The prevalence of and factors associated with C. trachomatis, N. gonorrheae, T. vaginalis, C. albicans infection, syphilis, HIV and bacterial vaginosis in females suffering lower genital tract infection symptoms in three healthcare attention sites in Bogo
DOI:
https://doi.org/10.18597/rcog.199Keywords:
Sexually-transmitted disease, cervicitis, vaginitis, bacterial vaginosis, epidemiology, risk factorAbstract
Objective: Determining the prevalence and aetiology of sexually-transmitted infections and endogenous infections in women of childbearing age having lower genital tract infection symptoms and describing the pertinent risk factors.
Materials and methods: This cross-sectional Colombia, Bogotá, Colombia. study was carried out at three outpatient healthcare. Etiologic diagnosis was made using Nugent's criteria for bacterial vaginosis, blood agar culture for Candida and wet mount for T. vaginalis. The In-pouch culture technique was used for T. vaginalis, the polymerase chain reaction for C. trachomatis and N. gonorroheae and serological tests for syphilis (RPR, TPHA) and HIV on a sample Network for Perinatal & Reproductive Health, Portland, Oregon, USA. of the aforementioned population.
Results: 1,385 females were recruited in 2010. 115 (8.3%) were sex workers. An LGTI was confirmed in 731 (52.7%); 560 (40.4%) had an endogenous infection and 170 (12.3%) a sexually-transmitted infection (STI). The most frequent aetiology were bacterial vaginosis (39.6%), candidiasis (11%), C. trachomatis (9.7%) and N. gonorroheae (1.4%); Trichomona was detected by wet mount (0.8%) and culture (1.2%), as were syphilis (0.8%) and HIV (1 case). Sex workers had a higher risk of having an STI (2.0 OR; 1.2-.3 95% CI), as were younger females (28 ± 7.8 cf 32 ± 8.9) (p = 0.001) and alcohol users (2.6 OR; 1.4-4.5 95% CI).
Conclusions: Aetiology was identified for 52.7% of the females who consulted for lower genital tract infection symptoms; bacterial vaginosis was the most common and Chlamydia the most frequent sexually-transmitted infection. No specific aetiology was identified in almost the same number of females (47.3%), even when using gold-standard diagnostic technology for each microorganism.
Author Biographies
Edith Ángel-Müller
Andrea Rodríguez
Lilian M. Núñez-Forero
Luisa F. Moyano
Patricia González
Elkin Osorio
Luz A. Díaz
Nelcy Rodríguez-Malagón
Ariel I. Ruiz-Parra
Jorge E. Tolosa
Hernando Gaitán-Duarte
References
World Health Organization. Sexually transmitted infections. Fact sheet August 2011. Visitado 2011 Nov 11. Disponible en:http://www.who.int/mediacentre/factsheets/fs110/en/.
Ilkit M, Guzel AB. The epidemiology, pathogenesis, and diagnosis of vulvovaginal candidosis: a mycological perspective. Crit Rev Microbiol 2011;37:250-61.
CDC, Data and Statistics. Trends in sexually transmitted diseases in the United States: 2009 national data for gonorrhea, chlamydia and syphilis. Visitado 2011 Dic 30. Disponible en: http://www.cdc.gov/nchhstp/newsroom/docs/2009STDSurvReportMediaFactSheet.pdf
European STD Guidelines 2001. European Branch of the International Union against Sexually Transmitted Infections and the European Office of the World Health Organization. Int J STD HIV 2001:12 Suppl 3.
Eckert LO. Acute vulvovaginitis. NEJM 2006; 355:1244-52.
Owen MK, Clenney TL. Management of vaginitis. Am Fam Physician 2004;70:2125-32, 39-40.
World Health Organization. Guidelines for the management of sexually transmitted infections. 2005. Visitado 2011 Nov 11. Disponible en: http://www.who.int/hiv/pub/sti/pub6/en/Consulted on11th November 2011.
República de Colombia. Ministerio de Salud. Dirección General de Promoción y Prevención. Normas técnicas y guías de atención. Agreement 117/98, Resolution 412/2000.
Secretaría Distrital de Salud de Bogotá. Protocolo de Vigilancia de Enfermedades de Transmisión Sexual. Bogotá; 2000.
Public Health Agency of Canada. Syndromic management of sexually transmitted infections. Canadian Guidelines on Sexual Transmitted Infections. 2010. Visitado 2011 Nov 29. Disponible en: http://www.phac-aspc.gc.ca/std-mts/sti-its/Consulted on 29th November 2011.
Groetsch S, Keck JW. Cervicitis. Clin Fam Pract 2005;7:43-56.
McGowin CL, Anderson-Smits C. Mycoplasma genitalium: an emerging cause of sexually transmitted disease in women. PLoS Pathog. 2011;7:e1001324.
Gaitán H, Angel E, Diaz R, Parada A, Sanchez L, Vargas C. Accuracy of five different diagnostic techniques in mild-to-moderate pelvic inflammatory disease. Infect Dis Obstet Gynecol 2002;10:171-80.
Dallabetta GA, Gerbase AC, Holmes KK. Problems, solutions, and challenges in syndromic management of sexually transmitted diseases. Sex Transm Infect 1998;74:S1-S11.
