Risk factors for gonorrhoea, syphilis, and trichomonas infections among women attending family planning clinics in Nairobi, Kenya.
Identifieur interne : 002184 ( Istex/Corpus ); précédent : 002183; suivant : 002185Risk factors for gonorrhoea, syphilis, and trichomonas infections among women attending family planning clinics in Nairobi, Kenya.
Auteurs : C C Daly ; N. Maggwa ; J K Mati ; M. Solomon ; S. Mbugua ; P M Tukei ; D J HunterSource :
- Genitourinary Medicine [ 0266-4348 ] ; 1994-06.
English descriptors
- KwdEn :
- Algorithm, Available result, Cervical, Circumcision, Circumcision status, Clinic, Condom, Contraceptive, Education level, Epidemiology, Family planning, Family planning clinics, First intercourse, First pregnancy, General population, Genital, Global impact, Gonorrhoea, Gonorrhoea infection, Indicator variables, Infection, Injectable, Injectable hormones, Kenya, Lifetime pregnancies, Maggwa, Marital status, Mati, Mbugua, Multivariate, Multivariate analysis, Nairobi, Oral contraceptives, Other studies, Past history, Past year, Past year andlor, Physical examination variables, Plenum press, Positive gonorrhoea cultures, Positive syphilis serology, Positive trichomonas microscopy, Pregnant women, Regression model, Reproductive, Reproductive health, Reproductive tract infections, Risk factors, Risk profiles, Serologic status, Serology, Seropositivity, Sexual behaviour, Sexual partners, Std, Syphilis, Syphilis infection, Syphilis seropositivity, Trend circumcision, Trichomonas, Trichomonas infection, Trichomonas infections, Tukei, Unmarried status, Women attendingfamily planning clinics, Years lifetime pregnancies, Years test.
- Teeft :
- Algorithm, Available result, Cervical, Circumcision, Circumcision status, Clinic, Condom, Contraceptive, Education level, Epidemiology, Family planning, Family planning clinics, First intercourse, First pregnancy, General population, Genital, Global impact, Gonorrhoea, Gonorrhoea infection, Indicator variables, Infection, Injectable, Injectable hormones, Kenya, Lifetime pregnancies, Maggwa, Marital status, Mati, Mbugua, Multivariate, Multivariate analysis, Nairobi, Oral contraceptives, Other studies, Past history, Past year, Past year andlor, Physical examination variables, Plenum press, Positive gonorrhoea cultures, Positive syphilis serology, Positive trichomonas microscopy, Pregnant women, Regression model, Reproductive, Reproductive health, Reproductive tract infections, Risk factors, Risk profiles, Serologic status, Serology, Seropositivity, Sexual behaviour, Sexual partners, Std, Syphilis, Syphilis infection, Syphilis seropositivity, Trend circumcision, Trichomonas, Trichomonas infection, Trichomonas infections, Tukei, Unmarried status, Women attendingfamily planning clinics, Years lifetime pregnancies, Years test.
Abstract
OBJECTIVE--To identify the risk factors for gonorrhoea, syphilis, and trichomonas infections among low risk women in Nairobi, Kenya. METHOD--In a cross-sectional study, 4,404 women attending two peri-urban family planning clinics between 1989 and 1991 were interviewed using a structured questionnaire and examined for signs of sexually transmitted disease (STD) infection. Cervical cultures for gonorrhoea, PAP smear (including microscopy for trichomonas), RPR and HIV testing were done. RESULTS--Positive cervical cultures for gonorrhoea were found in 3.2% of women, positive syphilis serology in 1.9%, and positive trichomonas microscopy in 5.2%. Genital ulcers were found in 1.9% of women. Although unmarried status and reporting more than one sex partner in the previous year were both significantly associated with each disease in the crude analysis, these associations were attenuated after controlling for each other and for other risk factors. The population attributable risks (PARs) for these factors were low (7-16%) owing to the high proportion of cases who were married and monogamous. The majority of women with microbiological evidence of infection had normal pelvic examinations. Clinical diagnostic algorithms for STDs in this population had a low sensitivity and positive predictive value. Nevertheless, a strong association between HIV seropositivity and STDs was observed. CONCLUSION--The low population attributable risks found in this study suggest that behaviour change messages directed to women, particularly if they are married have a low potential for preventing STDs. The poor performance of clinical diagnostic algorithms illustrates the desirability of testing these algorithms in a variety of populations and reinforces the need for low-cost methods of microbiologic diagnosis if populations with relatively low prevalences of these infections are to be included in programmes to diagnose and treat STDs.
