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.
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。