalence, especially among younger women and women registering later for antenatal care. Testing of pregnant women using easily collected urine specimens and a sensitive nucleic acid amplification assay is a feasible method of rapidly assessing chlamydial and gonococcal prevalence. 




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Selected References

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  1. Alary M., Joly J. R., Moutquin J. M., Labrecque M. Strategy for screening pregnant women for chlamydial infection in a low-prevalence area. Obstet Gynecol. 1993 Sep;82(3):399–404. [PubMed] [Google Scholar]
  2. Arkoulis T., Decavalas G., Papapetropoulou M., Detorakis J., Kondakis X., Tzigounis V. Prevalence of asymptomatic carriers of Chlamydia trachomatis among pregnant and non-pregnant women in south-western Greece. Eur J Epidemiol. 1989 Dec;5(4):526–528. doi: 10.1007/BF00140151. [DOI] [PubMed] [Google Scholar]
  3. Black C. M. Current methods of laboratory diagnosis of Chlamydia trachomatis infections. Clin Microbiol Rev. 1997 Jan;10(1):160–184. doi: 10.1128/cmr.10.1.160. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Campos-Outcalt D., Ryan K. Prevalence of sexually transmitted diseases in Mexican-American pregnant women by country of birth and length of time in the United States. Sex Transm Dis. 1995 Mar-Apr;22(2):78–82. doi: 10.1097/00007435-199503000-00002. [DOI] [PubMed] [Google Scholar]
  5. Chaisilwattana P., Chuachoowong R., Siriwasin W., Bhadrakom C., Mangclaviraj Y., Young N. L., Chearskul S., Chotpitayasunondh T., Mastro T. D., Shaffer N. Chlamydial and gonococcal cervicitis in HIV-seropositive and HIV-seronegative pregnant women in Bangkok: prevalence, risk factors, and relation to perinatal HIV transmission. Sex Transm Dis. 1997 Oct;24(9):495–502. doi: 10.1097/00007435-199710000-00001. [DOI] [PubMed] [Google Scholar]
  6. Dietrich M., Hoosen A. A., Moodley J., Moodley S. Urogenital tract infections in pregnancy at King Edward VIII Hospital, Durban, South Africa. Genitourin Med. 1992 Feb;68(1):39–41. doi: 10.1136/sti.68.1.39. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Goh T. H., Ngeow Y. F., Teoh S. K. Screening for gonorrhea in a prenatal clinic in Southeast Asia. Sex Transm Dis. 1981 Apr-Jun;8(2):67–69. doi: 10.1097/00007435-198104000-00005. [DOI] [PubMed] [Google Scholar]
  8. Gwinn M., Pappaioanou M., George J. R., Hannon W. H., Wasser S. C., Redus M. A., Hoff R., Grady G. F., Willoughby A., Novello A. C. Prevalence of HIV infection in childbearing women in the United States. Surveillance using newborn blood samples. JAMA. 1991 Apr 3;265(13):1704–1708. [PubMed] [Google Scholar]
  9. Hanenberg R. S., Rojanapithayakorn W., Kunasol P., Sokal D. C. Impact of Thailand's HIV-control programme as indicated by the decline of sexually transmitted diseases. Lancet. 1994 Jul 23;344(8917):243–245. doi: 10.1016/s0140-6736(94)93004-x. [DOI] [PubMed] [Google Scholar]
  10. Harrison H. R., Boyce W. T., Haffner W. H., Crowley B., Weinstein L., Lewis M., Alexander E. R. The prevalence of genital Chlamydia trachomatis and mycoplasmal infections during pregnancy in an American Indian population. Sex Transm Dis. 1983 Oct-Dec;10(4):184–186. doi: 10.1097/00007435-198311000-00004. [DOI] [PubMed] [Google Scholar]
  11. Jungkind D., Direnzo S., Beavis K. G., Silverman N. S. Evaluation of automated COBAS AMPLICOR PCR system for detection of several infectious agents and its impact on laboratory management. J Clin Microbiol. 1996 Nov;34(11):2778–2783. doi: 10.1128/jcm.34.11.2778-2783.1996. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Khurana C. M., Deddish P. A., delMundo F. Prevalence of Chlamydia trachomatis in the pregnant cervix. Obstet Gynecol. 1985 Aug;66(2):241–243. [PubMed] [Google Scholar]
  13. Lee H. H., Chernesky M. A., Schachter J., Burczak J. D., Andrews W. W., Muldoon S., Leckie G., Stamm W. E. Diagnosis of Chlamydia trachomatis genitourinary infection in women by ligase chain reaction assay of urine. Lancet. 1995 Jan 28;345(8944):213–216. doi: 10.1016/s0140-6736(95)90221-x. [DOI] [PubMed] [Google Scholar]