Url:
DOI: 10.1136/sti.70.3.155
Links to Exploration step
ISTEX:683AD4D76DF39CB85636B8565BF4E8D033E765A0Le document en format XML
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Maggwa</name><affiliation><mods:affiliation>Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115.</mods:affiliation></affiliation></author><author><name sortKey="Mati, J K" sort="Mati, J K" uniqKey="Mati J" first="J K" last="Mati">J K Mati</name><affiliation><mods:affiliation>Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115.</mods:affiliation></affiliation></author><author><name sortKey="Solomon, M" sort="Solomon, M" uniqKey="Solomon M" first="M" last="Solomon">M. Solomon</name><affiliation><mods:affiliation>Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115.</mods:affiliation></affiliation></author><author><name sortKey="Mbugua, S" sort="Mbugua, S" uniqKey="Mbugua S" first="S" last="Mbugua">S. 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Maggwa</name><affiliation><mods:affiliation>Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115.</mods:affiliation></affiliation></author><author><name sortKey="Mati, J K" sort="Mati, J K" uniqKey="Mati J" first="J K" last="Mati">J K Mati</name><affiliation><mods:affiliation>Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115.</mods:affiliation></affiliation></author><author><name sortKey="Solomon, M" sort="Solomon, M" uniqKey="Solomon M" first="M" last="Solomon">M. Solomon</name><affiliation><mods:affiliation>Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115.</mods:affiliation></affiliation></author><author><name sortKey="Mbugua, S" sort="Mbugua, S" uniqKey="Mbugua S" first="S" last="Mbugua">S. Mbugua</name><affiliation><mods:affiliation>Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115.</mods:affiliation></affiliation></author><author><name sortKey="Tukei, P M" sort="Tukei, P M" uniqKey="Tukei P" first="P M" last="Tukei">P M Tukei</name><affiliation><mods:affiliation>Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115.</mods:affiliation></affiliation></author><author><name sortKey="Hunter, D J" sort="Hunter, D J" uniqKey="Hunter D" first="D J" last="Hunter">D J Hunter</name><affiliation><mods:affiliation>Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115.</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Genitourinary Medicine</title><title level="j" type="abbrev">Genitourin Med</title><idno type="ISSN">0266-4348</idno><idno type="eISSN">1472-3263</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" 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hormones</term><term>Kenya</term><term>Lifetime pregnancies</term><term>Maggwa</term><term>Marital status</term><term>Mati</term><term>Mbugua</term><term>Multivariate</term><term>Multivariate analysis</term><term>Nairobi</term><term>Oral contraceptives</term><term>Other studies</term><term>Past history</term><term>Past year</term><term>Past year andlor</term><term>Physical examination variables</term><term>Plenum press</term><term>Positive gonorrhoea cultures</term><term>Positive syphilis serology</term><term>Positive trichomonas microscopy</term><term>Pregnant women</term><term>Regression model</term><term>Reproductive</term><term>Reproductive health</term><term>Reproductive tract infections</term><term>Risk factors</term><term>Risk profiles</term><term>Serologic status</term><term>Serology</term><term>Seropositivity</term><term>Sexual behaviour</term><term>Sexual partners</term><term>Std</term><term>Syphilis</term><term>Syphilis infection</term><term>Syphilis seropositivity</term><term>Trend circumcision</term><term>Trichomonas</term><term>Trichomonas infection</term><term>Trichomonas infections</term><term>Tukei</term><term>Unmarried status</term><term>Women attendingfamily planning clinics</term><term>Years lifetime pregnancies</term><term>Years test</term></keywords><keywords scheme="Teeft" xml:lang="en"><term>Algorithm</term><term>Available result</term><term>Cervical</term><term>Circumcision</term><term>Circumcision status</term><term>Clinic</term><term>Condom</term><term>Contraceptive</term><term>Education level</term><term>Epidemiology</term><term>Family planning</term><term>Family planning clinics</term><term>First intercourse</term><term>First pregnancy</term><term>General population</term><term>Genital</term><term>Global impact</term><term>Gonorrhoea</term><term>Gonorrhoea infection</term><term>Indicator variables</term><term>Infection</term><term>Injectable</term><term>Injectable hormones</term><term>Kenya</term><term>Lifetime pregnancies</term><term>Maggwa</term><term>Marital status</term><term>Mati</term><term>Mbugua</term><term>Multivariate</term><term>Multivariate analysis</term><term>Nairobi</term><term>Oral contraceptives</term><term>Other studies</term><term>Past history</term><term>Past year</term><term>Past year andlor</term><term>Physical examination variables</term><term>Plenum press</term><term>Positive gonorrhoea cultures</term><term>Positive syphilis serology</term><term>Positive trichomonas microscopy</term><term>Pregnant