title: Sexually transmitted infections, bacterial vaginosis, and candidiasis in women of reproductive age in rural Northeast Brazil: a population-based study.
abstract: Population-based data on sexually transmitted infections (STI), bacterial vaginosis (BV), and candidiasis reflect the epidemiological situation more accurately than studies performed in specific populations, but such data are scarce. To determine the prevalence of STI, BV, and candidiasis among women of reproductive age from a resource-poor community in Northeast Brazil, a population-based cross sectional study was undertaken. All women from seven hamlets and the centre of Pacoti municipality in the state of Ceará, aged 12 to 49 years, were invited to participate. The women were asked about socio-demographic characteristics and genital symptoms, and thereafter examined gynaecologically. Laboratory testing included polymerase chain reaction (PCR) for human papillomavirus (HPV), ligase chain reaction (LCR) for Chlamydia trachomatis and Neisseria gonorrhoeae, ELISA for human immunodeficiency virus (HIV), venereal disease research laboratory (VDRL) and fluorescent treponema antibody absorption test (FTA-ABS) for syphilis, and analysis of wet mounts, gram stains and Pap smears for trichomoniasis, candidiasis, and BV. Only women who had initiated sexual life were included in the analysis (n = 592). The prevalences of STI were: HPV 11.7% (95% confidence interval: 9.3-14.7), chlamydia 4.5% (3.0-6.6), trichomoniasis 4.1% (2.7-6.1), gonorrhoea 1.2% (0.5-2.6), syphilis 0.2% (0.0-1.1), and HIV 0%. The prevalence of BV and candidiasis was 20% (16.9-23.6) and 12.5% (10.0-15.5), respectively. The most common gynaecological complaint was lower abdominal pain. STI are common in women in rural Brazil and represent an important health threat in view of the HIV pandemic.
authors.affiliation: Departamento de Saúde Comunitária, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, 60430-140, Brasil. foliveira@web.de
authors.forename: Fabíola Araújo
authors.initials: FA
authors.lastname: Oliveira
authors.forename: Viola
authors.initials: V
authors.lastname: Pfleger
authors.forename: Katrin
authors.initials: K
authors.lastname: Lang
authors.forename: Jörg
authors.initials: J
authors.lastname: Heukelbach
authors.forename: Iracema
authors.initials: I
authors.lastname: Miralles
authors.forename: Francisco
authors.initials: F
authors.lastname: Fraga
authors.forename: Anastácio Queiroz
authors.initials: AQ
authors.lastname: Sousa
authors.forename: Marina
authors.initials: M
authors.lastname: Stoffler-Meilicke
authors.forename: Ralf
authors.initials: R
authors.lastname: Ignatius
authors.forename: Ligia Franco Sansigolo
authors.initials: LF
authors.lastname: Kerr
authors.forename: Hermann
authors.initials: H
authors.lastname: Feldmeier
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D002181:Candidiasis, Vulvovaginal / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012424:Rural Population; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000382:microbiology / Q000821:virology; D012959:Socioeconomic Factors; D016585:Vaginosis, Bacterial / Q000453:epidemiology* / Q000382:microbiology