Aetiological testing compared with syndromic management for sexually transmitted infections in HIV-infected pregnant women in South Africa: a non-randomised prospective cohort study

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dc.contributor.author Peters, Remco P.H.
dc.contributor.author Klausner, J.D.
dc.contributor.author De Vos, Lieschen
dc.contributor.author Feucht, Ute Dagmar
dc.contributor.author Medina-Marino, A.
dc.date.accessioned 2021-02-24T05:40:04Z
dc.date.available 2021-02-24T05:40:04Z
dc.date.issued 2020-12
dc.description.abstract OBJECTIVE: To measure the frequencies of sexually transmitted infections (STIs) and adverse pregnancy outcomes among women receiving either aetiological testing or syndromic management for STIs. DESIGN: Non-randomised prospective cohort study. SETTING: Primary healthcare facilities in Tshwane, South Africa. POPULATION: HIV-infected pregnant women attending antenatal care services. METHODS: Participants were enrolled to receive aetiological testing using Xpert CT/NG and Xpert TV assays or standard syndromic management. Outcome data were collected at the postnatal care visit (≤30 days from delivery) and from maternity records. Enrolment gestational age-adjusted relative risk (aRR) was calculated. MAIN OUTCOME MEASURES: STI prevalence at postnatal visit, and frequency of adverse pregnancy outcomes (preterm birth, low birthweight). RESULTS: We enrolled 841 women. The prevalence of any STI at baseline was 40%; Chlamydia trachomatis 30%, Neisseria gonorrhoeae 5.6%, Trichomonas vaginalis 20%. The prevalence of STIs at postnatal care was lower among those receiving aetiological testing compared with those receiving syndromic management (14% versus 23%; aRR 0.61; 95% CI 0.35–1.05). No difference was observed between study groups for frequency of preterm birth (23% versus 23%; aRR 1.2, 95% CI 0.81–1.8) and low birth weight (15% versus 13%; aRR 1.1, 95% CI 0.66–1.7). CONCLUSIONS: Aetiological testing provides an effective intervention to reduce the high burden of STIs in pregnant women in South Africa; however, the optimal implementation strategy remains to be determined. en_ZA
dc.description.department Paediatrics and Child Health en_ZA
dc.description.librarian pm2021 en_ZA
dc.description.sponsorship National Institute for Allergy and Infectious Diseases; U.S. President's Emergency Plan for AIDS Relief and Eunice Kennedy Shriver National Institute of Child Health and Human Development. en_ZA
dc.description.uri https://obgyn.onlinelibrary.wiley.com/journal/14710528 en_ZA
dc.identifier.citation Peters R.P.H., Klausner J.D., De Vos L., Feucht U.D., Medina-Marino A. Aetiological testing compared with syndromic management for sexually transmitted infections in HIV-infected pregnant women in South Africa: a non-randomised prospective cohort study. BJOG. 2020; https://doi.org/10.1111./1471-0528.16617. NYP. en_ZA
dc.identifier.issn 1470-0328 (print)
dc.identifier.issn 1471-0528 (online)
dc.identifier.other 10.1111/1471-0528.16617
dc.identifier.uri http://hdl.handle.net/2263/78817
dc.language.iso en en_ZA
dc.publisher Wiley en_ZA
dc.rights © 2020 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License. en_ZA
dc.subject Aetiological testing en_ZA
dc.subject Low birthweight en_ZA
dc.subject Pregnancy en_ZA
dc.subject Preterm birth en_ZA
dc.subject Syndromic management en_ZA
dc.subject Xpert en_ZA
dc.subject Human immunodeficiency virus (HIV) en_ZA
dc.subject Sexually transmitted infection (STI) en_ZA
dc.title Aetiological testing compared with syndromic management for sexually transmitted infections in HIV-infected pregnant women in South Africa: a non-randomised prospective cohort study en_ZA
dc.type Article en_ZA


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