HIGH-FREQUENCY OF SEXUALLY-TRANSMITTED DISEASES AMONG PREGNANT-WOMEN IN DAR-ES-SALAAM, TANZANIA - NEED FOR INTERVENTION

In order to determine the prevalence and characteristics of sexually t ransmitted diseases (STDs) in pregnant women (PW) attending a primary health care antenatal clinic (ANC) in metropolitan Dar es Salaam, Tanz ania, a randomly selected sample of PW in their second or third trimes ters were invited to participate at their first visit. They were inter viewed using a questionnaire and underwent genital examination. Genita l swabs were obtained for microscopy and/or culture isolation of Candi da albicans, Trichomonas vaginalis, and Neisseria gonorrhoeae. Blood s pecimens were also obtained for serological testing for syphilis and f or antibodies to the human immunodeficiency virus (HIV). A total of 77 7 PW aged 14 to 40 years were seen. Parities ranged from 0 to 10. Prev alence of syphilis, trichomoniasis, gonorrhoea and HIV infection were 4.0%, 22.7%, 3.6% and 15.2%, respectively. At least one acute STD (exc luding HIV infection) was found in 32.8% of the PW. The prevalence of multiple STDs (excluding HIV infection) was higher in teenagers (45.3% , 77/170) than in PW in other age groups (29.2%, 177/607) (p<0.001). T he prevalence of HIV infection Tn teenage PW was 10.0%. Most STDs were least prevalent in PW who were married monogamously. Of the 732 PW wh o had one or more genital infections (including infection with Candida species), 669 (91.4%) had one or more genital complaints. However, mo st of the genital complaints were not disease specific. Since this stu dy has shown that the prevalences of acute STDs were high in PW, espec ially in teenagers, it is recommended that all PW in Tanzania should b e screened for STDs syndromically including the use of appropriate cli nical and laboratory examination whenever possible.