Control of sexually transmitted diseases in Haiti: results and implications of a baseline study among pregnant women living in Cité Soleil Shantytowns.

Abstract

Women attending Haitian slum-based antenatal clinics were evaluated for sexually transmitted diseases (STDs): 110 (11%) of 996 were syphilis seroreactive, 313 (35%) of 903 had trichomoniasis, 110 (12%) of 897 had gonococcal or chlamydial cervical infection (or both), and 418 (47%) of 891 had at least one STD. Syphilis seroreactivity was associated with illiteracy (P = .007), lower socioeconomic status (P < .001), and a history of spontaneous abortion (P = .02). Of 663 evaluated sera, 56 (8%) had human immunodeficiency virus (HIV) antibodies. In multivariate analysis, positive HIV serostatus was associated with syphilis seroreactivity (P = .006), partner's unemployment (P = .002), and history of a previous sex partner (P = .04). Risk factors for gonococcal or chlamydial cervical infection were evaluated. Clinical assessment of cervical discharge, a World Health Organization algorithm, and a decision model based on local risk factors were 64%, 77%, and 89% sensitive, respectively, and 44%, 38%, and 43% specific, respectively, for predicting cervical infection. Alternative treatment approaches should be validated while waiting for affordable, simple, rapid, and accurate laboratory diagnostic tests for gonococcal and chlamydial cervical infections.

Authors

Behets, F M; Desormeaux, J; Joseph, D; Adrien, M; Coicou, G; Dallabetta, G; Hamilton, Holli; Moeng, S; Davis, H; Cohen, M S;

Keywords

  • Abortion, Spontaneous
  • Chlamydia Infections/ epidemiology
  • Chlamydia Infections/ prevention & control
  • Female
  • Gonorrhea/ epidemiology
  • Gonorrhea/ prevention & control
  • HIV Seropositivity/ epidemiology
  • Haiti/ epidemiology
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Male
  • Multivariate Analysis
  • Poverty
  • Pregnancy
  • Pregnancy Complications, Infectious/ epidemiology
  • Pregnancy Complications, Infectious/ prevention & control
  • Prenatal Care
  • Risk Factors
  • Sexual Behavior
  • Sexually Transmitted Diseases/ epidemiology
  • Sexually Transmitted Diseases/ prevention & control
  • Sexually Transmitted Diseases/ transmission
  • Socioeconomic Factors
  • Syphilis/ epidemiology
  • Urban Population
  • Vaginitis/ epidemiology

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