Sexually transmitted infections among married women in Dhaka, Bangladesh: unexpected high prevalence of herpes simplex type 2 infection

Objectives: To document the prevalence of reproductive tract infections (RT I) and sexually transmitted infections (STI) among women attending a basic healthcare clinic in Dhaka, Bangladesh, to identify risk factors associated with the diseases and to estimate the incidence of syphilis, hepatitis C ( HCV), hepatitis B (HBV), and herpes simplex type 2 (HSV-2) infection. Methods: A cross sectional sample of 2335 consecutive women was examined du ring 1996-8. Women were interviewed about risk factors for RTI/STI and test ed for Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, Treponema pallidum, HIV, HCV, HBV, HSV-1 and HSV-2 infection as well as va ginal candidosis and bacterial vaginosis. Women with antibodies to T pallid um were retested at regular intervals. One year after ending the study sero conversion for syphilis, HBV, HCV, and HSV-2 infection was detected among w omen initially negative for the respective diseases. Results: The overall prevalence rate of N gonorrhoeae, C trachomatis, T vag inalis, and T pallidum infection was 0.5%, 1.9%, 2.0%, and 2.9% respectivel y. Overall, 35% of the women had antibodies to hepatitis B core antigen, 0. 9% had HCV, and 12% HSV-2 infection. Risk factors for gonorrhoea/C trachoma tis infection were a husband not living at home or suspected of being unfai thful. HSV-2 infection was associated with the same risk factors and with a polygamous marriage. The prevalence of HSV-2 infection among women "at ris k" was 23%. HIV infection was not diagnosed. Repeated serological examinati on indicated that only 32% of women with serological evidence of syphilis h ad active disease. The seroincidences of HBV, HCV, and HSV-2 were 0.03, 0.0 07, and 0.009 per person year. Seroconversion for syphilis was not: observe d.