Prevalence and risk factors of sexually transmitted infections in women in eleven hospitals in two low-income countries: a cross-sectional study.

BACKGROUND

Sexually transmitted infections (STIs) remain a major public health challenge, particularly in low- and middle-income countries where surveillance and routine screening are limited. In Central Africa, data on Chlamydia trachomatis, Mycoplasma genitalium, Ureaplasma urealyticum, Mycoplasma hominis, and Neisseria gonorrhoeae remain scarce, despite their role in infertility, adverse pregnancy outcomes, and potential contribution to antimicrobial resistance. This study aims to determine the prevalence of these bacteria and identify risk factors among women in the West Region of Cameroon and neighboring city of N'Djamena in Chad.

METHODS

A total of 1246 participants were enrolled. Endocervical swabs were analyzed by multiplex qPCR to detect the five pathogens. Sociodemographic, sexual behavioral, and clinical characteristics were collected and assessed to identify risk factors for infection.

RESULTS

The prevalence of C. trachomatis, M. genitalium, U. urealyticum, M. hominis and N. gonorrhoeae was 2.96%, 15.40%, 24.87%, 9.55% and 20.14% respectively. Living apart (OR = 5.02) and polygamy (OR = 2.13) were significantly associated with M. genitalium infection. N. gonorrhoeae was associated with Semi-Bantu ethnicity, lower education level, alcohol consumption, vaginal bleeding, occasional condom use, and dyspareunia. It was also observed among women reporting anal sex (21.81%), substance use before sex (33.33%), and sex work (26.35%).

CONCLUSION

The high prevalence of STIs in Cameroon and Chad highlights the urgent need to strengthen surveillance, implement systematic screening, and expand access to effective treatment. Our results showed the necessity of integrating STI prevention into reproductive health services and promoting cross-border collaboration to mitigate the spread of infections and antimicrobial resistance.