Prevalence & Risk Factors of Three Curable Sexually Transmitted Infections among Women in Nairobi, Kenya

BACKGROUND:

Sexually transmitted infections (STIs) are a major public health problem, especially in developing countries. The complications of untreated STIs in the female genital tract and their role in adverse pregnancy and perinatal outcomes have been well documented. The prevalence of STIs in Kenya among women in the general population has not been extensively studied and there is a lack of guidelines for screening of non-pregnant women. Knowledge of the prevalence of curable STIs among this population can provide a basis for integrating STI screening in family planning clinics.

METHODS:

A cross-sectional study was conducted between May and September 2013 at the family planning (FP) clinic at Kenyatta National Hospital (KNH) in Nairobi, Kenya. A total of 261 participants aged 18-49 years were enrolled; with data from 249 participants being analysed. An interviewer-administered questionnaire was used to gather socio-demographic data and assess for risk factors. Each participant was screened for Trichomonas vaginalis (TV) by wet mount microscopy; Neisseria gonorrhoeae (GC) by culture and Chlamydia trachomatis (CT) by PCR.

RESULTS:

The prevalence of CT was 13 % (33/249), TV 0.4 % (1/249) and GC 0 % (0/249). All the infected women reported having had only one sexual partner in the previous 1 year. The age group prevalence for CT was highest in the 25-29 years age group (21 %). The syndromic approach to the management of STIs showed a low specificity (vaginal discharge, 65.7 %; lower abdominal pain, 60.6 %) and positive predictive value (vaginal discharge, 14 %; lower abdominal pain, 11.5 %) for the two commonly used symptoms when compared to the gold standard of CT PCR.

CONCLUSION:

A high prevalence of CT was identified among women attending the FP Clinic at KNH. The study reinforces the need to implement regular screening for STIs among FP clinic attendants. It also reveals the need to review the usage of the syndromic approach for the management of STIs.

Characteristics of CT positive participants

Characteristics	Chlamydia infections/n	Prevalence (%)	P value
Age group
<25	1/13	8
25–29	6/28	21
30–34	6/56	11
35–39	10/67	15
40–44	8/48	17
45–49	2/37	5
Marital status
Married	29/211	14	0.59
Not married	4/38	11
Education level
Primary and below	11/67	16	0.37
Above primary	22/182	12
Occupation
Paid employment	11/83	13	0.9
Self employed	16/127	13
Unemployed	6/39	15
Coitarche
≤20 years	21/160	13	0.95
>20 years	10/78	13
Treated STIs
No	32/224	14	0.22
Yes	1/25	4

Full article at:   http://goo.gl/zLt0e0

By:  Maina AN1, Kimani J2, Anzala O3.

• 1Department of Medical Microbiology, University of Nairobi, P.O BOX 19676-00202, Nairobi, Kenya. acnmaina@yahoo.com.
• 2Kenya AIDS Control Project, University of Manitoba/Nairobi Collaborative Research Group, P.O BOX 19676-00202, Nairobi, Kenya.
• 3KAVI Institute of Clinical Research, University of Nairobi, P.O BOX 19676-00202, Nairobi, Kenya.
• BMC Res Notes. 2016 Mar 29;9(1):193. doi: 10.1186/s13104-016-1990-x. 

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