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1996-02-26
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Document 0614
DOCN M9620614
TI Should screening of genital infections be part of antenatal care in
areas of high HIV prevalence? A prospective cohort study from Kigali,
Rwanda, 1992-1993. The Pregnancy and HIV (EGE) Group.
DT 9602
AU Leroy V; De Clercq A; Ladner J; Bogaerts J; Van de Perre P; Dabis F;
INSERM U. 330, Universite de Bordeaux II, France.
SO Genitourin Med. 1995 Aug;71(4):207-11. Unique Identifier : AIDSLINE
MED/96046495
AB OBJECTIVE--To study the prevalence and incidence of genital infections
and their association with HIV-1 infection among pregnant women in
Kigali, Rwanda. SUBJECTS AND METHODS--HIV+ and HIV- pregnant women were
followed prospectively during the last three months of pregnancy. At
enrolment, syphilis test (RPR) on blood sample, Chlamydiae trachomatis
ELISA test on cervical smear, laboratory gonococcal culture, trichomonas
and candida direct examination, CD4 lymphocyte count were performed. At
each monthly follow-up clinic visit until delivery, genital infections
were screened in the presence of clinical signs and symptoms.
RESULTS--The HIV seroprevalence rate was 34.4% (N = 1233), 384 HIV+
women and 381 HIV- women of same parity and age were enrolled.
Prevalence of genital infections at enrolment was generally higher in
HIV+ women than in HIV- women: syphilis, 6.3% versus 3.7% (p = 0.13);
Neisseria gonorrhoea, 7.0% versus 2.4% (p = 0.005); Trichomonas
vaginalis, 20.2% versus 10.9% (p = 0.0007); Chlamydia trachomatis, 3.4%
versus 5.5% (p = 0.21); Candida vaginalis, 22.3% versus 20.1% (p =
0.49). Until delivery, the relative risk of acquiring genital infections
was also higher in HIV+ women than in HIV- women: 1.0 for syphilis (95%
CI: 0.5-2.2), 3.7 for Neisseria gonorrhoea (1.0-13.3), 2.6 for
Trichomonas vaginalis (1.5-4.6) and 1.6 for Candida vaginalis (1.1-2.4).
CONCLUSION--In the context of high HIV-1 seroprevalence among pregnant
women, prenatal care should include at least once screening for genital
infections by clinical examination with speculum and a syphilis testing
in Africa.
DE Adolescence Adult Candidiasis, Vulvovaginal/EPIDEMIOLOGY Cohort
Studies Enzyme-Linked Immunosorbent Assay Female Genital Diseases,
Female/*EPIDEMIOLOGY Gonorrhea/EPIDEMIOLOGY Human HIV
Infections/*EPIDEMIOLOGY HIV Seroprevalence Incidence Mass Screening
Pregnancy Pregnancy Complications, Infectious/*EPIDEMIOLOGY Prenatal
Care Prevalence Prospective Studies Risk Factors Rwanda/EPIDEMIOLOGY
Support, Non-U.S. Gov't Syphilis/EPIDEMIOLOGY JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).