High prevalence of sexually transmitted infections in pregnant adolescent girls in Tanzania: a multi-community cross-sectional study.
High prevalence of sexually transmitted infections in pregnant adolescent girls in Tanzania: a multi-community cross-sectional study.
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DOI：
10.1136/sextrans-2014-051952
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发表时间：
2015-11
影响因子：
3.6
通讯作者：
Downs JA
中科院分区：
文献类型：
--
作者：
Hokororo A;Kihunrwa A;Hoekstra P;Kalluvya SE;Changalucha JM;Fitzgerald DW;Downs JA
撒哈拉以南非洲地区怀孕青少年中性传播感染 (STI) 的数据有限，该地区的产前筛查通常仅包括艾滋病毒和梅毒。鉴于该人群的艾滋病毒发病率是世界上最高的，我们试图评估坦桑尼亚农村怀孕青少年人群中与性传播感染相关的流行率和因素。我们从坦桑尼亚姆万扎附近的 10 个产前诊所招募了 403 名怀孕少女。女孩们接受了有关性健康和危险因素的结构化访谈，并接受了六种常见性传播感染的检测。一百九十九名女孩 (49.4%) 至少患有一种性传播感染。 HSV-2 最为常见 (34.5%)，其次是滴虫病 (12.4%)、衣原体病 (11.4%)、淋病 (6.7%)、梅毒 (5.2%) 和 HIV (4.7%)。值得注意的是，经实验室证实患有性传播感染的女孩中有 53/199 (26.6%) 无症状。在多变量分析中，任何性传播感染的存在都与长期（而不是短期）关系有关（比值比（OR）= 2.6 [1.4-4.9] p = 0.004），第一次性行为的年龄较小（每年OR = 0.9 [0.8-0.99]，p = 0.034），女孩和她的伴侣之间的年龄差异增加（OR = 1.1） [1.0–1.1] 每年，p= 0.03）和既往妊娠史（OR=1.6 [1.0–2.6]，p=0.04）。性传播感染影响了坦桑尼亚农村一半怀孕青少年。我们的工作表明，坦桑尼亚迫切需要将常规性传播感染检测纳入产前护理，以预防年轻女孩及其婴儿的发病和死亡。我们还确定了行为和人口统计风险因素，可用于针对风险最高的人群进行干预。
Limited data document sexually-transmitted infections (STIs) among pregnant adolescents in sub-Saharan Africa, where prenatal screening typically includes only HIV and syphilis. Given that HIV incidence in this population is among the world’s highest, we sought to assess the prevalence and factors associated with STIs in a population of rural pregnant adolescents in Tanzania. We enrolled 403 pregnant adolescent girls from 10 antenatal clinics near Mwanza, Tanzania. Girls answered structured interviews about sexual health and risk factors and were tested for six common STIs. One hundred ninety-nine girls (49.4%) had at least one STI. HSV-2 was most prevalent (34.5%), followed by trichomoniasis (12.4%), chlamydia (11.4%), gonorrhoea (6.7%), syphilis (5.2%), and HIV (4.7%). Of note, 53/199 (26.6%) of girls with laboratory-proven STIs were asymptomatic. On multivariable analysis, presence of any STI was associated with being in a long-term (as opposed to short-term) relationship (odds ratio (OR)=2.6 [1.4–4.9] p= 0.004), younger age at first sexual debut (OR =0.9 per year [0.8–0.99], p= 0.034), increasing age difference between the girl and her partner (OR=1.1 [1.0–1.1] per year, p= 0.03), and history of prior pregnancy (OR=1.6 [1.0–2.6], p=0.04). STIs affected half of rural pregnant adolescents in Tanzania. Our work demonstrates the urgent need to incorporate routine STI testing into antenatal care in Tanzania to prevent morbidity and mortality in young girls and their babies. We also identify behavioural and demographic risk factors that can be used to target interventions to those at highest risk.