title: Prevalence and risk factors of chlamydia and gonorrhea among rural Nepali women.
abstract: OBJECTIVE
  The epidemiology of sexually transmitted infections (STI) in rural, developing world populations is poorly understood. We estimated the prevalence and risk factors of Neisseria gonorrhoeae and Chlamydia trachomatis in a female population in rural Nepal.
  
  
  METHODS
  We conducted a cross sectional study in a sample of 1177 postpartum women participating in a micronutrient supplementation trial in Nepal. Urine samples were collected to test for the two infections using the ligase chain reaction (LCR).
  
  
  RESULTS
  C trachomatis was detected in 1.0% (95% confidence intervals (CI): 0.4 to 1.5) and N gonorrhoeae in 2.3% (95% CI: 1.2 to 3.4) of women. None of the women tested positive for both. Self report of all three symptoms of lower abdominal pain, pain and burning on urination, and vaginal discharge was associated with the presence of gonorrhoea (odds ratio (OR): 12.1, 95% CI: 1.3 to 115.0). Neonatal eye discharge was associated with maternal gonococcal infection (OR = 5.2, 95% CI: 1.1 to 24.9). Incidence of low birth weight was not related to these maternal infections, but very preterm delivery (<32 weeks) was higher among women positive for gonorrhoea (OR = 4.7, 95% CI: 1.0 to 22.0). In a multivariable analysis, low body mass index (<18.5) and cattle ownership were associated with gonorrhoea (p <0.05), whereas woman's literacy was associated with chlamydia (p = 0.06).
  
  
  CONCLUSIONS
  We found the rates of N gonorrhoeae and C trachomatis to be low among women in this rural population of Nepal.
authors.affiliation: Department of International Health, The Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Room W2041, Baltimore, MD 21205, USA. pchristi@jhsph.edu
authors.forename: P
authors.initials: P
authors.lastname: Christian
authors.forename: S K
authors.initials: SK
authors.lastname: Khatry
authors.forename: S C
authors.initials: SC
authors.lastname: LeClerq
authors.forename: A A
authors.initials: AA
authors.lastname: Roess
authors.forename: L
authors.initials: L
authors.lastname: Wu
authors.forename: J D
authors.initials: JD
authors.lastname: Yuenger
authors.forename: J M
authors.initials: JM
authors.lastname: Zenilman
mesh_terms: D015992:Body Mass Index; D002690:Chlamydia Infections / Q000453:epidemiology*; D004522:Educational Status; D004812:Epidemiologic Methods; D015818:Eye Infections, Bacterial / Q000453:epidemiology / Q000382:microbiology; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology*; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008423:Maternal Age; D009390:Nepal / Q000453:epidemiology; D007752:Obstetric Labor, Premature / Q000453:epidemiology / Q000382:microbiology; D011247:Pregnancy; D012423:Rural Health; D012959:Socioeconomic Factors