women</term><term>Regression model</term><term>Reproductive</term><term>Reproductive health</term><term>Reproductive tract infections</term><term>Risk factors</term><term>Risk profiles</term><term>Serologic status</term><term>Serology</term><term>Seropositivity</term><term>Sexual behaviour</term><term>Sexual partners</term><term>Std</term><term>Syphilis</term><term>Syphilis infection</term><term>Syphilis seropositivity</term><term>Trend circumcision</term><term>Trichomonas</term><term>Trichomonas infection</term><term>Trichomonas infections</term><term>Tukei</term><term>Unmarried status</term><term>Women attendingfamily planning clinics</term><term>Years lifetime pregnancies</term><term>Years test</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">OBJECTIVE--To identify the risk factors for gonorrhoea, syphilis, and trichomonas infections among low risk women in Nairobi, Kenya. METHOD--In a cross-sectional study, 4,404 women attending two peri-urban family planning clinics between 1989 and 1991 were interviewed using a structured questionnaire and examined for signs of sexually transmitted disease (STD) infection. Cervical cultures for gonorrhoea, PAP smear (including microscopy for trichomonas), RPR and HIV testing were done. RESULTS--Positive cervical cultures for gonorrhoea were found in 3.2% of women, positive syphilis serology in 1.9%, and positive trichomonas microscopy in 5.2%. Genital ulcers were found in 1.9% of women. Although unmarried status and reporting more than one sex partner in the previous year were both significantly associated with each disease in the crude analysis, these associations were attenuated after controlling for each other and for other risk factors. The population attributable risks (PARs) for these factors were low (7-16%) owing to the high proportion of cases who were married and monogamous. The majority of women with microbiological evidence of infection had normal pelvic examinations. Clinical diagnostic algorithms for STDs in this population had a low sensitivity and positive predictive value. Nevertheless, a strong association between HIV seropositivity and STDs was observed. CONCLUSION--The low population attributable risks found in this study suggest that behaviour change messages directed to women, particularly if they are married have a low potential for preventing STDs. The poor performance of clinical diagnostic algorithms illustrates the desirability of testing these algorithms in a variety of populations and reinforces the need for low-cost methods of microbiologic diagnosis if populations with relatively low prevalences of these infections are to be included in programmes to diagnose and treat STDs.</div></front></TEI><istex><corpusName>bmj</corpusName><keywords><teeft><json:string>gonorrhoea</json:string><json:string>std</json:string><json:string>syphilis</json:string><json:string>trichomonas</json:string><json:string>past year</json:string><json:string>multivariate</json:string><json:string>kenya</json:string><json:string>risk factors</json:string><json:string>sexual partners</json:string><json:string>family planning clinics</json:string><json:string>nairobi</json:string><json:string>serology</json:string><json:string>maggwa</json:string><json:string>past history</json:string><json:string>epidemiology</json:string><json:string>cervical</json:string><json:string>regression model</json:string><json:string>injectable</json:string><json:string>seropositivity</json:string><json:string>mati</json:string><json:string>trichomonas infections</json:string><json:string>years test</json:string><json:string>condom</json:string><json:string>injectable hormones</json:string><json:string>mbugua</json:string><json:string>tukei</json:string><json:string>genital</json:string><json:string>gonorrhoea infection</json:string><json:string>first pregnancy</json:string><json:string>oral contraceptives</json:string><json:string>algorithm</json:string><json:string>reproductive</json:string><json:string>marital status</json:string><json:string>multivariate analysis</json:string><json:string>positive gonorrhoea cultures</json:string><json:string>syphilis seropositivity</json:string><json:string>plenum press</json:string><json:string>education level</json:string><json:string>reproductive health</json:string><json:string>positive syphilis serology</json:string><json:string>physical examination variables</json:string><json:string>syphilis infection</json:string><json:string>pregnant women</json:string><json:string>reproductive tract infections</json:string><json:string>clinic</json:string><json:string>circumcision</json:string><json:string>contraceptive</json:string><json:string>infection</json:string><json:string>circumcision status</json:string><json:string>indicator variables</json:string><json:string>trend circumcision</json:string><json:string>serologic status</json:string><json:string>available result</json:string><json:string>positive trichomonas microscopy</json:string><json:string>women attendingfamily planning clinics</json:string><json:string>lifetime pregnancies</json:string><json:string>sexual behaviour</json:string><json:string>trichomonas infection</json:string><json:string>risk profiles</json:string><json:string>past year andlor</json:string><json:string>other studies</json:string><json:string>general population</json:string><json:string>family planning</json:string><json:string>unmarried status</json:string><json:string>global impact</json:string><json:string>years lifetime pregnancies</json:string><json:string>first intercourse</json:string></teeft></keywords><author><json:item><name>C C Daly</name><affiliations><json:string>Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115.