Prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae infection and associated factors among asymptomatic pregnant women in Botswana.

Abstract

BACKGROUND:

Chlamydia trachomatis (C. trachomatis) and Neisseria gonorrhoeae (N. gonorrhoeae) are curable sexually transmitted infections (STIs) that cause adverse pregnancy and neonatal outcomes. Most countries, including Botswana, do not offer C. trachomatis or N. gonorrhoeae screening during antenatal care (ANC) and instead use a syndromic approach for management of STIs.

METHODS:

The Maduo Study is a prospective, cluster-controlled trial in Botswana evaluating the impact of diagnostic screening for antenatal C. trachomatis and N. gonorrhoeae infections to prevent adverse neonatal outcomes. Using baseline data from the Maduo Study (March 2021-March 2022), we determined the prevalence of C. trachomatis and N. gonorrhoeae infection among asymptomatic pregnant women in Botswana and correlates of infection using multivariable logistic regression.

RESULTS:

Of 251 women who underwent C. trachomatis and N. gonorrhoeae screening at first ANC visit, 55 (21.9%, 95%CI 17.0-27.5) tested positive for C. trachomatis, 1 (0.4%, 95%CI 0-2.2) for N. gonorrhoeae; and 2 (0.8%, 95%CI 0-2.8) for dual C. trachomatis and N. gonorrhoeae infection. Older age was associated with lower odds (aOR 0.93; 95%CI 0.88-0.98; p = 0.011) while any alcohol use during pregnancy was associated with higher odds (aOR = 3.53; 95%CI 1.22-10.16; p = 0.020) of testing positive for C. trachomatis or N. gonorrhoeae.

CONCLUSIONS:

A high frequency of C. trachomatis infections was detected among asymptomatic pregnant women in Botswana indicating that many antenatal STIs are missed by the syndromic management approach. Our results highlight the need for diagnostic C. trachomatis screening during ANC in Botswana and other low- and middle-income countries that rely solely on the syndromic approach for management of STIs.

• Authors: Aamirah Mussa, Adriane Wynn, Rebecca Ryan, Chibuzor M Babalola, Emily Hansman, Selebaleng Simon, Bame Bame, Lefhela Tamuthiba, Kehumile Ramontshonyana, Neo Ndlovu, Neo Moshashane, Maitumelo Masole, Jeffrey D Klausner, Chelsea Morroni
• Journal: International journal of STD & AIDS (Int J STD AIDS) Vol. 34 Issue 7 Pg. 448-456 (06 2023) ISSN: 1758-1052 [Electronic] England
• PMID: 36930946 (Publication Type: Controlled Clinical Trial, Journal Article, Research Support, N.I.H., Extramural)

Topics

• Female
• Humans
• Infant, Newborn
• Pregnancy
• Botswana (epidemiology)
• Chlamydia Infections (diagnosis, epidemiology, complications)
• Chlamydia trachomatis
• Gonorrhea (diagnosis, epidemiology, complications)
• Neisseria gonorrhoeae
• Pregnancy Complications, Infectious (epidemiology, diagnosis)
• Pregnant Women
• Prevalence
• Prospective Studies
• Sexually Transmitted Diseases (diagnosis, epidemiology, complications)