PT  - JOURNAL ARTICLE
AU  - Adriane Wynn
AU  - Doreen Ramogola-Masire
AU  - Ponatshego Gaolebale
AU  - Neo Moshashane
AU  - Ontiretse Sickboy
AU  - Sofia Duque
AU  - Elizabeth Williams
AU  - Klara Doherty
AU  - Jeffrey D Klausner
AU  - Chelsea Morroni
TI  - Prevalence and treatment outcomes of routine <em>Chlamydia trachomatis</em>, <em>Neisseria gonorrhoeae</em> and <em>Trichomonas vaginalis</em> testing during antenatal care, Gaborone, Botswana
AID  - 10.1136/sextrans-2017-053134
DP  - 2017 Nov 02
TA  - Sexually Transmitted Infections
PG  - sextrans-2017-053134
4099  - http://sti.bmj.com/content/early/2017/11/02/sextrans-2017-053134.short
4100  - http://sti.bmj.com/content/early/2017/11/02/sextrans-2017-053134.full
AB  - Objectives Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Trichomonas vaginalis (TV) are curable, mostly asymptomatic, STIs that cause adverse maternal and perinatal outcomes. Most countries do not test for those infections during antenatal care. We implemented a CT, NG and TV testing and treatment programme in an antenatal clinic in Gaborone, Botswana.Methods We conducted a prospective study in the antenatal clinic at Princess Marina Hospital in Gaborone, Botswana. We offered pregnant women who were 18 years or older and less than 35 weeks of gestation, CT, NG and TV testing using self-collected vaginal swabs. Testing was conducted using a GeneXpert® CT/NG and TV system. Those who tested positive were given directly observed antibiotic therapy and asked to return for a test of cure. We determined the prevalence of infections, uptake of treatment and proportion cured. The relationships between positive STI test and participant characteristics were assessed.Results We enrolled 400 pregnant women. Fifty-four (13.5%) tested positive for CT, NG and/or TV: 31 (8%) for CT, 5 (1.3%) for NG and 21 (5%) for TV. Among those who tested positive, 74% (40) received same-day, in person results and treatment. Among those who received delayed results (6), 67% (4) were treated. Statistical comparisons showed that being unmarried and HIV infected were positively association CT, NG and/or TV infection. Self-reported STI symptoms were not associated with CT, NG and/or TV infection.Conclusion The prevalence of CT, NG and/or TV was high, particularly among women with HIV infection. Among women with CT, NG and/or TV infection, those who received same-day results were more likely to be treated than those who received delayed results. More research is needed on the costs and benefits of integrating highly sensitive and specific STI testing into antenatal care in Southern Africa.