Pregnant women as a reservoir of undetected sexually transmitted diseases in rural South Africa: implications for disease control.
OBJECTIVE
This study was undertaken to determine the prevalence of sexually transmitted diseases (STDs) in pregnant women in rural South Africa and to determine the value of using abnormal urogenital symptoms to identify infected women.


METHODS
This was a cross-sectional study of 327 patients attending prenatal clinics.


RESULTS
Of the 271 women with complete data, 141 (52%) had at least 1 STD and 49 (18%) had more than 1. Abnormal symptoms were common (n = 225; 83%), but associations were weak, and the positive predictive value of different symptoms for infection ranged from 2% to 54%.


CONCLUSIONS
Most STDs in rural South African women remain undetected and untreated. As the scope for laboratory diagnosis in resource-poor settings is limited, presumptive treatment of pregnant women and their partners may be a cost-effective option to reduce transmission of STDs and HIV infection.
Department of Medical Microbiology, University of Natal, Durban, South Africa.
A W
AW
Sturm
D
D
Wilkinson
N
N
Ndovela
S
S
Bowen
C
C
Connolly
D000328:Adult; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004197:Disease Reservoirs / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology* / Q000517:prevention & control; D012424:Rural Population / Q000706:statistics & numerical data*; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission*; D013019:South Africa / Q000453:epidemiology