Control of sexually transmitted diseases in Haiti: results and implications of a baseline study among pregnant women living in Cité Soleil Shantytowns.
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 < .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.
Behets
F M
FM
University of North Carolina, Department of Medicine, Chapel Hill 27599, USA.
Desormeaux
J
J
Joseph
D
D
Adrien
M
M
Coicou
G
G
Dallabetta
G
G
Hamilton
H A
HA
Moeng
S
S
Davis
H
H
Cohen
M S
MS
D000022:Abortion, Spontaneous; D002690:Chlamydia Infections / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology / Q000517:prevention & control; D006679:HIV Seropositivity / Q000453:epidemiology; D006205:Haiti / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D011203:Poverty; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology / Q000517:prevention & control*; D011295:Prenatal Care; D012307:Risk Factors; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D012959:Socioeconomic Factors; D013587:Syphilis / Q000453:epidemiology; D014505:Urban Population; D014627:Vaginitis / Q000453:epidemiology