Article Text
Abstract
Introduction There is strong evidence that sexually transmitted infections (STIs) cause adverse pregnancy outcomes, including preterm birth, stillbirth, low birth-weight and congenital infections. The prevalence of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Trichomonas vaginalis (TV) in the Asia Pacific region varies. The recently estimated mean prevalence of CT, NG and TV in low and middle income countries in Asia was 0.8%, 2.8% and 13.6% respectively. In Vietnam, pregnant women are not screened for CT, NG and TV during their antenatal visits. The aim of our current study was to estimate the prevalence of STIs and access feasibility and acceptability of screening for CT, NG and TV among pregnant women in Hanoi.
Methods We plan to enrol 800 pregnant women coming to Ha Dong General Hospital, Hanoi for antenatal care. Eligibility includes age 18 years or older, gestational age less than 35 weeks and willing to come back to the hospital for counselling and treatment if tested positive. After informed consent, enrolled women self-collect vaginal swabs or urine samples for testing using Xpert CT/NG and TV assays (Cepheid, Sunnyvale, CA, USA). We offer CT/NG testing to all 800 participants but only offer TV testing to the first 387 participants (due to TV’s low prevalence).
Results To date we have enrolled 490 participants (Acceptability was 99.0% (95%CI, 97.7–99.7)). Among them, 34 had CT (6.9%; 95% CI, 4.9–9.6) and none had NG. Among 387 women who were tested for TV, 3 had the infection (0.78%; 95% CI, 0.16–2.25). Feasibility was 94.4% (95%CI, 81.3–99.3), with 34 out of 36 infected women treated for the corresponding infection.
Conclusion Acceptability and feasibility of STI screening among pregnant women in Vietnam was very high. The prevalence of CT was much higher than the mean prevalence of CT among low and middle income countries in Asia. Study findings support policy to incorporate routine screening for STIs during pregnancy to improve maternal and infant health.