Backgound Epidemiological data, required to inform the design and implementation of control programmes, in relation to genital Chlamydia and Gonorrhoea in rural Africa, are limited. There are no data on the prevalence of rectal or pharyngeal infections among women. We evaluate the use of dry swabs by Roche 4800 CT/NG and the PRESTO-PLUS to determine the prevalence in three anatomic locations of chlamydial and gonococcal infections in African women.
Methods Cross-sectional study of 604 women visiting 25 randomly selected primary healthcare (PHC) facilities. Participants were recruited between November 2011 and February 2012. Setting: PHC facilities across rural Mopani District in Limpopo Province, South Africa. Participants: Women aged 18–49 years who reported at least one sex act in the past 6 months were eligible. A questionnaire was administered and physical examination conducted. Vaginal, anorectal and oropharyngeal swabs were tested for Chlamydia trachomatis and Neisseria gonorrhoeae.
Results 480 (including 5 times 4 controls) samples have been tested by both assays at this moment, the others are in progress. Overall prevalence of either infection was 20%. Prevalence of genital chlamydia was 13% and gonorrhoea 5%; rectal chlamydial infection was diagnosed in 4% and gonococcal in 2% of women. Clear geographical differences were observed in the CT and NG prevalances. Roche and PRESTO-PLUS had similar prevalences with slightly higher prevalances found by PRESTO-PLUS, however not all 604 samples have been tested, and discrepancy analyses will be performed in the upcoming 2–3 months.
Conclusion Dry swab collection seems a reliable method of sampling without majot prevalence differences between Roche and PRESTO-PLUS. Genital and rectal, but not pharyngeal, chlamydia and gonorrhoea infections are highly prevalent and frequently asymptomatic in women in rural South Africa. Young women attending healthcare facilities for antenatal care or family planning should be prioritised in control efforts.
- South Africa
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