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Mogaka, Pintye, Drake, and John-Stewart Author Research on STIs Among HIV-Negative Pregnant Women in Kenya

Posted: 11/2/2023 (CSDE Research)

Jerusha Mogaka (PhD candidate, Nursing), Dr. Jillian Pintye (Associate Professor, Nursing) and CSDE Affiliates Dr. Alison Drake (Associate Professor, Global Health), and Dr. Grace John-Stewart (Professor, Global Health, Epidemiology, Medicine, and Pediatrics) recently published their research with co-authors, “Prevalence and predictors of Chlamydia trachomatis and Neisseria gonorrhoeae among HIV-negative pregnant women in Kenya” in Sexually Transmitted Diseases. Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections in pregnancy contribute to adverse perinatal outcomes. Authors identified predictors of CT and/or NG infection among pregnant Kenyan women. For their research design, women without HIV were enrolled at two antenatal clinics in Western Kenya. CT and NG were assessed using endocervical samples for nucleic acid amplification tests (NAAT). Poisson regression models were used to evaluate potential CT/NG risk factors. Classification and regression trees (CART) were generated to evaluate the joint effects of predictors.

Overall, 1276 women had both CT and NG assessments. Women enrolled at a median of 26 weeks gestation (IQR 22-31), median age was 22 years (IQR 19-27), and 78% were married. In total, 98 (7.7%) tested positive for CT/NG: 70 (5.5%) for CT, 32 (2.5%) for NG, 4 of whom (0.3%) had co-infections. Two-thirds (66%) of CT/NG cases were asymptomatic and would have been missed with only syndromic management. Risk factors of CT/NG included age < 22 years, crowded living conditions, being unmarried, being in partnerships for <1-year, abnormal vaginal discharge, previous STI history, and T. vaginalis diagnosis(p < 0.05). CART analyses identified unmarried women <22 years in relationships for <1 year as 6.1 times more likely to have CT/NG compared to women without these characteristics (26% vs. 6%, adjusted prevalence ratio = 6.1, 95% CI: 3.55–10.39, p < 0.001).

CT/NG was frequently asymptomatic and common among young unmarried women in newer partnerships in this cohort. Integrating CT/NG testing into routine antenatal care may be beneficial, especially for young women in Kenya.

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