Aetiological testing compared with syndromic management for sexually transmitted infections in HIV-infected pregnant women in South Africa : a non-randomised prospective cohort study
© 2020 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd..
OBJECTIVE: To measure the frequencies of sexually transmitted infections (STIs) and adverse pregnancy outcomes among women receiving either aetiological testing or syndromic management for STIs.
DESIGN: Non-randomised prospective cohort study.
SETTING: Primary healthcare facilities in Tshwane, South Africa.
POPULATION: HIV-infected pregnant women attending antenatal care services.
METHODS: Participants were enrolled to receive aetiological testing using Xpert® CT/NG and Xpert® TV assays or standard syndromic management. Outcome data were collected at the postnatal care visit (≤30 days from delivery) and from maternity records. Enrolment gestational age-adjusted relative risk (aRR) was calculated.
MAIN OUTCOME MEASURES: STI prevalence at postnatal visit, and frequency of adverse pregnancy outcomes (preterm birth, low birthweight).
RESULTS: We enrolled 841 women. The prevalence of any STI at baseline was 40%; Chlamydia trachomatis 30%, Neisseria gonorrhoeae 5.6%, Trichomonas vaginalis 20%. The prevalence of STIs at postnatal care was lower among those receiving aetiological testing compared with those receiving syndromic management (14% versus 23%; aRR 0.61; 95% CI 0.35-1.05). No difference was observed between study groups for frequency of preterm birth (23% versus 23%; aRR 1.2, 95% CI 0.81-1.8) and low birth weight (15% versus 13%; aRR 1.1, 95% CI 0.66-1.7).
CONCLUSIONS: Aetiological testing provides an effective intervention to reduce the high burden of STIs in pregnant women in South Africa; however, the optimal implementation strategy remains to be determined.
TWEETABLE ABSTRACT: Aetiological testing effectively reduces the burden of sexually transmitted infections in pregnancy.
| Errataetall: | |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:128 |
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| Enthalten in: |
BJOG : an international journal of obstetrics and gynaecology - 128(2021), 8 vom: 19. Juli, Seite 1335-1342 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Peters, Rph [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 22.07.2021 Date Revised 22.07.2021 published: Print-Electronic CommentIn: BJOG. 2021 Jul;128(8):1343. - PMID 33666327 Citation Status MEDLINE |
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| doi: |
10.1111/1471-0528.16617 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM318437554 |
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| 100 | 1 | |a Peters, Rph |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Aetiological testing compared with syndromic management for sexually transmitted infections in HIV-infected pregnant women in South Africa |b a non-randomised prospective cohort study |
| 264 | 1 | |c 2021 | |
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| 500 | |a Date Revised 22.07.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: BJOG. 2021 Jul;128(8):1343. - PMID 33666327 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2020 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd. | ||
| 520 | |a OBJECTIVE: To measure the frequencies of sexually transmitted infections (STIs) and adverse pregnancy outcomes among women receiving either aetiological testing or syndromic management for STIs | ||
| 520 | |a DESIGN: Non-randomised prospective cohort study | ||
| 520 | |a SETTING: Primary healthcare facilities in Tshwane, South Africa | ||
| 520 | |a POPULATION: HIV-infected pregnant women attending antenatal care services | ||
| 520 | |a METHODS: Participants were enrolled to receive aetiological testing using Xpert® CT/NG and Xpert® TV assays or standard syndromic management. Outcome data were collected at the postnatal care visit (≤30 days from delivery) and from maternity records. Enrolment gestational age-adjusted relative risk (aRR) was calculated | ||
| 520 | |a MAIN OUTCOME MEASURES: STI prevalence at postnatal visit, and frequency of adverse pregnancy outcomes (preterm birth, low birthweight) | ||
| 520 | |a RESULTS: We enrolled 841 women. The prevalence of any STI at baseline was 40%; Chlamydia trachomatis 30%, Neisseria gonorrhoeae 5.6%, Trichomonas vaginalis 20%. The prevalence of STIs at postnatal care was lower among those receiving aetiological testing compared with those receiving syndromic management (14% versus 23%; aRR 0.61; 95% CI 0.35-1.05). No difference was observed between study groups for frequency of preterm birth (23% versus 23%; aRR 1.2, 95% CI 0.81-1.8) and low birth weight (15% versus 13%; aRR 1.1, 95% CI 0.66-1.7) | ||
| 520 | |a CONCLUSIONS: Aetiological testing provides an effective intervention to reduce the high burden of STIs in pregnant women in South Africa; however, the optimal implementation strategy remains to be determined | ||
| 520 | |a TWEETABLE ABSTRACT: Aetiological testing effectively reduces the burden of sexually transmitted infections in pregnancy | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Aetiological testing | |
| 650 | 4 | |a HIV | |
| 650 | 4 | |a Xpert® | |
| 650 | 4 | |a low birthweight | |
| 650 | 4 | |a pregnancy | |
| 650 | 4 | |a preterm birth | |
| 650 | 4 | |a sexually transmitted infections | |
| 650 | 4 | |a syndromic management | |
| 700 | 1 | |a Klausner, J D |e verfasserin |4 aut | |
| 700 | 1 | |a de Vos, L |e verfasserin |4 aut | |
| 700 | 1 | |a Feucht, U D |e verfasserin |4 aut | |
| 700 | 1 | |a Medina-Marino, A |e verfasserin |4 aut | |
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