</json:string></affiliations></json:item><json:item><name>N Maggwa</name><affiliations><json:string>Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115.</json:string></affiliations></json:item><json:item><name>J K Mati</name><affiliations><json:string>Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115.</json:string></affiliations></json:item><json:item><name>M Solomon</name><affiliations><json:string>Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115.</json:string></affiliations></json:item><json:item><name>S Mbugua</name><affiliations><json:string>Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115.</json:string></affiliations></json:item><json:item><name>P M Tukei</name><affiliations><json:string>Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115.</json:string></affiliations></json:item><json:item><name>D J Hunter</name><affiliations><json:string>Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115.</json:string></affiliations></json:item></author><language><json:string>eng</json:string></language><originalGenre><json:string>research-article</json:string></originalGenre><abstract>OBJECTIVE--To identify the risk factors for gonorrhoea, syphilis, and trichomonas infections among low risk women in Nairobi, Kenya. METHOD--In a cross-sectional study, 4,404 women attending two peri-urban family planning clinics between 1989 and 1991 were interviewed using a structured questionnaire and examined for signs of sexually transmitted disease (STD) infection. Cervical cultures for gonorrhoea, PAP smear (including microscopy for trichomonas), RPR and HIV testing were done. RESULTS--Positive cervical cultures for gonorrhoea were found in 3.2% of women, positive syphilis serology in 1.9%, and positive trichomonas microscopy in 5.2%. Genital ulcers were found in 1.9% of women. Although unmarried status and reporting more than one sex partner in the previous year were both significantly associated with each disease in the crude analysis, these associations were attenuated after controlling for each other and for other risk factors. The population attributable risks (PARs) for these factors were low (7-16%) owing to the high proportion of cases who were married and monogamous. The majority of women with microbiological evidence of infection had normal pelvic examinations. Clinical diagnostic algorithms for STDs in this population had a low sensitivity and positive predictive value. Nevertheless, a strong association between HIV seropositivity and STDs was observed. CONCLUSION--The low population attributable risks found in this study suggest that behaviour change messages directed to women, particularly if they are married have a low potential for preventing STDs. The poor performance of clinical diagnostic algorithms illustrates the desirability of testing these algorithms in a variety of populations and reinforces the need for low-cost methods of microbiologic diagnosis if populations with relatively low prevalences of these infections are to be included in programmes to diagnose and treat STDs.</abstract><qualityIndicators><score>8</score><pdfVersion>1.3</pdfVersion><pdfPageSize>600 x 864 pts</pdfPageSize><refBibsNative>false</refBibsNative><keywordCount>0</keywordCount><abstractCharCount>1936</abstractCharCount><pdfWordCount>5613</pdfWordCount><pdfCharCount>37235</pdfCharCount><pdfPageCount>7</pdfPageCount><abstractWordCount>276</abstractWordCount></qualityIndicators><title>Risk factors for gonorrhoea, syphilis, and trichomonas infections among women attending family planning clinics in Nairobi, Kenya.</title><pmid><json:string>8039777</json:string></pmid><genre><json:string>research-article</json:string></genre><host><title>Genitourinary Medicine</title><language><json:string>unknown</json:string></language><issn><json:string>0266-4348</json:string></issn><eissn><json:string>1472-3263</json:string></eissn><volume>70</volume><issue>3</issue><pages><first>155</first></pages><genre><json:string>journal</json:string></genre></host><categories><wos></wos><scienceMetrix><json:string>health sciences</json:string><json:string>public health & health services</json:string><json:string>public health</json:string></scienceMetrix><inist><json:string>sciences appliquees, technologies et medecines</json:string><json:string>sciences biologiques et medicales</json:string><json:string>sciences medicales</json:string><json:string>pathologie 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Kenya.