Reproductive Tract Infections (RTIs) including Sexually Transmitted Infections (STIs): a population-based study of women of reproductive age in a rural district of Vietnam

Abstract

Objectives: to (i) investigate the prevalences of RTIs/STIs among married women in a rural district of Vietnam, and (ii) analyse the influence of socio-economic, socio-demographic, and other determinants possibly related to RTIs/STIs.

Methods: Community-based cross-sectional study. Married women aged 18-49 years (n=1012) were interviewed and underwent a gynaecological examination. Specimens were collected for laboratory diagnosis of chlamydia, gonorrhoea, trichomonas, bacterial vaginosis (BV), candidiasis, hepatitis B, HIV, and syphilis.

Results: In total, 37% of the women were clinically diagnosed with an RTI/STI. Etiologically confirmed RTI/STI was identified in 39% of the women (including 6.0% with STIs). Endogenous infections were most prevalent (candidiasis 26%, BV 11%) followed by hepatitis B 8.3%, Chlamydia trachomatis 4.3%, Trichomonas vaginalis 1%, Neisseria gonorrhoeae 0.7%, genital warts 0.2%, and HIV and syphilis 0%. Fifty percent of the STI cases were asymptomatic. Younger age and intra-uterine devices were significantly associated with increased risk of BV. Determinants of candidiasis were vaginal douching, high education level and low economic status, whereas a determinant of chlamydia was high economic status. Out-migration of the husband was associated with increased risk of HBsAg seroposivity among the women.

Conclusions: RTIs/STIs were prevalent among married women in a rural population of Vietnam. Syndromic algorithms should be consistently supplemented by risk assessment in order to reduce under- and over-treatment. Microscopic diagnosis could be applied in primary care settings to achieve more accurate diagnoses. Promotion of health education aiming at reducing RTI/STI prevalences is an important tool in STI/HIV control programs. Vaccination to prevent hepatitis B for migrants should be considered.