High prevalence of preventable infections in pregnancy in sub-Saharan Africa
MedWire News: Malaria, sexually transmitted infections (STIs), and reproductive tract infections (RTIs) are highly prevalent in sub-Saharan Africa, suggest results from a systematic review and meta-analysis.
The authors of the article, published in JAMA, believe that a combination anti-malarial, antibiotic drug treatment would be extremely valuable to these women, and would significantly reduce neonatal mortality.
"We reviewed evidence over a twenty year period to calculate prevalence estimates of STIs/RTIs and malaria. This makes it clear that a combined treatment could save a great many lives," said lead author Matthew Chico (London School of Hygiene & Tropical Medicine, UK) in a press statement.
"We are now conducting trials of azithromycin-based combination treatment to give all pregnant women preventative medication that will clear placental malaria infection, protect against re-infection in between antenatal visits, and cure syphilis, gonorrhoea, chlamydia and, to a lesser extent, trichomononiasis, the most common STI in the world," he explained.
"If given in early pregnancy, combined treatment may also reduce bacterial vaginosis, which affects half of all pregnant women in the region."
The researchers included 171 studies in their analysis with a total combined cohort of 340,904 women from East and Southern Africa, or West and Central Africa. The studies were conducted between 1990 and 2011.
The most common infection was bacterial vaginosis with a mean prevalence ranging from 37.6% in women from West and Central Africa to 50.8% in those from East and Southern Africa.
Peripheral and placental malaria were also common in both areas with prevalences ranging from 32.0 to 38.2% and 25.8 to 39.9%, respectively.
Trichomononiasis infection was also common ranging in prevalence from 17.8% in West and Central Africa to 29.1% in East and Southern Africa.
Less common infections with a prevalence below 6.9% included syphilis, gonorrhea, and chlamydia.
"The current World Health Organization recommended treatment to prevent malaria in pregnancy is failing due to drug resistance," commented Chico. "By switching to azithromycin-based combination treatment to reduce the dual burden of malaria and STIs/RTIs in pregnancy, we could have a transformative effect on maternal, fetal and neonatal health."
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By Helen Albert