</title><respStmt><resp>Références bibliographiques récupérées via GROBID</resp><name resp="ISTEX-API">ISTEX-API (INIST-CNRS)</name></respStmt></titleStmt><publicationStmt><authority>ISTEX</authority><publisher scheme="https://publisher-list.data.istex.fr">BMJ Publishing Group Ltd</publisher><availability><licence><p>© British Medical Journal Publishing Group</p></licence><p scheme="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-7M42M2QJ-2">bmj</p></availability><date>1994-06-01</date></publicationStmt><notesStmt><note type="research-article" scheme="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</note><note type="journal" scheme="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Risk factors for gonorrhoea, syphilis, and trichomonas infections among women attending family planning clinics in Nairobi, Kenya.</title><author xml:id="author-0000"><persName><forename type="first">C C</forename><surname>Daly</surname></persName><affiliation>Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115.</affiliation></author><author xml:id="author-0001"><persName><forename type="first">N</forename><surname>Maggwa</surname></persName><affiliation>Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115.</affiliation></author><author xml:id="author-0002"><persName><forename type="first">J K</forename><surname>Mati</surname></persName><affiliation>Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115.</affiliation></author><author xml:id="author-0003"><persName><forename type="first">M</forename><surname>Solomon</surname></persName><affiliation>Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115.</affiliation></author><author xml:id="author-0004"><persName><forename type="first">S</forename><surname>Mbugua</surname></persName><affiliation>Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115.</affiliation></author><author xml:id="author-0005"><persName><forename type="first">P M</forename><surname>Tukei</surname></persName><affiliation>Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115.</affiliation></author><author xml:id="author-0006"><persName><forename type="first">D J</forename><surname>Hunter</surname></persName><affiliation>Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115.</affiliation></author><idno type="istex">683AD4D76DF39CB85636B8565BF4E8D033E765A0</idno><idno type="ark">ark:/67375/NVC-HK1P6WHP-K</idno><idno type="DOI">10.1136/sti.70.3.155</idno><idno type="href">sextrans-70-155.pdf</idno><idno type="PMID">8039777</idno><idno type="local">sextrans;70/3/155</idno></analytic><monogr><title level="j">Genitourinary Medicine</title><title level="j" type="abbrev">Genitourin Med</title><idno type="pISSN">0266-4348</idno><idno type="eISSN">1472-3263</idno><idno type="PublisherID-hwp">sextrans</idno><idno type="PublisherID-nlm-ta">Genitourin Med</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="1994-06"></date><biblScope unit="volume">70</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="155">155</biblScope></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>1994-06-01</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>OBJECTIVE--To identify the risk factors for gonorrhoea, syphilis, and trichomonas infections among low risk women in Nairobi, Kenya. METHOD--In a cross-sectional study, 4,404 women attending two peri-urban family planning clinics between 1989 and 1991 were interviewed using a structured questionnaire and examined for signs of sexually transmitted disease (STD) infection. Cervical cultures for gonorrhoea, PAP smear (including microscopy for trichomonas), RPR and HIV testing were done. RESULTS--Positive cervical cultures for gonorrhoea were found in 3.2% of women, positive syphilis serology in 1.9%, and positive trichomonas microscopy in 5.2%. Genital ulcers were found in 1.9% of women. Although unmarried status and reporting more than one sex partner in the previous year were both significantly associated with each disease in the crude analysis, these associations were attenuated after controlling for each other and for other risk factors. The population attributable risks (PARs) for these factors were low (7-16%) owing to the high proportion of cases who were married and monogamous. The majority of women with microbiological evidence of infection had normal pelvic examinations. Clinical diagnostic algorithms for STDs in this population had a low sensitivity and positive predictive value. Nevertheless, a strong association between HIV seropositivity and STDs was observed. CONCLUSION--The low population attributable risks found in this study suggest that behaviour change messages directed to women, particularly if they are married have a low potential for preventing STDs. The poor performance of clinical diagnostic algorithms illustrates the desirability of testing these algorithms in a variety of populations and reinforces the need for low-cost methods of microbiologic diagnosis if populations with relatively low prevalences of these infections are to be included in programmes to diagnose and treat STDs.