Determinants of reproductive tract infections among asymptomatic women in Harare, Zimbabwe.

OBJECTIVES

To determine the prevalence of and risk factors for reproductive tract infections (RTI) among asymptomatic women attending primary health care clinics in Harare, Zimbabwe.

DESIGN

A cross sectional study.

MAIN OUTCOME MEASURES: Prevalent RTI, HIV and socio-demographic data.

SETTING

Two primary health care clinics in Harare.

SUBJECTS: 393 consecutive, consenting women aged 15 to 49 years, presenting at the clinics for antenatal care, family planning, or bringing their children to attend preventive care clinics.

RESULTS

More than half of the women had at least one ongoing RTI. Voluntary reporting of symptoms was almost non-existent. Prevalence of HIV was 29.3% and that of classical STIs was 15.4% Trichomoniasis vaginalis, 3.9% syphilis, 3.9% Chlamydia trachomatis and 1.8% Neisseria gonorrhoea. Bacteria vaginosis was diagnosed in 30.3% of the women and candidiasis in 25.4%. Presence of any RTI was significantly associated with lower level of education, sexual debut < 20 years, a non-monogamous partner, and use of a condom during the last sexual encounter. Independent factors associated with cervical infections were young age (< 20 years), being unmarried, current dysuria, warts, clinical signs of purulent or yellowish discharge, lower abdominal pain and cervical friability. Vaginitis was associated with sexual debut or marriage < 20 years, a partner who was a frequent traveller, history of STI, and presence of abnormal vaginal discharge.

CONCLUSION

In view of the high prevalence of RTI and HIV and the low reporting of symptoms by infected women, it is recommended that strategies that improve women's awareness of urogenital symptoms be adopted, along with pro-active inquiry of genital symptoms by the health care workers, and treatment of RTIs, in order to reduce the unnecessary burden of RTIs.