• 1.

    Kent HL, 1991. Epidemiology of vaginitis. Am J Obstet Gynecol 165: 11681176.

  • 2.

    Haiti Ministère de la Santé Publique et de la Population, Port au Prince, 2011. 2010 Estimate, Département Sanitaire de la Grand'Anse, Etat Des Lieux de la Situation du Département: Rapport Final.

    • Search Google Scholar
    • Export Citation
  • 3.

    World Health Organization (WHO), 2005. Department of Reproductive Health and Research: Sexually Transmitted and Other Reproductive Tract Infections: A Guide to Essential Practice. Geneva: World Health Organization.

    • Search Google Scholar
    • Export Citation
  • 4.

    World Health Organization (WHO), 2013. Sexually Transmitted Infections (STIs): The Importance of a Renewed Commitment to STI Prevention and Control in Achieving Global Sexual and Reproductive Health. Geneva: World Health Organization.

    • Search Google Scholar
    • Export Citation
  • 5.

    Smith Fawzi MC, Lambert W, Singler JM, 2003. Prevalence and risk factors of STDs in rural Haiti: implications for policy and programming in resource-poor settings. Int J STD AIDS 14: 848853.

    • Search Google Scholar
    • Export Citation
  • 6.

    Fitzgerald DW, Behets F, Caliendo A, 2000. Economic hardship and sexually transmitted diseases in Haiti's rural Artibonite Valley. Am J Trop Med Hyg 62: 496501.

    • Search Google Scholar
    • Export Citation
  • 7.

    Behets FM, Desormeaux J, Joseph D, 1995. Control of sexually transmitted diseases in Haiti: results and implications of a baseline study among pregnant women living in Cité Soleil Shantytowns. J Infect Dis 172: 764771.

    • Search Google Scholar
    • Export Citation
  • 8.

    Smith Fawzi MC, Lambert W, Singler J, 2006. Identification of Chlamydia and gonorrhoea among women in rural Haiti: maximising access to treatment in a resource poor setting. Sex Transm Infect 82: 175181.

    • Search Google Scholar
    • Export Citation
  • 9.

    Mcgowin CL, Anderson-Smits C, 2011. Mycoplasma genitalium: an emerging cause of sexually transmitted disease in women. PLoS Pathog 7: e1001324.

    • Search Google Scholar
    • Export Citation
  • 10.

    Romoren M, Velauthapillai M, Rahman M, Sundby J, Klouman E, Hjortdahl P, 2007. Trichomoniasis and bacterial vaginosis in pregnancy: inadequately managed with the syndromic approach. Bull World Health Organ 85: 297304.

    • Search Google Scholar
    • Export Citation
  • 11.

    Castro AR, Esfandiari J, Kumar S, 2010. Novel point-of-care test for simultaneous detection of nontreponemal and treponemal antibodies in patients with syphilis. J Clin Microbiol 48: 46154619.

    • Search Google Scholar
    • Export Citation
  • 12.

    Brown HL, Fuller DD, Jasper LT, Davis TE, Wright JD, 2004. Clinical evaluation of affirm VPIII in the detection and identification of Trichomonas vaginalis, Gardnerella vaginalis, and Candida species in vaginitis/vaginosis. Infect Dis Obstet Gynecol 12: 1721.

    • Search Google Scholar
    • Export Citation
  • 13.

    Andrea SB, Chapin KC, 2011. Comparison of Aptima Trichomonas vaginalis transcription-mediated amplification assay and BD affirm VPIII for detection of T. vaginalis in symptomatic women: performance parameters and epidemiological implications. J Clin Microbiol 49: 866869.

    • Search Google Scholar
    • Export Citation
  • 14.

    Haïti Ministère de la Santé Publique et de la Population, Port au Prince, 2007. Profil Épidémiologique De l'infection par le VIH et du SIDA dans le Grand Sud, Haiti.

    • Search Google Scholar
    • Export Citation
  • 15.

    Vuylsteke B, Laga M, Alary M, 1993. Clinical algorithms for the screening of women for gonococcal and chlamydial infection: evaluation of pregnant women and prostitutes in Zaire. Clin Infect Dis 17: 8288.

    • Search Google Scholar
    • Export Citation
  • 16.

