Prevalence and Correlates of Curable Sexually Transmitted Infections in Women With Miscarriage in Nairobi

Abstract

Background: Sexually transmitted infections (STI) are a major public concern globally among women in the reproductive age. The curable STIs (gonorrhoea, chlamydial infections, syphilis and trichomoniasis) have a global estimate of 1 million new cases daily. Globally, 23 million miscarriages occur annually. There is evidence that young women who present with 12 spontaneous abortion have a higher likelihood of an STI. The presence of STIs increases the risk of complications and long-term sequelae after abortions. Pelvic inflammatory disease is the most prevalent complication and can lead to chronic pelvic pain, dyspareunia, infertility, and a higher risk of ectopic pregnancy. There is paucity of data in Sub-Saharan Africa on STIs in miscarriage. In Kenya, the post abortion care standards and guidelines lack screening guidelines for STIs in this population. The syndromic approach in management is deficient in both sensitivity and specificity. Objective: To determine the prevalence and correlates of curable sexually transmitted infections in women presenting with miscarriage at the Kenyatta National Hospital, Mama Lucy Kibaki Hospital and Mbagathi Hospital. Methods: This was a descriptive cross-sectional multi-center study that was conducted at Kenyatta National Hospital, Mama Lucy Kibaki hospital and Mbagathi Hospital. The study population was comprised of women presenting with miscarriage during the study period. An interviewer administered questionnaire was used to gather socio-demographic data and determine risk factors for eligible women. Endo-cervical and vaginal samples for testing gonorrhoea, Chlamydia and Trichomoniasis using multiplex PCR and blood samples for testing syphilis using venereal disease research laboratory (VDRL) and Treponema pallidum hemagglutination (TPHA) was collected with utmost confidentiality. Data was exported to the Statistical Package for Social Sciences version 26 for analysis. Categorical variables were summarized as frequencies and proportions while continuous variables were summarized as means and medians where appropriate, with their measures of dispersion. Prevalence was presented as percentages. The correlates were analyzed with the use of chi-squared test. For the statistical analysis, significance will be considered where p=value is below 0.05. Data was presented using tables and charts where applicable...