  14. Mastro T. D., Limpakarnjanarat K. Condom use in Thailand: how much is it slowing the HIV/AIDS epidemic? AIDS. 1995 May;9(5):523–525. [PubMed] [Google Scholar]
  15. Mastro T. D., Satten G. A., Nopkesorn T., Sangkharomya S., Longini I. M., Jr Probability of female-to-male transmission of HIV-1 in Thailand. Lancet. 1994 Jan 22;343(8891):204–207. doi: 10.1016/s0140-6736(94)90990-3. [DOI] [PubMed] [Google Scholar]
  16. Mouton J. W., Verkooyen R., van der Meijden W. I., van Rijsoort-Vos T. H., Goessens W. H., Kluytmans J. A., Deelen S. D., Luijendijk A., Verbrugh H. A. Detection of Chlamydia trachomatis in male and female urine specimens by using the amplified Chlamydia trachomatis test. J Clin Microbiol. 1997 Jun;35(6):1369–1372. doi: 10.1128/jcm.35.6.1369-1372.1997. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Nelson K. E., Celentano D. D., Eiumtrakol S., Hoover D. R., Beyrer C., Suprasert S., Kuntolbutra S., Khamboonruang C. Changes in sexual behavior and a decline in HIV infection among young men in Thailand. N Engl J Med. 1996 Aug 1;335(5):297–303. doi: 10.1056/NEJM199608013350501. [DOI] [PubMed] [Google Scholar]
  18. Niamsanit S., Nunthapisud P., Limpongsanurak S. Prevalence of Chlamydia trachomatis among women attending an antenatal clinic in Bangkok. Southeast Asian J Trop Med Public Health. 1988 Dec;19(4):609–613. [PubMed] [Google Scholar]
  19. Nopkesorn T., Mastro T. D., Sangkharomya S., Sweat M., Singharaj P., Limpakarnjanarat K., Gayle H. D., Weniger B. G. HIV-1 infection in young men in northern Thailand. AIDS. 1993 Sep;7(9):1233–1239. doi: 10.1097/00002030-199309000-00013. [DOI] [PubMed] [Google Scholar]
  20. Pasternack R., Vuorinen P., Miettinen A. Evaluation of the Gen-Probe Chlamydia trachomatis transcription-mediated amplification assay with urine specimens from women. J Clin Microbiol. 1997 Mar;35(3):676–678. doi: 10.1128/jcm.35.3.676-678.1997. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Roseberry W. L., Heymann D. L., Ndoye I., Nsubuga P. S. Rapid sexually transmitted disease assessment in two developing countries. Sex Transm Dis. 1994 Mar-Apr;21(2 Suppl):S84–S85. [PubMed] [Google Scholar]
  22. Schachter J., Moncada J., Whidden R., Shaw H., Bolan G., Burczak J. D., Lee H. H. Noninvasive tests for diagnosis of Chlamydia trachomatis infection: application of ligase chain reaction to first-catch urine specimens of women. J Infect Dis. 1995 Nov;172(5):1411–1414. doi: 10.1093/infdis/172.5.1411. [DOI] [PubMed] [Google Scholar]
  23. Skulnick M., Chua R., Simor A. E., Low D. E., Khosid H. E., Fraser S., Lyons E., Legere E. A., Kitching D. A. Use of the polymerase chain reaction for the detection of Chlamydia trachomatis from endocervical and urine specimens in an asymptomatic low-prevalence population of women. Diagn Microbiol Infect Dis. 1994 Dec;20(4):195–201. doi: 10.1016/0732-8893(94)90003-5. [DOI] [PubMed] [Google Scholar]
  24. Stutz D. R., Spence M. R., Duangmani C. Oropharyngeal gonorrhea during pregnancy. J Am Vener Dis Assoc. 1976 Dec;3(2 Pt 1):65–67. [PubMed] [Google Scholar]
  25. Thejls H., Rahm V. A., Gnarpe J., Gnarpe H. Diagnostic efficacy of chlamydial antibodies in cervical secretions from pregnant women and adolescent girls. Genitourin Med. 1995 Dec;71(6):370–374. doi: 10.1136/sti.71.6.370. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Vuylsteke B., Bastos R., Barreto J., Crucitti T., Folgosa E., Mondlane J., Dusauchoit T., Piot P., Laga M. High prevalence of sexually transmitted diseases in a rural area in Mozambique. Genitourin Med. 1993 Dec;69(6):427–430. doi: 10.1136/sti.69.6.427. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Weniger B. G., Limpakarnjanarat K., Ungchusak K., Thanprasertsuk S., Choopanya K., Vanichseni S., Uneklabh T., Thongcharoen P., Wasi C. The epidemiology of HIV infection and AIDS in Thailand. AIDS. 1991;5 (Suppl 2):S71–S85. doi: 10.1097/00002030-199101001-00011. [DOI] [PubMed] [Google Scholar]

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