Trichomonas vaginalis and Chlamydia trachomatis Prevalence, Incidence and Associated Factors in Pregnant Adolescents from Belém City, in the Brazilian Amazon
Open Journal of Obstetrics and Gynecology (OJOG)
Chlamydia trachomatis (CT) and Trichomonas vaginalis (TV)
are the most frequent curable STI in adolescents, causing serious consequences
for their reproductive health. Therefore, we aimed to determine the prevalence
and incidence of CT and TV, as well as their risk factors in pregnant adolescents from Belém, northern Brazilian Amazon.
Methods: This prospective study enrolled 199 adolescents up to 20 weeks
of pregnancy. They were scheduled for follow-up visit between 28 and 29 weeks
of pregnancy. Sociodemographic and behavioral data were obtained by interview.
Cervicovaginal samples were taken to test for TV, CT, Neisseria gonorrhoeae and bacterial vaginosis. Univariate and
multivariate analyses were performed to test the association of prevalent/incident
CT and TV with the variables. Results: Prevalence of cervical CT infection was
33.7% (n = 67/ 199), and for trichomoniasis it was 4.0% (n = 8/199). Cervical
ectopy increased the risk for prevalent CT (OR, 1.93; 95% CI, 1.01 - 3.70),
while having treated vaginal discharge in the past (OR, 0.51; 95% CI, 0.26 - 0.98)
and being married (OR, 0.10; 95% CI, 0.01 - 0.83) were protective against
current CT and TV, respectively. Among the 95 (47.7%) adolescents who completed
follow-up, 15 cases of incident CT were identified. Incident CT was associated
with having a formal or informal job (OR, 28.4; 95% CI, 2.1 - 391.6) and
bacterial vaginosis treatment at the baseline (OR, 0.08; 95% CI, 0.01 - 0.69).
Conclusion: Prevalence and incidence rates of TV and CT are high in this
population devoid of STI routine screening. Treatment of bacterial vaginosis
may benefit this population by reducing risk for CT acquisition.