Urogenital Schistosomiasis and Sexually Transmitted Coinfections among Pregnant Women in a Schistosome-Endemic Region of the Democratic Republic of Congo
Urogenital Schistosomiasis and Sexually Transmitted Coinfections among Pregnant Women in a Schistosome-Endemic Region of the Democratic Republic of Congo
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DOI：
10.4269/ajtmh.19-0024
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发表时间：
2019-01-01
影响因子：
3.3
通讯作者：
Rinnoin, Anne W.
中科院分区：
文献类型：
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作者：
Gadoth, Adva;Mvumbi, Gisele;Rinnoin, Anne W.
据估计，非洲每年有1 000万孕妇感染血吸虫病。越来越多的证据表明，泌尿生殖道血吸虫病对生殖健康产生不利影响，包括艾滋病毒传播增加，因此有必要进一步研究产前疾病流行病学，并对孕产妇和胎儿健康产生影响。在2016年10月至2017年3月期间，我们进行了一项横断面研究，检查了刚果Kisantu卫生区前往产前诊所的孕妇中泌尿生殖道血吸虫病的患病率及其与艾滋病毒以外的性传播感染（STI）的相关性。一个广泛的社会人口和临床调查管理同意的参与者，尿液样本和阴道拭子收集，以推断活动性血吸虫病和性传播感染，分别。总的来说，17.4%的孕妇感染了埃及血吸虫，3.1%感染了沙眼衣原体（CT），1.4%感染了淋病奈瑟菌（NG），14.6%感染了阴道毛滴虫（TV）。感染泌尿生殖道血吸虫病的女性携带CT、NG或TV感染的几率显著增加（调整后的比值比= 3.0，95%CI：1.5，6.0），但临床症状的报告率较低，从血吸虫病的17.2%到TV病例的30.8%不等。血吸虫病和性传播感染的实验室确认为低血吸虫病队列提供了客观证据，其中综合征管理可能不足够。阐明当地的危险因素和相关的泌尿生殖道血吸虫病合并感染，可以确定独特的干预机会，在吸虫病流行地区的产前护理，并有助于减少不良妊娠结局。
Schistosomiasis afflicts an estimated 10 million pregnant women in Africa annually. With mounting evidence of adverse impacts to reproductive health resulting from urogenital schistosomiasis, including increased transmission of HIV, further research on prenatal disease epidemiology is warranted, with implications for maternal and fetal health. Between October 2016 and March 2017, we conducted a cross-sectional study examining the prevalence of urogenital schistosomiasis and its association with sexually transmitted infections (STIs) other than HIV among pregnant women visiting antenatal clinics in Kisantu health zone, Democratic Republic of Congo. An extensive sociodemographic and clinical survey was administered to consenting participants, with urine samples and vaginal swabs collected to deduce active schistosomiasis and STIs, respectively. In total, 17.4% of expectant mothers were infected with Schistosoma haematobium, 3.1% with Chlamydia trachomatis (CT), 1.4% with Neisseria gonorrhoeae (NG), and 14.6% with Trichomonas vaginalis (TV). Women infected with urogenital schistosomiasis were at significantly increased odds of harboring a CT, NG, or TV infection (adjusted odds ratio = 3.0, 95% CI: 1.5, 6.0), but reports of clinical symptoms were low, ranging from 17.2% of schistosomiasis to 30.8% of TV cases. Laboratory confirmation of schistosomiasis and STIs provided objective evidence of disease in a cohort with low symptomology where syndromic management may not suffice. Shedding light on local risk factors and associated coinfections of urogenital schistosomiasis can identify unique intervention opportunities for prenatal care in trematode-endemic regions and aid in reducing adverse pregnancy outcomes.