Low prevalence of cervical infections in women with vaginal discharge in west Africa: implications for syndromic management
Identifieur interne : 000F23 ( Main/Exploration ); précédent : 000F22; suivant : 000F24Low prevalence of cervical infections in women with vaginal discharge in west Africa: implications for syndromic management
Auteurs : J. Pepin ; S. Deslandes ; N. Khonde ; D. Kintin ; S. Diakite ; M. Sylla ; H. Meda ; F. Sobela ; C. Asamoah-Adu ; T. Agyarko-Poku ; E. FrostSource :
- Sexually Transmitted Infections [ 1368-4973 ] ; 2004.
Abstract
Url:
DOI: 10.1136/sti.2003.007534
PubMed: 15170011
PubMed Central: 1744831
Affiliations:
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Low prevalence of cervical infections in women with vaginal discharge in west Africa: implications for syndromic management</title><author><name sortKey="Pepin, J" sort="Pepin, J" uniqKey="Pepin J" first="J" last="Pepin">J. Pepin</name></author><author><name sortKey="Deslandes, S" sort="Deslandes, S" uniqKey="Deslandes S" first="S" last="Deslandes">S. Deslandes</name></author><author><name sortKey="Khonde, N" sort="Khonde, N" uniqKey="Khonde N" first="N" last="Khonde">N. Khonde</name></author><author><name sortKey="Kintin, D" sort="Kintin, D" uniqKey="Kintin D" first="D" last="Kintin">D. Kintin</name></author><author><name sortKey="Diakite, S" sort="Diakite, S" uniqKey="Diakite S" first="S" last="Diakite">S. Diakite</name></author><author><name sortKey="Sylla, M" sort="Sylla, M" uniqKey="Sylla M" first="M" last="Sylla">M. Sylla</name></author><author><name sortKey="Meda, H" sort="Meda, H" uniqKey="Meda H" first="H" last="Meda">H. Meda</name></author><author><name sortKey="Sobela, F" sort="Sobela, F" uniqKey="Sobela F" first="F" last="Sobela">F. Sobela</name></author><author><name sortKey="Asamoah Adu, C" sort="Asamoah Adu, C" uniqKey="Asamoah Adu C" first="C" last="Asamoah-Adu">C. Asamoah-Adu</name></author><author><name sortKey="Agyarko Poku, T" sort="Agyarko Poku, T" uniqKey="Agyarko Poku T" first="T" last="Agyarko-Poku">T. Agyarko-Poku</name></author><author><name sortKey="Frost, E" sort="Frost, E" uniqKey="Frost E" first="E" last="Frost">E. Frost</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">15170011</idno><idno type="pmc">1744831</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1744831</idno><idno type="RBID">PMC:1744831</idno><idno type="doi">10.1136/sti.2003.007534</idno><date when="2004">2004</date><idno type="wicri:Area/Pmc/Corpus">000525</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000525</idno><idno type="wicri:Area/Pmc/Curation">000524</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000524</idno><idno type="wicri:Area/Pmc/Checkpoint">000502</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000502</idno><idno type="wicri:Area/Ncbi/Merge">000152</idno><idno type="wicri:Area/Ncbi/Curation">000152</idno><idno type="wicri:Area/Ncbi/Checkpoint">000152</idno><idno type="wicri:doubleKey">1368-4973:2004:Pepin J:low:prevalence:of</idno><idno type="wicri:Area/Main/Merge">000F69</idno><idno type="wicri:Area/Main/Curation">000F23</idno><idno type="wicri:Area/Main/Exploration">000F23</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Low prevalence of cervical infections in women with vaginal discharge in west Africa: implications for syndromic management</title><author><name sortKey="Pepin, J" sort="Pepin, J" uniqKey="Pepin J" first="J" last="Pepin">J. Pepin</name></author><author><name sortKey="Deslandes, S" sort="Deslandes, S" uniqKey="Deslandes S" first="S" last="Deslandes">S. Deslandes</name></author><author><name sortKey="Khonde, N" sort="Khonde, N" uniqKey="Khonde N" first="N" last="Khonde">N. Khonde</name></author><author><name sortKey="Kintin, D" sort="Kintin, D" uniqKey="Kintin D" first="D" last="Kintin">D. Kintin</name></author><author><name sortKey="Diakite, S" sort="Diakite, S" uniqKey="Diakite S" first="S" last="Diakite">S. Diakite</name></author><author><name sortKey="Sylla, M" sort="Sylla, M" uniqKey="Sylla M" first="M" last="Sylla">M. Sylla</name></author><author><name sortKey="Meda, H" sort="Meda, H" uniqKey="Meda