Redwood-Campbell L, Plumb J. The syndromic approach to treatment of sexually transmitted diseases in low-income countries: issues, challenges, and future directions. J Obstet Gynaecol Can 2002;24:417-24.
Pettifor A, Walsh J, Wilkins V, Raghunathan P. How effective is syndromic management of STDs?: A review of current studies. Sex Transm Dis 2000;27:371-85.
Trollope-Kumar K, Guyatt G. Syndromic approach for treatment of STIs: time for a change. Lancet 2006;367:1380-1.
Gerbase AC, Toscano C, Titan S, Cuchí P, González-Salvatierra R, Zacarías F. Sexually transmitted diseases in Latin America and the Caribbean. Rev Panam Salud Pública 1999;6:362-70.
Wolff H, Lourenço A, Bodenmann P, Epiney M, Uny M, Andreoli N, et al. Chlamydia trachomatis prevalence in undocumented migrants undergoing voluntary termination of pregnancy: a prospective cohort study. BMC Public Health 2008;8:391
Soto RJ, Ghee AE, Nunez CA, Mayorga R, Tapia KA, Astete SG, Sentinel surveillance of sexually transmitted infections/HIV and risk behaviors in vulnerable populations in 5 Central American countries. J Acquir Immune Defic Syndr 2007;46:101-11.
Zavaleta C, Fernández C, Konda K, Valderrama Y, Vermund SH, Gotuzzo E. High prevalence of HIV and syphilis in a remote native community of the Peruvian Amazon. Am J Trop Med Hyg 2007;76:703-5.
Rodrigues M, Guimarães MC, Garcia de Lima CM. Prevalence of sexually transmitted diseases in female sex workers in a city in the interior of São Paulo, Brazil. Rev. Latino-Am Enfermagem 2011;19:493-9.
Camejo M, Díaz M. Prevalencia de hepatitis B, hepatitis C y sífilis en trabajadoras sexuales de Venezuela / Prevalence of hepatitis B, hepatitis C and syphilis in female sex workers in Venezuela. Rev Saúde Pública 2003;37:339-344.
Fernández J, Martinez A, Castillon R, Tamariz J . Vaginosis bacteriana en trabajadoras sexuales que acuden a un centro especializado de referencia de enfermedades de transmisión sexual y SIDA. Rev Med Hered 2010;21:32-8.
Alvarado E, García A, Castruita DE, Cardosa FJ, Ruiz R. Prevalencia de infección por Chlamydia trachomatis en prostitutas registradas de la ciudad de Durango, México. Salud Pública Méx 2000;42:43-7.
Ángel-Müller E, González MP, Núñez L, Pacheco J, Tolosa JE, Díaz LA, et al. Frecuencia de infecciones del tracto genital femenino en mujeres sintomáticas y uso de pruebas rápidas para su diagnóstico en dos poblaciones de Bogotá (Colombia) 2008. Rev Colomb Obstet Ginecol 2010;61:220-30.
Money D. The laboratory diagnosis of bacterial vaginosis. Can J Infect Dis Med Microbiol 2005;16:77-9.
Nyirjesy P. Vulvovaginal candidiasis and bacterial vaginosis. Infect Dis Clin North Am 2008;22:637-52.
Pinzón-Rondón AM, Ross TW, Botero JC, Baquero- Umaña M. Prevalencia y factores asociados a enfermedades de transmisión sexual en menores explotados sexualmente en Bogotá, Colombia. Rev Salud Pública 2009;11:468-79.
Hernández-Girón C, Cruz-Valdez A, Juárez L, Hernández- Avila M. Prevalencia y factores de riesgo asociados a sífilis en mujeres. Rev Saúde Pública 1998;32:579-86.
Simões-Barbosa A, Coutinho G, da Silva JX, Rama II, and Paes TW. A six-year follow-up survey of sexually transmitted diseases in Brasilia, the Capital of Brazil. Braz J Infect Dis 2002;6:110-7.
Tamayo LS, Guevara E, López MI. Vaginosis bacteriana, cándida y tricomonas por citología cervico-vaginal en mujeres del régimen subsidiado, Medellín Colombia, 2008. Revista Salud Pública Medellín 2009:4:87-99.
De Codes JS, Cohen DA, Almeida de Melo N, Gonzaga G, dos Santos A, Silva T, et al. Detecção de doenças sexualmente transmissíveis em ambientes clínicos e não clínicos na Cidade de Salvador, Bahia, Brasil. Cad Saúde Pública Rio de Janeiro 2006;22:325-34.
Berlan ED, Holland-Hall C. Sexually transmitted infections in adolescents: advances in epidemiology, screening, and diagnosis. Adolesc Med State Art Rev. 2010;21:332-46.
Nahmias SB, Nahmias D. Society, sex, and STIs: human behavior and the evolution of sexually transmitted diseases and their agents. Ann N Y Acad Sci 2011;1230:59-73.
Alvis N, Mattar S, García J, Conde E y Díaz A. Infecciones de transmisión sexual en un grupo de alto riesgo de la ciudad de Montería, Colombia. Rev Salud Pública 2007;9:86-96.
Yoshimura K, Yoshimura M, Kobayashi T, Kubo T, Hachisuga T, Kashimura M. Can bacterial vaginosis help to find sexually transmitted diseases, especially chlamydial cervicitis? Int J STD AIDS 2009;20: 108-11.
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