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1994-08-27
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Document 0761
DOCN M9480761
TI Risk factors for gonorrhoea, syphilis, and trichomonas infections among
women attending family planning clinics in Nairobi, Kenya.
DT 9410
AU Daly CC; Maggwa N; Mati JK; Solomon M; Mbugua S; Tukei PM; Hunter DJ;
Department of Epidemiology, Harvard School of Public Health,; Boston, MA
02115.
SO Genitourin Med. 1994 Jun;70(3):155-61. Unique Identifier : AIDSLINE
MED/94314301
AB OBJECTIVE--To identify the risk factors for gonorrhoea, syphilis, and
trichomonas infections among low risk women in Nairobi, Kenya.
METHOD--In a cross-sectional study, 4,404 women attending two peri-urban
family planning clinics between 1989 and 1991 were interviewed using a
structured questionnaire and examined for signs of sexually transmitted
disease (STD) infection. Cervical cultures for gonorrhoea, PAP smear
(including microscopy for trichomonas), RPR and HIV testing were done.
RESULTS--Positive cervical cultures for gonorrhoea were found in 3.2% of
women, positive syphilis serology in 1.9%, and positive trichomonas
microscopy in 5.2%. Genital ulcers were found in 1.9% of women. Although
unmarried status and reporting more than one sex partner in the previous
year were both significantly associated with each disease in the crude
analysis, these associations were attenuated after controlling for each
other and for other risk factors. The population attributable risks
(PARs) for these factors were low (7-16%) owing to the high proportion
of cases who were married and monogamous. The majority of women with
microbiological evidence of infection had normal pelvic examinations.
Clinical diagnostic algorithms for STDs in this population had a low
sensitivity and positive predictive value. Nevertheless, a strong
association between HIV seropositivity and STDs was observed.
CONCLUSION--The low population attributable risks found in this study
suggest that behaviour change messages directed to women, particularly
if they are married have a low potential for preventing STDs. The poor
performance of clinical diagnostic algorithms illustrates the
desirability of testing these algorithms in a variety of populations and
reinforces the need for low-cost methods of microbiologic diagnosis if
populations with relatively low prevalences of these infections are to
be included in programmes to diagnose and treat STDs.
DE Adolescence Adult Age Factors Cross-Sectional Studies Educational
Status Female Gonorrhea/*EPIDEMIOLOGY Human HIV Seropositivity
Kenya/EPIDEMIOLOGY Middle Age Risk Factors Sensitivity and
Specificity Sex Behavior Sexual Partners Support, Non-U.S. Gov't
Support, U.S. Gov't, P.H.S. Syphilis/*EPIDEMIOLOGY Syphilis
Serodiagnosis Trichomonas Vaginitis/*EPIDEMIOLOGY JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).