Control of sexually transmitted diseases in Haiti: results and implications of a baseline study among pregnant women living in Cité Soleil Shantytowns
Behets, F.M.; Desormeaux, J.; Joseph, D.; Adrien, M.; Coicou, G.; Dallabetta, G.; Hamilton, H.A.; Moeng, S.; Davis, H.; Cohen, M.S.
Journal of Infectious Diseases 172(3): 764-771
1995
ISSN/ISBN: 0022-1899 PMID: 7658070 DOI: 10.1093/infdis/172.3.764Document Number: 295767
Women attending Haitian slum-based antenatal clinics were evaluated for sexually transmitted diseases (STDs): 110 (11%) of 996 were syphilis seroreactive, 313 (35%) of 903 had trichomoniasis, 110 (12%) of 897 had gonococcal or chlamydial cervical infection (or both), and 418 (47%) of 891 had at least one STD. Syphilis seroreactivity was associated with illiteracy (P = .007), lower socioeconomic status (P lt .001), and a history of spontaneous abortion (P = .02). Of 663 evaluated sera, 56 (8%) had human immunodeficiency virus (HIV) antibodies. In multivariate analysis, positive HIV serostatus was associated with syphilis seroreactivity (P = .006), partner's unemployment (P = .002), and history of a previous sex partner (P = .04). Risk factors for gonococcal or chlamydial cervical infection were evaluated. Clinical assessment of cervical discharge, a World Health Organization algorithm, and a decision model based on local risk factors were 64%, 77%, and 89% sensitive, respectively, and 44%, 38%, and 43% specific, respectively, for predicting cervical infection. Alternative treatment approaches should be validated while waiting for affordable, simple, rapid, and accurate laboratory diagnostic tests for gonococcal and chlamydial cervical infections.