AEGiS-13IAC: Reproductive tract infections in Moroccan women. A cross sectional study among ANC and FP clients in Rabat.

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

Reproductive tract infections in Moroccan women. A cross sectional study among ANC and FP clients in Rabat.

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. ThOrC729)

Alami K, Mahjour J, Khattabi H, Bennani A, El Aouad R, Hancali A, Ghidinelli MN
K. Alami, National AIDS Control Programme Ministry of Health, 14, rue Ibn El Haitam, Avenue Oukba, Agdal, Rabat, Morocco, Tel.: +212 7 77 86 25, Fax: +212 7 77 86 25, E-mail: kaalami@sante.gov.ma

BACKGROUND: Morbidity related to STIs has been constantly increasing in recent years in Morocco, where more than two thirds of reported cases occur in women. Effectiveness of STI services has been improved by introducing syndromic management of symptomatic cases throughout the PHC system. Furthermore, the issue of RTIs among ANC and FP clients was addressed, in order to assess their extent and to provide the rationale for specific intervention.

METHODS: A cross sectional study was conducted in five health centres in Rabat between June and August 1999. 842 women accepted to participate in the study. Data were collected by an interview, followed by physical and pelvic examination. Genital, blood and urine samples were taken for the laboratory diagnosis of commonest agents of RTI; techniques included direct microscopy, culture, serology and DNA amplification. Data analysis was performed by EPIINFO 6, uni and multivariate analysis by SPSS.

RESULTS: The profile of the studied population is consistent with the outcome of the 1997 PAPCHILD survey, FP outnumber ANC clients (61.5 and 38.5% respectively), mean age is 31 years, parity 2.3 children, illiteracy rate 54% and unemployment 85%. Symptoms and signs related to a RTI were reported by 70% of participants and described in 28% of the women examined. Laboratory diagnosis of vaginitis was established in 41.6% of women, cervicitis in 1.6% (based on microbiological and immunology tests); 4.6% of women had at least one STI, including trichomoniasis, gonococcal or chlamydial cervicitis. Syphilis seroprevalence was 2.8%; no cases of HIV infection were detected.

CONCLUSIONS: Commonly reported and found among the studied population, symptoms and signs of RTI do not significantly correlate with actual infection. Laboratory results show relatively high rates of RTIs, mainly vaginal infections, as cervicitis do not seem to occur frequently; however, exposure to syphilis appears rather common. Data on HIV serology confirm the limited spread of HIV in the region of Maghreb. Guidelines for screening of RTIs among ANC and FP clients are expected to contribute to the control of STIs, the improvement of reproductive health and the prevention of sexual transmission of HIV.

Keywords: AEGIS, Cross-Sectional Studies, HIV Infections, Syphilis, Chlamydia Infections, Gonorrhea, Respiratory Tract Infections, Culture, Seroepidemiologic Studies, Africa, Northern, Morocco, Human, Adult, Female, Child
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ThOrC729