title: Prevalence of and factors associated with reproductive tract infections among pregnant women in ten communes in Nghe An Province, Vietnam.
abstract: BACKGROUND
  A community-based survey was conducted to investigate reproductive tract infections (RTIs) among pregnant women in Vietnam, where epidemiologic data on these infections are scarce.
  
  
  METHODS
  The focus of the study were: candidiasis, bacterial vaginosis, group B streptococcal infection,trichomoniasis, gonorrhea, syphilis, and hepatitis B. In addition to their prevalence, a generalized estimating equation was used to analyze infection-associated factors and diagnostic test analysis to examine the accuracy of currently performed presumptive clinical diagnoses.
  
  
  RESULTS
  Among 505 pregnant women in 10 communes, 182 (36%) had at least one infection with a wide regional variation in prevalence. The most prevalent infection was candidiasis (17%); sexually transmitted infections were rare except hepatitis B (10%); and the prevalence of bacterial vaginosis and group B streptococcal infections was 7% and 4%, respectively. Two factors were associated with the decreased risk of endogenous infections: a higher household assets score (odds ratio [OR] = 0.67) and condom use (OR = 0.15). Not living with a husband (OR = 1.55) was associated with an increased risk. For hepatitis B, three factors were associated with a decreased risk: employment by the government (OR = 0.26), higher education (OR = 0.18), and being older at the time of first sexual intercourse (OR = 0.58). Women's self-reported symptoms and clinical findings had low positive predictive values. Only clinical findings from the vaginal wall showed both a sensitivity and specificity over 50%.
  
  
  CONCLUSIONS
  Suggested recommendations are: extensive application of microscopic diagnosis, prevention of hepatitis B transmission, and addressing the issues of regional differences in the prevalence of RTI and of less wealthy people.
authors.affiliation: Department of Public Health, Fukushima Medical University School of Medicine, Hikarigaoka 1, Fukushima 960-1295, Japan. agoto@fmu.ac.jp
authors.forename: Aya
authors.initials: A
authors.lastname: Goto
authors.forename: Quang Vinh
authors.initials: QV
authors.lastname: Nguyen
authors.forename: Nghiem Minh
authors.initials: NM
authors.lastname: Pham
authors.forename: Kumiko
authors.initials: K
authors.lastname: Kato
authors.forename: Thi Phi Nga
authors.initials: TP
authors.lastname: Cao
authors.forename: Thi Hoai Chung
authors.initials: TH
authors.lastname: Le
authors.forename: Quoc Kieu
authors.initials: QK
authors.lastname: Hoang
authors.forename: Thi Quynh Nga
authors.initials: TQ
authors.lastname: Le
authors.forename: Ba Tan
authors.initials: BT
authors.lastname: Nguyen
authors.forename: Mayumi
authors.initials: M
authors.lastname: Katsube
authors.forename: Sumie
authors.initials: S
authors.lastname: Ishii
authors.forename: Seiji
authors.initials: S
authors.lastname: Yasumura
mesh_terms: D000328:Adult; D002181:Candidiasis, Vulvovaginal / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D005831:Genital Diseases, Female / Q000453:epidemiology* / Q000382:microbiology; D006509:Hepatitis B / Q000453:epidemiology; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D012749:Sexually Transmitted Diseases / Q000453:epidemiology; D013290:Streptococcal Infections / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014247:Trichomonas Vaginitis / Q000453:epidemiology; D016585:Vaginosis, Bacterial / Q000453:epidemiology; D014744:Vietnam / Q000453:epidemiology