Prevalence of sexually transmitted infections in women attending antenatal care in Tete province, Mozambique

There is little information about the prevalence of sexually transmitted infections (STIs) in pregnant women in Mozambique. In Tete, a province in the country's northwest, recent data are not available. However, the province's Directorate of Health reported an antenatal clinic (ANC) attendance rate of nearly 100%. This study set out to assess the prevalence of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (G) and syphilis in pregnant women attending urban health centres. It is important to detect these STIs in pregnancy as they are a significant cause of neonatal morbidity and adverse pregnancy outcomes.

Objective. To determine the prevalence of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and syphilis in pregnant women.
Methods. A cross-sectional study was conducted among women attending antenatal care clinics (ANCs). Blood samples were tested for syphilis using the rapid plasma reagin (RPR) and treponemal haemagglutination (TPHA) tests; CT and NG were diagnosed using a manual polymerase chain reaction assay on first-void urine samples. A socio-demographic questionnaire was completed. Results were compared with
previous published data on sexually transmitted infection (STI) prevalence in Mozambique. Results. Blood and urine samples were collected from 1 119 and 835 women, respectively. The prevalence of CT was 4.1%, and that of NG 2.5%. The RPR test was positive in 5.2% of the
women, and 7.1% had a positive TPHA test. Active syphilis was found in 4.7%. In univariate analysis, CT was associated with having had any level of education (p<0.05), reactive RPR and TPHA were associated with illiteracy (p<0.05), and TPHA was associated with age >25. Multivariate analysis did not show any significant association. In comparison with published data from 1993, a decline was observed for CT (p<0.05), NG and syphilis (p<0.001). Conclusions. Compared with available data, a decline of STI prevalence was observed in our setting. This might be the result of community-based education programmes focusing on changes to sexual behaviour, as well as the widespread use of
the syndromic approach to managing STIs and the expansion of syphilis screening in primary health care settings. However, STI rates are still high, and the problem needs more concrete and sustained efforts for its control.

Authors & affiliation: 
Jhonny Luján (ICRH), Wouter Arrázola de Oñate (ICRH), Wim Delva (ICRH), Patricia Claeys (ICRH), Fulgencia Sambola (ICRH), Marleen Temmerman (ICRH), Joaquim Fernando (Provincial Hospital Directorate, Tete) , Elena Folgosa (Laboratory of Microbiology, Universidade Eduardo Mondlane, Maputo)
Published In: 
S Afr Med J 2008; 98: 49-51.
Publication date: 
Tuesday, January 1, 2008