1316. Prevalence and Correlates of Sexually Transmitted Infections Among Pregnant Women, Gaborone, Botswana, 2016.
Session: Poster Abstract Session: Clinical Infectious Diseases: Sexually Transmitted Infections
Friday, October 28, 2016
Room: Poster Hall
Background: Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis are curable, mostly asymptomatic, sexually transmitted infections (STIs) that can cause adverse maternal and perinatal outcomes. Most countries do not conduct routine screening during antenatal care. We present data on the prevalence and correlates of STIs from a project to screen pregnant women in Gaborone, Botswana.

Methods: The study took place in the antenatal clinic in Princess Marina Hospital in Gaborone, Botswana. We offered pregnant women Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis screening using self-collected vaginal swabs. Eligibility criteria include: 18 years or older, less than 35 weeks of gestation, and planning to return for follow-up care. Screening was conducted using a GeneXpert® CT/NG and TV [Cepheid, Sunnyvale, CA] system, which provided a 90-minute time to result. Those who tested positive were given directly observed therapy with azithromycin, ceftriaxone, and/or metronidazole, as indicated; and asked to return for a test of cure in four weeks. The relationships between a positive STI test and independent variables were assessed using bivariate comparisons and a multivariable logistic regression.

Results: We enrolled 300 pregnant women into the study. The median age of our study sample was 30 years; most were unmarried (76%), with a median gestational age of 27 weeks, and a 22% HIV prevalence. Forty-five (15%) tested positive for any STI, including 25 (8%) for Chlamydia trachomatis, five (2%) for Neisseria gonorrhoeae, and 18 (6%) for Trichomonas vaginalis. Testing positive for an STI was associated with being single (OR, 2.72; 95% CI, 1.03-7.20), having a low level of education (OR, 2.23; 95% CI, 1.08-5.02) and independently associated with being positive for HIV (adjusted OR, 2.18; 95% CI, 1.18-4.02). Reported STI-related symptoms were not associated with testing positive for an STI (OR, 1.03; 95% CI 0.54-1.97).

Conclusion: STI prevalence was high in our sample. Our findings support continued efforts to increase STI screening and treatment in pregnant women in middle-income country settings, particularly for those living with HIV.

Adriane Wynn, MPP1, Doreen Ramogola-Masire, BMedSci, BMBS, MRCOG, FCOG2, Ponatshego Gaolebale, MD3, Neo Moshashane, BA4, Ontiretse Sickboy, BA2, Ogechukwu Offorjebe, BA5, Kaitlin Arena, BA6, Elizabeth Williams, MD7, Sofia Duque, BA2, Jeffrey Klausner, MD, MPH8 and Chelsea Morroni, MPH, MPhil, PhD, MBChB, DTM&H, DFSRH2, (1)Health Policy and Management, UCLA, Los Angeles, CA, (2)Botswana-UPenn Partnership, Gaborone, Botswana, (3)Princess Marina Hospital, Gaborone, Botswana, (4)University of Botswana, Gaborone, Botswana, (5)Charles R. Drew/UCLA Medical Education Program, Los Angeles, CA, (6)UCLA David Geffen School of Medicine, Los Angeles, CA, (7)Bart’s Health NHS Trust, UK, London, United Kingdom, (8)Division of Infectious Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA

Disclosures:

A. Wynn, None

D. Ramogola-Masire, None

P. Gaolebale, None

N. Moshashane, None

O. Sickboy, None

O. Offorjebe, None

K. Arena, None

E. Williams, None

S. Duque, None

J. Klausner, None

C. Morroni, None

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