</p></abstract></profileDesc><revisionDesc><change when="1994-06-01">Created</change><change when="1994-06">Published</change><change xml:id="refBibs-istex" who="#ISTEX-API" when="2017-10-17">References added</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/683AD4D76DF39CB85636B8565BF4E8D033E765A0/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus bmj" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="no"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Archiving and Interchange DTD v2.3 20070202//EN" URI="archivearticle.dtd" name="istex:docType"></istex:docType><istex:document><article article-type="research-article" xml:lang="EN"><front><journal-meta><journal-id journal-id-type="hwp">sextrans</journal-id><journal-id journal-id-type="nlm-ta">Genitourin Med</journal-id><journal-title>Genitourinary Medicine</journal-title><abbrev-journal-title abbrev-type="publisher">Genitourin Med</abbrev-journal-title><issn pub-type="ppub">0266-4348</issn><issn pub-type="epub">1472-3263</issn><publisher><publisher-name>BMJ Publishing Group Ltd</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">8039777</article-id><article-id pub-id-type="other">sextrans;70/3/155</article-id><article-id pub-id-type="doi">10.1136/sti.70.3.155</article-id><article-id pub-id-type="other">155</article-id><article-id pub-id-type="other">sti.70.3.155</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title>Risk factors for gonorrhoea, syphilis, and trichomonas infections among women attending family planning clinics in Nairobi, Kenya.</article-title></title-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Daly</surname><given-names>C C</given-names></name></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Maggwa</surname><given-names>N</given-names></name></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Mati</surname><given-names>J K</given-names></name></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Solomon</surname><given-names>M</given-names></name></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Mbugua</surname><given-names>S</given-names></name></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Tukei</surname><given-names>P M</given-names></name></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Hunter</surname><given-names>D J</given-names></name></contrib></contrib-group><aff>Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115.</aff><pub-date pub-type="ppub"><month>6</month><year>1994</year></pub-date><pub-date pub-type="epub"><day>1</day><month>6</month><year>1994</year></pub-date><volume>70</volume><volume-id pub-id-type="other">70</volume-id><volume-id pub-id-type="other">70</volume-id><issue>3</issue><issue-id pub-id-type="other">sextrans;70/3</issue-id><issue-id pub-id-type="other">3</issue-id><issue-id pub-id-type="other">70/3</issue-id><fpage>155</fpage><self-uri content-type="pdf" xlink:role="full-text" xlink:href="sextrans-70-155.pdf"></self-uri><abstract><p>OBJECTIVE--To identify the risk factors for gonorrhoea, syphilis, and trichomonas infections among low risk women in Nairobi, Kenya. METHOD--In a cross-sectional study, 4,404 women attending two peri-urban family planning clinics between 1989 and 1991 were interviewed using a structured questionnaire and examined for signs of sexually transmitted disease (STD) infection. Cervical cultures for gonorrhoea, PAP smear (including microscopy for trichomonas), RPR and HIV testing were done. RESULTS--Positive cervical cultures for gonorrhoea were found in 3.2% of women, positive syphilis serology in 1.9%, and positive trichomonas microscopy in 5.2%. Genital ulcers were found in 1.9% of women. Although unmarried status and reporting more than one sex partner in the previous year were both significantly associated with each disease in the crude analysis, these associations were attenuated after controlling for each other and for other risk factors. The population attributable risks (PARs) for these factors were low (7-16%) owing to the high proportion of cases who were married and monogamous. The majority of women with microbiological evidence of infection had normal pelvic examinations. Clinical diagnostic algorithms for STDs in this population had a low sensitivity and positive predictive value. Nevertheless, a strong association between HIV seropositivity and STDs was observed. CONCLUSION--The low population attributable risks found in this study suggest that behaviour change messages directed to women, particularly if they are married have a low potential for preventing STDs. The poor performance of clinical diagnostic algorithms illustrates the desirability of testing these algorithms in a variety of populations and reinforces the need for low-cost methods of microbiologic diagnosis if populations with relatively low prevalences of these infections are to be included in programmes to diagnose and treat STDs.</p></abstract></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Risk factors for gonorrhoea, syphilis, and trichomonas infections among women attending family planning clinics in Nairobi, Kenya.