    Behets FM, Génécé E, Narcisse M, Liautaud B, Cohen M, Dallabetta GA, 1998. Approaches to control sexually transmitted diseases in Haiti, 1992–95. Bull World Health Organ 76: 189194.

    • Search Google Scholar
    • Export Citation
  • 17.

    World Health Organization, 2003. Guidelines for the Management of Sexually Transmitted Infections. Geneva: World Health Organization.

  • 18.

    Taylor-Robinson D, 2002. Mycoplasma genitalium–an up-date. Int J STD AIDS 13: 145151.

  • 19.

    Björnelius E, Anagrius C, Bojs G, 2008. Antibiotic treatment of symptomatic Mycoplasma genitalium infection in Scandinavia: a controlled clinical trial. Sex Transm Infect 84: 7276.

    • Search Google Scholar
    • Export Citation
 
 
 
 

 

 
 

 

 

 

 

 

 

Epidemiology of Sexually Transmitted Infections in Rural Southwestern Haiti: The Grand'Anse Women's Health Study

View More View Less
  • University of Washington, Division of Emergency Medicine, Seattle, Washington; Seattle–King County Disaster Team, Seattle, Washington; Sysmex America, Inc., Laboratory Application Services, San Diego, California; Providence Health and Services, North Coast Urgent Care Clinics, Seaside, Oregon; MultiCare Health System, Department of Social Work, Tacoma, Washington; Oregon Health & Science University, Department of Emergency Medicine, Portland, Oregon

The study attempts to define socioeconomic, clinical, and laboratory correlates in vaginitis and other sexually transmitted infections in rural southwestern Haiti. A convenience sample of subjects recruited from a rural women's health clinic and attending an established clinic at the Haitian Health Foundation (HHF) clinic was studied. A standardized history and physical examination, including speculum examination, and collection of blood, urine, and vaginal swabs were obtained from the women at the rural clinic. Additional vaginal swab samples only for Nucleic Acid Amplification Test (NAAT) testing were obtained from women at the HHF clinic in Jérémie. Laboratory results from Leon subjects were positive for Gardnerella vaginalis in 41% (41 of 100), Trichomonas vaginalis in 13.5% (14 of 104), Candida sp. in 9% (9 of 100), Mycoplasma genitalium in 6.7% (7 of 104), Chlamydia trachomatis in 1.9% (2 of 104), and Neisseria gonorrhea in 1% (1 of 104) of patients. Human immunodeficiency virus (HIV) antibody tests were negative in 100% (103 of 103) of patients, and syphilis antibody testing was positive for treponemal antibodies in 7.7% (8 of 104) patients. For subjects from the HHF, 19.9% were positive for T. vaginalis, 11.9% were positive for C. trachomatis, 10.1% were positive for M. genitalium, and 4.1% were positive for N. gonorrhea. Infections with G. vaginalis, T. vaginalis, and Candida were the most common. N. gonorrhea, C. trachomatis, Candida sp., T. vaginalis, and M. genitalium infections were associated with younger age (less than 31 years old).

Author Notes

* Address correspondence to Robert F. Downey, Seattle-King County Disaster Team, PO Box 17306, Seattle, WA 98127. E-mail: labboy@earthlink.net

Financial support: No outside funding was received for this project. Funding for transportation, medicine, interpreters, and clinic supplies was provided by the authors.

Authors' addresses: Kathleen A. Jobe, Division of Emergency Medicine, University of Washington, Seattle, WA, and Seattle–King County Disaster Team, Seattle, WA, E-mail: kaj@uw.edu. Robert F. Downey, Sysmex America, Inc., Laboratory Application Services, San Diego, CA, and Seattle–King County Disaster Team, Seattle, WA, E-mail: labboy@earthlink.net. Donna Hammar, Providence Health and Services, North Coast Urgent Care Clinics, Seaside, OR, and Seattle–King County Disaster Team, Seattle, WA, E-mail: ddhammar6@yahoo.com. Lori Van Slyke, MultiCare Health System,Department of Social Work, Tacoma, WA, and Seattle–King County Disaster Team, Seattle, WA, E-mail: vanslyke99@hotmail.com. Terri A. Schmidt, Department of Emergency Medicine, Oregon Health & Science University, Portland, OR, and Seattle–King County Disaster Team, Seattle, WA, E-mail: schmidtt@ohsu.edu.

Save