Abstract：
OBJECTIVE: To estimate the prevalence of the curable sexually transmitted infections (STIs) Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Trichomonas vaginalis and Treponema pallidum, to identify associated risk factors and to assess ciprofloxacin resistance in N. gonorrhoeae-positive specimens among female sex workers (FSWs) in Guinea-Bissau.
METHODS: For this cross-sectional study, FSWs were recruited from October 2014 to May 2019. A questionnaire on STI risk factors was completed by the study participants, and the women were asked to provide a vaginal swab for nucleic acid amplification tests for C. trachomatis, N. gonorrhoeae, M. genitalium, T. vaginalis (Aptima, Hologica), as well as a blood sample for T. pallidum serological testing and discriminatory HIV-testing. The prevalence of STIs was determined, and multivariate logistic regression was used to identify STI risk factors.
RESULTS: The study included 467 women. The prevalence of current infection with any curable STI was 46.7%, and the most common pathogen was T. vaginalis (26.3%), followed by M. genitalium (21.9%), C. trachomatis (11.8%), N. gonorrhoeae (10.1%) and T. pallidum (2.8%). The proportion of asymptomatic infections among the diagnosed STIs was 61.8%, 61.5%, 55.3%, 55.3% and 52.2% for C. trachomatis, T. pallidum, N. gonorrhoeae, T. vaginalis and M. genitalium, respectively. The prevalence of the gyrA S91F mutation conferring ciprofloxacin resistance in N. gonorrhoeae-positive specimens was 84.0%. Significant risk factors for having a curable STI were age and HIV-1 infection, while use of female condoms was a protective factor.
CONCLUSIONS: This study demonstrated that the prevalence of curable STIs was high among FSWs in Guinea-Bissau during the study period, indicating an unmet need for STI services. Moreover, the results indicated that symptomatic treatment might be insufficient, highlighting a need for periodic aetiological testing to facilitate detection of asymptomatic as well as symptomatic STIs to stop ongoing transmission.
METHODS: For this cross-sectional study, FSWs were recruited from October 2014 to May 2019. A questionnaire on STI risk factors was completed by the study participants, and the women were asked to provide a vaginal swab for nucleic acid amplification tests for C. trachomatis, N. gonorrhoeae, M. genitalium, T. vaginalis (Aptima, Hologica), as well as a blood sample for T. pallidum serological testing and discriminatory HIV-testing. The prevalence of STIs was determined, and multivariate logistic regression was used to identify STI risk factors.
RESULTS: The study included 467 women. The prevalence of current infection with any curable STI was 46.7%, and the most common pathogen was T. vaginalis (26.3%), followed by M. genitalium (21.9%), C. trachomatis (11.8%), N. gonorrhoeae (10.1%) and T. pallidum (2.8%). The proportion of asymptomatic infections among the diagnosed STIs was 61.8%, 61.5%, 55.3%, 55.3% and 52.2% for C. trachomatis, T. pallidum, N. gonorrhoeae, T. vaginalis and M. genitalium, respectively. The prevalence of the gyrA S91F mutation conferring ciprofloxacin resistance in N. gonorrhoeae-positive specimens was 84.0%. Significant risk factors for having a curable STI were age and HIV-1 infection, while use of female condoms was a protective factor.
CONCLUSIONS: This study demonstrated that the prevalence of curable STIs was high among FSWs in Guinea-Bissau during the study period, indicating an unmet need for STI services. Moreover, the results indicated that symptomatic treatment might be insufficient, highlighting a need for periodic aetiological testing to facilitate detection of asymptomatic as well as symptomatic STIs to stop ongoing transmission.
摘要：
目的：评估可治愈的性传播感染（STIs）沙眼衣原体的患病率，淋病奈瑟菌,生殖支原体，阴道毛滴虫和梅毒螺旋体，在几内亚比绍女性性工作者（FSWs）淋病奈瑟菌阳性标本中，确定相关危险因素并评估环丙沙星耐药性。
方法：对于这项横断面研究，FSW于2014年10月至2019年5月招募。研究参与者完成了关于性传播感染危险因素的问卷，要求这些妇女提供阴道拭子进行沙眼衣原体的核酸扩增测试，淋病奈瑟菌,生殖M，T.vaginalis(Aptima，Hologica),以及用于梅毒螺旋体血清学检测和歧视性HIV检测的血液样本。确定了性传播感染的患病率，采用多因素logistic回归分析确定STI危险因素。
结果：该研究包括467名女性。任何可治愈的性传播感染的当前感染率为46.7％，最常见的病原体是阴道毛虫(26.3%)，其次是生殖支原体(21.9%)，沙眼衣原体（11.8%），淋病奈瑟菌（10.1%）和梅毒奈瑟菌（2.8%）。在确诊的性传播感染中,无症状感染的比例为61.8%,61.5%,55.3%,沙眼衣原体分别为55.3%和52.2%，T.苍白球，淋病奈瑟菌,阴道毛虫和生殖支原体，分别。淋病奈瑟菌阳性标本中给予环丙沙星耐药的gyrAS91F突变的患病率为84.0%。患有可治愈性传播感染的重要风险因素是年龄和HIV-1感染，而使用女性避孕套是一个保护因素。
结论：这项研究表明，在研究期间，几内亚比绍的FSW中可治愈性性传播感染的患病率很高，表明对STI服务的需求未得到满足。此外，结果表明对症治疗可能不足，强调需要定期进行病因检测，以促进无症状和有症状的性传播感染的检测，以阻止持续传播。
方法：对于这项横断面研究，FSW于2014年10月至2019年5月招募。研究参与者完成了关于性传播感染危险因素的问卷，要求这些妇女提供阴道拭子进行沙眼衣原体的核酸扩增测试，淋病奈瑟菌,生殖M，T.vaginalis(Aptima，Hologica),以及用于梅毒螺旋体血清学检测和歧视性HIV检测的血液样本。确定了性传播感染的患病率，采用多因素logistic回归分析确定STI危险因素。
结果：该研究包括467名女性。任何可治愈的性传播感染的当前感染率为46.7％，最常见的病原体是阴道毛虫(26.3%)，其次是生殖支原体(21.9%)，沙眼衣原体（11.8%），淋病奈瑟菌（10.1%）和梅毒奈瑟菌（2.8%）。在确诊的性传播感染中,无症状感染的比例为61.8%,61.5%,55.3%,沙眼衣原体分别为55.3%和52.2%，T.苍白球，淋病奈瑟菌,阴道毛虫和生殖支原体，分别。淋病奈瑟菌阳性标本中给予环丙沙星耐药的gyrAS91F突变的患病率为84.0%。患有可治愈性传播感染的重要风险因素是年龄和HIV-1感染，而使用女性避孕套是一个保护因素。
结论：这项研究表明，在研究期间，几内亚比绍的FSW中可治愈性性传播感染的患病率很高，表明对STI服务的需求未得到满足。此外，结果表明对症治疗可能不足，强调需要定期进行病因检测，以促进无症状和有症状的性传播感染的检测，以阻止持续传播。