H" first="H" last="Meda">H. Meda</name></author><author><name sortKey="Sobela, F" sort="Sobela, F" uniqKey="Sobela F" first="F" last="Sobela">F. Sobela</name></author><author><name sortKey="Asamoah Adu, C" sort="Asamoah Adu, C" uniqKey="Asamoah Adu C" first="C" last="Asamoah-Adu">C. Asamoah-Adu</name></author><author><name sortKey="Agyarko Poku, T" sort="Agyarko Poku, T" uniqKey="Agyarko Poku T" first="T" last="Agyarko-Poku">T. Agyarko-Poku</name></author><author><name sortKey="Frost, E" sort="Frost, E" uniqKey="Frost E" first="E" last="Frost">E. Frost</name></author></analytic><series><title level="j">Sexually Transmitted Infections</title><idno type="ISSN">1368-4973</idno><idno type="eISSN">1472-3263</idno><imprint><date when="2004">2004</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><bold>Objectives:</bold> To measure prevalence and risk factors for cervical infections among a large sample of women consulting for vaginal discharge in west Africa and to evaluate its syndromic management through a two visit algorithm. </p><p><bold>Methods:</bold> In 11 health centres in Bénin, Burkina Faso, Ghana, Guinée, and Mali 726 women who presented with a vaginal discharge without abdominal pain and who denied being a sex worker (SW) were enrolled. Cervical samples were tested for the detection of <italic>Neisseria gonorrhoeae</italic> (NG) and <italic>Chlamydia trachomatis</italic> (CT) with polymerase chain reaction (PCR) assays. All participants were treated with single dose (2 g) metronidazole and clotrimazole cream for 3 days. They were randomised to be told either to come back on day 7 only if there was no improvement in the discharge (group A), or to come back on day 7 regardless of response to treatment (group B). </p><p><bold>Results:</bold> Overall, the prevalence of NG and CT was only 1.9% (14/726) and 3.2% (23/726) respectively. Risk factors previously recommended by the WHO were not associated with the presence of cervical infection, with the exception of the number of sex partners in the past 3 months. When taken together, these risk factors had a positive predictive value of only 6.4% to identify cervical infections. Prevalence of cervical infection was not higher in women who came back on day 7, regardless of the strategy used. Prevalence of NG/CT was lower in Ghana and Bénin (5/280, 1.8%), where comprehensive interventions for SW have been ongoing for years, than in the three other countries (27/446, 6.1%, p = 0.01). </p><p><bold>Conclusions:</bold> NG and CT infections are uncommon in west African women who consult for vaginal discharge and who are not SW. Syndromic management of vaginal discharge should focus on the proper management of vaginitis. The control of gonococcal and chlamydial infection should be redesigned around interventions focusing on sex workers. </p></div></front></TEI><affiliations><list></list><tree><noCountry><name sortKey="Agyarko Poku, T" sort="Agyarko Poku, T" uniqKey="Agyarko Poku T" first="T" last="Agyarko-Poku">T. Agyarko-Poku</name><name sortKey="Asamoah Adu, C" sort="Asamoah Adu, C" uniqKey="Asamoah Adu C" first="C" last="Asamoah-Adu">C. Asamoah-Adu</name><name sortKey="Deslandes, S" sort="Deslandes, S" uniqKey="Deslandes S" first="S" last="Deslandes">S. Deslandes</name><name sortKey="Diakite, S" sort="Diakite, S" uniqKey="Diakite S" first="S" last="Diakite">S. Diakite</name><name sortKey="Frost, E" sort="Frost, E" uniqKey="Frost E" first="E" last="Frost">E. Frost</name><name sortKey="Khonde, N" sort="Khonde, N" uniqKey="Khonde N" first="N" last="Khonde">N. Khonde</name><name sortKey="Kintin, D" sort="Kintin, D" uniqKey="Kintin D" first="D" last="Kintin">D. Kintin</name><name sortKey="Meda, H" sort="Meda, H" uniqKey="Meda H" first="H" last="Meda">H. Meda</name><name sortKey="Pepin, J" sort="Pepin, J" uniqKey="Pepin J" first="J" last="Pepin">J. Pepin</name><name sortKey="Sobela, F" sort="Sobela, F" uniqKey="Sobela F" first="F" last="Sobela">F. Sobela</name><name sortKey="Sylla, M" sort="Sylla, M" uniqKey="Sylla M" first="M" last="Sylla">M. 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