       Document 0614
 DOCN  M9620614
 TI    Should screening of genital infections be part of antenatal care in
       areas of high HIV prevalence? A prospective cohort study from Kigali,
       Rwanda, 1992-1993. The Pregnancy and HIV (EGE) Group.
 DT    9602
 AU    Leroy V; De Clercq A; Ladner J; Bogaerts J; Van de Perre P; Dabis F;
       INSERM U. 330, Universite de Bordeaux II, France.
 SO    Genitourin Med. 1995 Aug;71(4):207-11. Unique Identifier : AIDSLINE
       MED/96046495
 AB    OBJECTIVE--To study the prevalence and incidence of genital infections
       and their association with HIV-1 infection among pregnant women in
       Kigali, Rwanda. SUBJECTS AND METHODS--HIV+ and HIV- pregnant women were
       followed prospectively during the last three months of pregnancy. At
       enrolment, syphilis test (RPR) on blood sample, Chlamydiae trachomatis
       ELISA test on cervical smear, laboratory gonococcal culture, trichomonas
       and candida direct examination, CD4 lymphocyte count were performed. At
       each monthly follow-up clinic visit until delivery, genital infections
       were screened in the presence of clinical signs and symptoms.
       RESULTS--The HIV seroprevalence rate was 34.4% (N = 1233), 384 HIV+
       women and 381 HIV- women of same parity and age were enrolled.
       Prevalence of genital infections at enrolment was generally higher in
       HIV+ women than in HIV- women: syphilis, 6.3% versus 3.7% (p = 0.13);
       Neisseria gonorrhoea, 7.0% versus 2.4% (p = 0.005); Trichomonas
       vaginalis, 20.2% versus 10.9% (p = 0.0007); Chlamydia trachomatis, 3.4%
       versus 5.5% (p = 0.21); Candida vaginalis, 22.3% versus 20.1% (p =
       0.49). Until delivery, the relative risk of acquiring genital infections
       was also higher in HIV+ women than in HIV- women: 1.0 for syphilis (95%
       CI: 0.5-2.2), 3.7 for Neisseria gonorrhoea (1.0-13.3), 2.6 for
       Trichomonas vaginalis (1.5-4.6) and 1.6 for Candida vaginalis (1.1-2.4).
       CONCLUSION--In the context of high HIV-1 seroprevalence among pregnant
       women, prenatal care should include at least once screening for genital
       infections by clinical examination with speculum and a syphilis testing
       in Africa.
 DE    Adolescence  Adult  Candidiasis, Vulvovaginal/EPIDEMIOLOGY  Cohort
       Studies  Enzyme-Linked Immunosorbent Assay  Female  Genital Diseases,
       Female/*EPIDEMIOLOGY  Gonorrhea/EPIDEMIOLOGY  Human  HIV
       Infections/*EPIDEMIOLOGY  HIV Seroprevalence  Incidence  Mass Screening
       Pregnancy  Pregnancy Complications, Infectious/*EPIDEMIOLOGY  Prenatal
       Care  Prevalence  Prospective Studies  Risk Factors  Rwanda/EPIDEMIOLOGY
       Support, Non-U.S. Gov't  Syphilis/EPIDEMIOLOGY  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

