Exploring the prevalence of chlamydial and gonorrheal infections in pregnant women: a multicenter study in Egypt.
Chlamydia trachomatis
GeneXpert CT/NG
Neisseria gonorrhoeae
Sexually transmitted infections (STIs)
Journal
BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562
Informations de publication
Date de publication:
16 Oct 2024
16 Oct 2024
Historique:
received:
05
03
2024
accepted:
01
10
2024
medline:
17
10
2024
pubmed:
17
10
2024
entrez:
16
10
2024
Statut:
epublish
Résumé
Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are widespread, treatable sexually transmitted infections (STIs) of global significance, affecting millions annually. Left untreated, they pose significant risks, including pelvic inflammatory disease (PID), infertility, and complications during pregnancy. The U.S. Centers for Disease Control recommends annual chlamydial screening for sexually active women to address these risks. Responding to this global challenge, the World Health Organization (WHO) has formulated a global health sector strategy on sexually transmitted infections, outlining priority actions to strengthen STI responses in countries. However, STI epidemiological studies encounter challenges in developing nations like Egypt due to socio-cultural factors, poverty, and limited diagnostic facilities. In Egypt, STI diagnosis primarily relies on clinical presentations, lacking structured screening programs for CT and NG. This study's main objective is to estimate the prevalence of Chlamydial and gonorrheal infections, advocating for supportive STI strategies in Egypt. Additionally, the study aims to provide a foundation for national prevalence estimates of CT and NG infections. A cross-sectional study encompassed five antenatal clinics in different regions of Egypt. A total of 1040 pregnant women attending these clinics were consecutively sampled. Data collection involved structured questionnaires, and urine samples were subjected to the GeneXpert CT/NG qualitative real-time PCR test. The prevalence of CT infections was 0.29% (95% CI, 0.10-0.86%), with no detected NG infections. The three CT-positive cases were distributed across different recruitment centers, with no statistically significant differences observed between infected and non-infected participants. Notably, 40.3% of recruited women reported gynecological symptoms, primarily discharge. Additionally, 9.6% had undergone previous testing for sexually transmitted infections, with 8.2% receiving positive results. This study provides valuable data on the prevalence of CT and NG infections among pregnant women attending ANC clinics in Egypt. The findings underscore the importance of ongoing surveillance, routine screening, and targeted interventions to ensure the reproductive health and well-being of pregnant women and their infants. Further research is warranted to explore the broader implications of STIs in different populations and to inform evidence-based guidelines for screening and management in diverse settings. IRB no.: 17,400,017; WHO ERC Protocol Id. A66005.
Sections du résumé
BACKGROUND
BACKGROUND
Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are widespread, treatable sexually transmitted infections (STIs) of global significance, affecting millions annually. Left untreated, they pose significant risks, including pelvic inflammatory disease (PID), infertility, and complications during pregnancy. The U.S. Centers for Disease Control recommends annual chlamydial screening for sexually active women to address these risks. Responding to this global challenge, the World Health Organization (WHO) has formulated a global health sector strategy on sexually transmitted infections, outlining priority actions to strengthen STI responses in countries. However, STI epidemiological studies encounter challenges in developing nations like Egypt due to socio-cultural factors, poverty, and limited diagnostic facilities. In Egypt, STI diagnosis primarily relies on clinical presentations, lacking structured screening programs for CT and NG. This study's main objective is to estimate the prevalence of Chlamydial and gonorrheal infections, advocating for supportive STI strategies in Egypt. Additionally, the study aims to provide a foundation for national prevalence estimates of CT and NG infections.
METHODS
METHODS
A cross-sectional study encompassed five antenatal clinics in different regions of Egypt. A total of 1040 pregnant women attending these clinics were consecutively sampled. Data collection involved structured questionnaires, and urine samples were subjected to the GeneXpert CT/NG qualitative real-time PCR test.
RESULTS
RESULTS
The prevalence of CT infections was 0.29% (95% CI, 0.10-0.86%), with no detected NG infections. The three CT-positive cases were distributed across different recruitment centers, with no statistically significant differences observed between infected and non-infected participants. Notably, 40.3% of recruited women reported gynecological symptoms, primarily discharge. Additionally, 9.6% had undergone previous testing for sexually transmitted infections, with 8.2% receiving positive results.
CONCLUSIONS
CONCLUSIONS
This study provides valuable data on the prevalence of CT and NG infections among pregnant women attending ANC clinics in Egypt. The findings underscore the importance of ongoing surveillance, routine screening, and targeted interventions to ensure the reproductive health and well-being of pregnant women and their infants. Further research is warranted to explore the broader implications of STIs in different populations and to inform evidence-based guidelines for screening and management in diverse settings.
TRIAL REGISTRATION
BACKGROUND
IRB no.: 17,400,017; WHO ERC Protocol Id. A66005.
Identifiants
pubmed: 39415099
doi: 10.1186/s12889-024-20239-9
pii: 10.1186/s12889-024-20239-9
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
2852Informations de copyright
© 2024. The Author(s).
Références
Smith LE. Sexually transmitted diseases. Princ. Pract. Surg. Colon, Rectum, Anus, Third Ed., 2007.
Carey AJ, Beagley KW. Chlamydia trachomatis, a hidden epidemic: effects on Female Reproduction and options for treatment. Am J Reprod Immunol. 2010;63:576–86. https://doi.org/10.1111/j.1600-0897.2010.00819.x .
doi: 10.1111/j.1600-0897.2010.00819.x
pubmed: 20192953
World Health Organization. Sexually transmitted infections (STIs) 2022. https://www.who.int/news-room/fact-sheets/detail/sexually-transmitted-infections-(stis) (accessed August 14, 2024).