</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Risk factors for gonorrhoea, syphilis, and trichomonas infections among women attending family planning clinics in Nairobi, Kenya.</title></titleInfo><name type="personal"><namePart type="given">C C</namePart><namePart type="family">Daly</namePart><affiliation>Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">N</namePart><namePart type="family">Maggwa</namePart><affiliation>Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">J K</namePart><namePart type="family">Mati</namePart><affiliation>Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">M</namePart><namePart type="family">Solomon</namePart><affiliation>Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">S</namePart><namePart type="family">Mbugua</namePart><affiliation>Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">P M</namePart><namePart type="family">Tukei</namePart><affiliation>Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">D J</namePart><namePart type="family">Hunter</namePart><affiliation>Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</genre><originInfo><publisher>BMJ Publishing Group Ltd</publisher><dateIssued encoding="w3cdtf">1994-06</dateIssued><dateCreated encoding="w3cdtf">1994-06-01</dateCreated><copyrightDate encoding="w3cdtf">1994</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><abstract lang="en">OBJECTIVE--To identify the risk factors for gonorrhoea, syphilis, and trichomonas infections among low risk women in Nairobi, Kenya. METHOD--In a cross-sectional study, 4,404 women attending two peri-urban family planning clinics between 1989 and 1991 were interviewed using a structured questionnaire and examined for signs of sexually transmitted disease (STD) infection. Cervical cultures for gonorrhoea, PAP smear (including microscopy for trichomonas), RPR and HIV testing were done. RESULTS--Positive cervical cultures for gonorrhoea were found in 3.2% of women, positive syphilis serology in 1.9%, and positive trichomonas microscopy in 5.2%. Genital ulcers were found in 1.9% of women. Although unmarried status and reporting more than one sex partner in the previous year were both significantly associated with each disease in the crude analysis, these associations were attenuated after controlling for each other and for other risk factors. The population attributable risks (PARs) for these factors were low (7-16%) owing to the high proportion of cases who were married and monogamous. The majority of women with microbiological evidence of infection had normal pelvic examinations. Clinical diagnostic algorithms for STDs in this population had a low sensitivity and positive predictive value. Nevertheless, a strong association between HIV seropositivity and STDs was observed. CONCLUSION--The low population attributable risks found in this study suggest that behaviour change messages directed to women, particularly if they are married have a low potential for preventing STDs. The poor performance of clinical diagnostic algorithms illustrates the desirability of testing these algorithms in a variety of populations and reinforces the need for low-cost methods of microbiologic diagnosis if populations with relatively low prevalences of these infections are to be included in programmes to diagnose and treat STDs.</abstract><relatedItem type="host"><titleInfo><title>Genitourinary Medicine</title></titleInfo><titleInfo type="abbreviated"><title>Genitourin Med</title></titleInfo><genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre><identifier type="ISSN">0266-4348</identifier><identifier type="eISSN">1472-3263</identifier><identifier type="PublisherID-hwp">sextrans</identifier><identifier type="PublisherID-nlm-ta">Genitourin Med</identifier><part><date>1994</date><detail type="volume"><caption>vol.</caption><number>70</number></detail><detail type="issue"><caption>no.</caption><number>3</number></detail><extent unit="pages"><start>155</start></extent></part></relatedItem><identifier type="istex">683AD4D76DF39CB85636B8565BF4E8D033E765A0</identifier><identifier type="ark">ark:/67375/NVC-HK1P6WHP-K</identifier><identifier type="DOI">10.1136/sti.70.3.155</identifier><identifier type="href">sextrans-70-155.pdf</identifier><identifier type="PMID">8039777</identifier><identifier type="local">sextrans;70/3/155</identifier><accessCondition type="use and reproduction" contentType="copyright">© British Medical Journal Publishing Group</accessCondition><recordInfo><recordContentSource authority="ISTEX" authorityURI="https://loaded-corpus.data.istex.fr" valueURI="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-7M42M2QJ-2">bmj</recordContentSource><recordOrigin>© British Medical Journal Publishing Group</recordOrigin></recordInfo></mods><json:item><extension>json</extension><original>false</original><mimetype>application/json</mimetype><uri>https://api.istex.fr/document/683AD4D76DF39CB85636B8565BF4E8D033E765A0/metadata/json</uri></json:item></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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