AEGiS-11IAC: The supermarket for women's reproductive health: a demonstration intervention project in Nairobi, Kenya.

11th International AIDS Conference

Vancouver, British Columbia — July 7-12, 1996

The supermarket for women's reproductive health: a demonstration intervention project in Nairobi, Kenya.

Int Conf AIDS 1996 Jul 7-12; 11:220 (abstract no. Th.B.116)
Temmerman M, Kidula N, Tyndall M, Ndinya-Achola J, Rukaria-Kaumbutho, Muchiri L; International Centre for Reproductive Health, University of Ghent, Belgium. Fax: 32 9 240 3867.

OBJECTIVES: 1) To study the burden of disease of reproductive tract infections (RTI) and cervical lesions in women attending a family planning (FP) clinic in Nairobi, Kenya and, 2) to assess the feasibility of integrating reproductive health care services into existing FP facilities.

METHODS: In a FP clinic in Nairobi, 520 women were enroled in the study on RTI and cervical precancerous lesions. Information on social, demographic, medical and sexual behaviour characteristics were collected using a structured, pre-tested questionnaire. A general physical examination, including a pelvic assessment was performed. Specimen collection included endocervical swabs for gonococcal culture and chlamydia EIA, high vaginal swabs for direct microscopy for Trichomonas vaginalis and Candida albicans. The cervix was scraped using an endocervical brush to obtain a specimen for cytology. A blood sample was taken for syphilis serology and HIV-1 antibodies.

RESULTS: Data were obtained of 520 randomly selected women. RTI pathogens were detected in over 20% of women, the majority being asymptomatic (N. gonorrhoeae, 2.1%; C. trachomatis, 3.8%; syphilis, 2.1%), 10.2% tested positive for HIV-1 antibodies. PID was found in 4.2%. The diagnosis of cervical dysplasia was made on 12% of the cytology smears (5.8% mild dysplasia, 3.5% moderate, 1.2% severe), and 1.5% had invasive carcinoma.

CONCLUSIONS: 1. In this low risk population' of well-women attending FP services, the prevalence of RTI was high. This situation calls for integrated programs in condom promotion, RTI management and sexual education among women attending FP clinics in Kenya and other countries in the region. 2. Early detection and treatment of potentially curable precancerous cervical lesions and RTI provide a unique opportunity to improve women's health. In Kenya, where the current contraceptive prevalence rate is 33%, FP clinics are excellent sites to introduce health interventions.

Keywords: AEGIS, Women's Health, Reproductive Medicine, Chlamydia Infections, Chlamydia trachomatis, Family Planning, Gonorrhea, Cervix Dysplasia, Women's Health Services, Cervix Diseases, Sezary Syndrome, Prevalence, Syphilis Serodiagnosis, Cervix Uteri, Neisseria gonorrhoeae, Syphilis, Kenya, Sjogren's Syndrome, Human, Female, ICA11

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ThB116