El-Kettani A, Mahiané G, Bennani A, Abu-Raddad L, Smolak A, Rowley J, et al. Trends in Adult Chlamydia and Gonorrhea Prevalence, incidence and urethral discharge case reporting in Morocco over 1995-2015-Estimates using the spectrum-sexually transmitted infection model. Sex Transm Dis. 2017;44:557–64. https://doi.org/10.1097/OLQ.0000000000000647 .
doi: 10.1097/OLQ.0000000000000647
pubmed: 28806354
pmcid: 5559184
Mullick S, Watson-Jones D, Beksinska M, Mabey D. Sexually transmitted infections in pregnancy: prevalence, impact on pregnancy outcomes, and approach to treatment in developing countries. Sex Transm Infect. 2005. https://doi.org/10.1136/sti.2002.004077 .
doi: 10.1136/sti.2002.004077
pubmed: 16061534
pmcid: 1745010
Baraitser P, Alexander S, Sheringham J. Chlamydia trachomatis screening in young women. Curr Opin Obstet Gynecol. 2011. https://doi.org/10.1097/GCO.0b013e32834ac776 .
doi: 10.1097/GCO.0b013e32834ac776
pubmed: 21897235
World Health Organization. Geneva: World Health Organization; Global Health Sector Strategy on Sexually Transmitted Infections 2016–2021. Clin Colon Rectal Surg 2007;20:58–63.
Smolak A, Chemaitelly H, Hermez JG, Low N, Abu-Raddad LJ. Epidemiology of Chlamydia trachomatis in the Middle East and North Africa: a systematic review, meta-analysis, and meta-regression. Lancet Glob Heal. 2019;7:e1197–225. https://doi.org/10.1016/S2214-109X(19)30279-7 .
doi: 10.1016/S2214-109X(19)30279-7
El-Moselhy E, Issa L, Mohamed M, Abdelati M, Eldhshan R, Mekky A, et al. Sexually transmitted infections: risk-factors among married female patients’ in Assiut, Egypt. Al-Azhar Int Med J. 2020;0:0–0. https://doi.org/10.21608/aimj.2020.38500.1295 .
doi: 10.21608/aimj.2020.38500.1295
Elkayal NM, Mahmoud NF, Abdalla S. Detection of Chlamydia trachomatis and Neisseria gonorrhoeae in Egyptian women suffering from infertility. Adv Microbiol. 2015;05:769–79. https://doi.org/10.4236/aim.2015.512081 .
doi: 10.4236/aim.2015.512081
Central Agency for. public mobilization and statistics (CAPMAS). Egypt Family Health Survey 2021. 2022.
Jacobsson S, Boiko I, Golparian D, Blondeel K, Kiarie J, Toskin I, et al. WHO laboratory validation of Xpert
doi: 10.1111/apm.12902
pubmed: 30456870
pmcid: 6488022
Han Y, Shi MQ, Jiang QP, Le WJ, Qin XL, Xiong HZ, et al. Clinical performance of the Xpert
doi: 10.3389/fcimb.2021.784610
Xie TA, Liu YL, Meng RC, Liu XS, Fang KY, Deng ST et al. Evaluation of the diagnostic efficacy of Xpert CT/NG for Chlamydia trachomatis and Neisseria gonorrhoeae. Biomed Res Int 2020;2020. https://doi.org/10.1155/2020/2892734
Dean AG, Arner TG, Sunki GG, Friedman R, Lantinga M, Sangam S, Zubieta JC, Sullivan KM, BrendDean AG, Arner TG, Sunki GG, Friedman R, Lantinga M, Sangam S, Zubieta JC, Sullivan KM, Brendel KA, Gao Z, Fontaine N, Shu M, Fuller G, Smith DC, Nitschke DA. and and FR. Epi Info™, a database and statistics program for public health professionals. 2011.
Cepheid. Xpert
Julious SA. Two-sided confidence intervals for the single proportion: comparison of seven methods. Stat Med. 2005;24:3383–4. https://doi.org/10.1002/sim.2164 .
doi: 10.1002/sim.2164
pubmed: 16206245
Abdella RMA, Abdelmoaty HI, Elsherif RH, Sayed AM, Sherif NA, Gouda HM, et al. Screening for Chlamydia trachomatis in Egyptian women with unexplained infertility, comparing real-time PCR techniques to standard serology tests: case control study. BMC Womens Health. 2015;15:1–8. https://doi.org/10.1186/s12905-015-0202-5 .
doi: 10.1186/s12905-015-0202-5
El-Shourbagy M, Abd-El-Maeboud K, Diab KM, El-Ghannam A, Nabegh L, Ammar S. Genital Chlamydia trachomatis infection in Egyptian women: incidence among different clinical risk groups. J Obstet Gynaecol Res. 1996;22:467–72. https://doi.org/10.1111/j.1447-0756.1996.tb01059.x .
doi: 10.1111/j.1447-0756.1996.tb01059.x
pubmed: 8987330
Abd S, Agha E-F, El-Mashad N, Rakha SA, El A, Metwally G, El. Value of direct antigen detection methods in diagnosing women with suspected genital Chlamydia trachomatis infection. Afr J Microbiol Res. 2011;5:1215–9. https://doi.org/10.5897/AJMR11.178 .
doi: 10.5897/AJMR11.178
Haberland N, Winikoff B, Sloan N, Coggins C, Elias C. Case finding and case management of chlamydia and gonorrhea infections among women. What we do and do not know; 1999.
WHO. Sexually transmitted infections-Fact Sheet n.d. https://www.who.int/news-room/fact-sheets/detail/sexually-transmitted-infections-(stis ).
WHO. Standard protocol to assess prevalence of gonorrhoea and chlamydia among pregnant women in antenatal care clinics. 2018.