The Etiology of Vaginal Discharge Syndrome in Zimbabwe

Details

• Alternative Title:
  Sex Transm Dis
• Personal Author:
  Chirenje, Z. Mike ; Dhibi, Nicholas ; Handsfield, H. Hunter ; Gonese, Elizabeth ; Barr, Beth Tippett ; Gwanzura, Lovemore ; Latif, Ahmed S. ; Maseko, Dumisili Venessa ; Kularatne, Ranmini S. ; Tshimanga, Mufuta ; Kilmarx, Peter H. ; Machiha, Anna ; Mugurungi, Owen ; Rietmeijer, Cornelis A.
• Description:
  Introduction:
  
  Symptomatic vaginal discharge is a common gynecological condition managed syndromically in most developing countries. In Zimbabwe, women presenting with symptomatic vaginal discharge are treated with empirical regimens that commonly cover both sexually transmitted infections (STI) and reproductive tract infections, typically including a combination of an intramuscular injection of kanamycin, and oral doxycycline and metronidazole regimens. This study was conducted to determine the current etiology of symptomatic vaginal discharge and assess adequacy of current syndromic management guidelines.
  
  Methods:
  
  We enrolled 200 women with symptomatic vaginal discharge presenting at 6 STI clinics in Zimbabwe. Microscopy was used to detect bacterial vaginosis and yeast infection. Nucleic acid amplifications tests were used to detect Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis and Mycoplasma genitalium. In addition, serologic testing was performed to detect HIV infection.
  
  Results:
  
  Of the 200 women, 146 (73%) had an etiology detected, including bacterial vaginosis (24.7%); N. gonorrhoeae (24.0%); yeast infection (20.7%); T. vaginalis (19.0%); C. trachomatis (14.0%) and M. genitalium (7.0%). Among women with STIs (N=90), 62 (68.9%) had a single infection, 18 (20.0%) had a dual infection and 10 (11.1%) had three infections.
  
  Conclusion:
  
  Among women presenting with symptomatic vaginal discharge, bacterial vaginosis was the most common etiology and gonorrhea was the most frequently detected STI. The current syndromic management algorithm is suboptimal for coverage of women presenting with symptomatic vaginal discharge; addition of point of care testing could compliment the effectiveness of the syndromic approach.
  
  
• Keywords:
  Adolescent Adult Algorithms Chlamydia Infections Chlamydia Trachomatis Disease Management Etiology Female Gonorrhea HIV Infections Humans Male Middle Aged Mycoplasma Genitalium Mycoplasma Infections Neisseria Gonorrhoeae STI Surveys And Questionnaires Syndromic Management Trichomonas Vaginalis Vaginal Discharge Vaginosis, Bacterial Young Adult Zimbabwe

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• Source:
  Sex Transm Dis. 45(6):422-428
• Pubmed ID:
  29465674
• Pubmed Central ID:
  PMC6879447
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/ ; U2G GH000315/GH/CGH CDC HHSUnited States/
• Volume:
  45
• Issue:
  6
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:30f20dd375b5a6bc31f84482b85f8b1c8d4b93aaaa29cdef2b652f8955e496db
• Download URL:
  https://stacks.cdc.gov/view/cdc/83425/cdc_83425_DS1.pdf
• File Type:
  [PDF - 434.44 KB ]