title: Control of sexually transmitted diseases in Haiti: results and implications of a baseline study among pregnant women living in Cité Soleil Shantytowns.
abstract: 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.
authors.affiliation: University of North Carolina, Department of Medicine, Chapel Hill 27599, USA.
authors.forename: F M
authors.initials: FM
authors.lastname: Behets
authors.forename: J
authors.initials: J
authors.lastname: Desormeaux
authors.forename: D
authors.initials: D
authors.lastname: Joseph
authors.forename: M
authors.initials: M
authors.lastname: Adrien
authors.forename: G
authors.initials: G
authors.lastname: Coicou
authors.forename: G
authors.initials: G
authors.lastname: Dallabetta
authors.forename: H A
authors.initials: HA
authors.lastname: Hamilton
authors.forename: S
authors.initials: S
authors.lastname: Moeng
authors.forename: H
authors.initials: H
authors.lastname: Davis
authors.forename: M S
authors.initials: MS
authors.lastname: Cohen
mesh_terms: 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