Acceptability and Feasibility of Integrating Point-of-Care Diagnostic Testing of Sexually Transmitted Infections into a South African Antenatal Care Program for HIV-Infected Pregnant Women

doi:10.1155/2018/3946862

. 2018 May 9:2018:3946862.

doi: 10.1155/2018/3946862. eCollection 2018.

Acceptability and Feasibility of Integrating Point-of-Care Diagnostic Testing of Sexually Transmitted Infections into a South African Antenatal Care Program for HIV-Infected Pregnant Women

E Morikawa¹, M Mudau², D Olivier², L de Vos², D Joseph Davey^{3

4}, C Price¹, J A McIntyre^{5

6}, R P Peters^{5

7

8}, J D Klausner^{1

3}, A Medina-Marino²

Affiliations

¹ Division of Infectious Disease, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
² Research Unit, Foundation for Professional Development, Pretoria, South Africa.
³ Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA.
⁴ Department of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
⁵ Anova Health Institute, Johannesburg, South Africa.
⁶ School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
⁷ Department of Medical Microbiology, School of Public Health and Primary Care, Maastricht University, Maastricht, Netherlands.
⁸ Department of Medical Microbiology, University of Pretoria, Pretoria, South Africa.

PMID: 29861622
PMCID: PMC5971359
DOI: 10.1155/2018/3946862

Acceptability and Feasibility of Integrating Point-of-Care Diagnostic Testing of Sexually Transmitted Infections into a South African Antenatal Care Program for HIV-Infected Pregnant Women

E Morikawa et al. Infect Dis Obstet Gynecol. 2018.

. 2018 May 9:2018:3946862.

doi: 10.1155/2018/3946862. eCollection 2018.

Authors

E Morikawa¹, M Mudau², D Olivier², L de Vos², D Joseph Davey^{3

4}, C Price¹, J A McIntyre^{5

6}, R P Peters^{5

7

8}, J D Klausner^{1

3}, A Medina-Marino²

Affiliations

¹ Division of Infectious Disease, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
² Research Unit, Foundation for Professional Development, Pretoria, South Africa.
³ Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA.
⁴ Department of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
⁵ Anova Health Institute, Johannesburg, South Africa.
⁶ School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
⁷ Department of Medical Microbiology, School of Public Health and Primary Care, Maastricht University, Maastricht, Netherlands.
⁸ Department of Medical Microbiology, University of Pretoria, Pretoria, South Africa.

PMID: 29861622
PMCID: PMC5971359
DOI: 10.1155/2018/3946862

Abstract

Background: Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Trichomonas vaginalis (TV) infections may increase the risk of vertical transmission of the human immunodeficiency virus (HIV). In resource-limited settings, symptomatic screening, and syndromic management of sexually transmitted infections (STIs) during pregnancy continue to be the standard of care. In the absence of diagnostic testing, asymptomatic infections in pregnant women go untreated.

Objective: To describe the acceptability and feasibility of integrating diagnostic STI screening into first antenatal care visits for HIV-infected pregnant women.

Methods: HIV-infected pregnant women were recruited during their first antenatal care visit from three antenatal care clinics in Tshwane District, South Africa, between June 2016 and October 2017. Self-collected vaginal swabs were used to screen for CT, NG, and TV with a diagnostic point-of-care (POC) nucleic acid amplification test. Those with STIs were provided treatment per South African national guidelines.

Results: Of 442 eligible women, 430 (97.3%) agreed to participate and were tested. Of those with a positive STI test result (n = 173; 40.2%), 159 (91.9%) received same-day results and treatment; 100% of STI-infected women were treated within seven days.

Conclusions: Integration of POC diagnostic STI screening into first-visit antenatal care services was feasible and highly acceptable for HIV-infected pregnant women.

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Figures

**Figure 1**
Schematic diagram of the number of women approached, enrolled, and tested in the antenatal screening study in Tshwane District, South Africa (June 2016–October 2017).

