Prevalence of sexually transmitted infections and bacterial vaginosis among women in sub-Saharan Africa: An individual participant data meta-analysis of 18 HIV prevention studies

Autor: Torrone, Elizabeth A, Morrison, Charles S, Chen, Pai-Lien, Kwok, Cynthia, Francis, Suzanna C, Hayes, Richard J, Looker, Katharine J, McCormack, Sheena, McGrath, Nuala, van de Wijgert, Janneke HHM, Watson-Jones, Deborah, Low, Nicola, Gottlieb, Sami L, Grp, STIMA Working
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Zdroj: PLOS MEDICINE
PLoS Medicine
Torrone, E A, Morrison, C S, Chen, P-L, Kwok, C, Francis, S C, Hayes, R J, Looker, K J, McCormack, S, McGrath, N, van de Wijgert, J H H M, Watson-Jones, D, Low, N, Gottlieb, S L 2018, ' Prevalence of sexually transmitted infections and bacterial vaginosis among women in sub-Saharan Africa : An individual participant data meta-analysis of 18 HIV prevention studies ', PLoS Medicine, vol. 15, no. 2, e1002511 . https://doi.org/10.1371/journal.pmed.1002511
PLoS Medicine, Vol 15, Iss 2, p e1002511 (2018)
Torrone, Elizabeth A; Morrison, Charles S; Chen, Pai-Lien; Kwok, Cynthia; Francis, Suzanna C; Hayes, Richard J; Looker, Katharine J; McCormack, Sheena; McGrath, Nuala; van de Wijgert, Janneke H H M; Watson-Jones, Deborah; Low, Nicola; Gottlieb, Sami L (2018). Prevalence of sexually transmitted infections and bacterial vaginosis among women in sub-Saharan Africa: An individual participant data meta-analysis of 18 HIV prevention studies. PLoS medicine, 15(2), e1002511. Public Library of Science 10.1371/journal.pmed.1002511
ISSN: 1549-1277
DOI: 10.1371/journal.pmed.1002511
Popis: BACKGROUND: Estimates of sexually transmitted infection (STI) prevalence are essential for efforts to prevent and control STIs. Few large STI prevalence studies exist, especially for low- and middle-income countries (LMICs). Our primary objective was to estimate the prevalence of chlamydia, gonorrhea, trichomoniasis, syphilis, herpes simplex virus type 2 (HSV-2), and bacterial vaginosis (BV) among women in sub-Saharan Africa by age, region, and population type.METHODS AND FINDINGS: We analyzed individual-level data from 18 HIV prevention studies (cohort studies and randomized controlled trials; conducted during 1993-2011), representing >37,000 women, that tested participants for ≥1 selected STIs or BV at baseline. We used a 2-stage meta-analysis to combine data. After calculating the proportion of participants with each infection and standard error by study, we used a random-effects model to obtain a summary mean prevalence of each infection and 95% confidence interval (CI) across ages, regions, and population types. Despite substantial study heterogeneity for some STIs/populations, several patterns emerged. Across the three primary region/population groups (South Africa community-based, Southern/Eastern Africa community-based, and Eastern Africa higher-risk), prevalence was higher among 15-24-year-old than 25-49-year-old women for all STIs except HSV-2. In general, higher-risk populations had greater prevalence of gonorrhea and syphilis than clinic/community-based populations. For chlamydia, prevalence among 15-24-year-olds was 10.3% (95% CI: 7.4%, 14.1%; I2 = 75.7%) among women specifically recruited from higher-risk settings for HIV in Eastern Africa and was 15.1% (95% CI: 12.7%, 17.8%; I2 = 82.3%) in South African clinic/community-based populations. Among clinic/community-based populations, prevalence was generally greater in South Africa than in Southern/Eastern Africa for most STIs; for gonorrhea, prevalence among 15-24-year-olds was 4.6% (95% CI: 3.3%, 6.4%; I2 = 82.8%) in South Africa and was 1.7% (95% CI: 1.2%, 2.6%; I2 = 55.2%) in Southern/Eastern Africa. Across the three primary region/population groups, HSV-2 and BV prevalence was high among 25-49-year-olds (ranging from 70% to 83% and 33% to 44%, respectively). The main study limitation is that the data are not from random samples of the target populations.CONCLUSIONS: Combining data from 18 HIV prevention studies, our findings highlight important features of STI/BV epidemiology among sub-Saharan African women. This methodology can be used where routine STI surveillance is limited and offers a new approach to obtaining critical information on STI and BV prevalence in LMICs.
Databáze: OpenAIRE
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