See this image and copyright information in PMC

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References

1. Newman L., Rowley J., Vander Hoorn S., et al. Global estimates of the prevalence and incidence of four curable sexually transmitted infections in 2012 based on systematic review and global reporting. 2015;10(12) doi: 10.1371/journal.pone.0143304.e0143304 - DOI - PMC - PubMed
1. Rours G. I. J. G., Duijts L., Moll H. A., et al. Chlamydia trachomatis infection during pregnancy associated with preterm delivery: a population-based prospective cohort study. 2011;26(6):493–502. doi: 10.1007/s10654-011-9586-1. - DOI - PMC - PubMed
1. Adachi K., Klausner J. D., Xu J., et al. Chlamydia trachomatis and Neisseria gonorrhoeae in HIV-infected pregnant women and adverse infant outcomes. 2016;35(8):894–900. doi: 10.1097/INF.0000000000001199. - DOI - PMC - PubMed
1. Mullick S., Watson-Jones D., Beksinska M., Mabey D. Sexually transmitted infections in pregnancy: Prevalence, impact on pregnancy outcomes, and approach to treatment in developing countries. 2005;81(4):294–302. doi: 10.1136/sti.2002.004077. - DOI - PMC - PubMed
1. Moodley D., Sartorius B., Madurai S., Chetty V., Maman S. Pregnancy outcomes in association with STDs including genital HSV-2 shedding in a South African Cohort Study. 2017;93(7):460–466. doi: 10.1136/sextrans-2017-053113. - DOI - PubMed

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[1] Newman L., Rowley J., Vander Hoorn S., et al. Global estimates of the prevalence and incidence of four curable sexually transmitted infections in 2012 based on systematic review and global reporting. 2015;10(12) doi: 10.1371/journal.pone.0143304.e0143304 - DOI - PMC - PubMed

[2] Newman L., Rowley J., Vander Hoorn S., et al. Global estimates of the prevalence and incidence of four curable sexually transmitted infections in 2012 based on systematic review and global reporting. 2015;10(12) doi: 10.1371/journal.pone.0143304.e0143304 - DOI - PMC - PubMed

[3] Rours G. I. J. G., Duijts L., Moll H. A., et al. Chlamydia trachomatis infection during pregnancy associated with preterm delivery: a population-based prospective cohort study. 2011;26(6):493–502. doi: 10.1007/s10654-011-9586-1. - DOI - PMC - PubMed

[4] Rours G. I. J. G., Duijts L., Moll H. A., et al. Chlamydia trachomatis infection during pregnancy associated with preterm delivery: a population-based prospective cohort study. 2011;26(6):493–502. doi: 10.1007/s10654-011-9586-1. - DOI - PMC - PubMed

[5] Adachi K., Klausner J. D., Xu J., et al. Chlamydia trachomatis and Neisseria gonorrhoeae in HIV-infected pregnant women and adverse infant outcomes. 2016;35(8):894–900. doi: 10.1097/INF.0000000000001199. - DOI - PMC - PubMed

[6] Adachi K., Klausner J. D., Xu J., et al. Chlamydia trachomatis and Neisseria gonorrhoeae in HIV-infected pregnant women and adverse infant outcomes. 2016;35(8):894–900. doi: 10.1097/INF.0000000000001199. - DOI - PMC - PubMed

[7] Mullick S., Watson-Jones D., Beksinska M., Mabey D. Sexually transmitted infections in pregnancy: Prevalence, impact on pregnancy outcomes, and approach to treatment in developing countries. 2005;81(4):294–302. doi: 10.1136/sti.2002.004077. - DOI - PMC - PubMed

[8] Mullick S., Watson-Jones D., Beksinska M., Mabey D. Sexually transmitted infections in pregnancy: Prevalence, impact on pregnancy outcomes, and approach to treatment in developing countries. 2005;81(4):294–302. doi: 10.1136/sti.2002.004077. - DOI - PMC - PubMed

[9] Moodley D., Sartorius B., Madurai S., Chetty V., Maman S. Pregnancy outcomes in association with STDs including genital HSV-2 shedding in a South African Cohort Study. 2017;93(7):460–466. doi: 10.1136/sextrans-2017-053113. - DOI - PubMed

[10] Moodley D., Sartorius B., Madurai S., Chetty V., Maman S. Pregnancy outcomes in association with STDs including genital HSV-2 shedding in a South African Cohort Study. 2017;93(7):460–466. doi: 10.1136/sextrans-2017-053113. - DOI - PubMed

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Acceptability and Feasibility of Integrating Point-of-Care Diagnostic Testing of Sexually Transmitted Infections into a South African Antenatal Care Program for HIV-Infected Pregnant Women

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Acceptability and Feasibility of Integrating Point-of-Care Diagnostic Testing of Sexually Transmitted Infections into a South African Antenatal Care Program for HIV-Infected Pregnant Women

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