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Bacterial etiology of sexually transmitted infections at a STI clinic in Ghana; use of multiplex real time PCR.

Abstract

BACKGROUND

Most sexually transmitted infection (STI) management efforts focus on the syndromic approach to diagnose and treat patients. However, most women with STIs have been shown to be entirely asymptomatic, or if symptoms exist, are often missed when either clinical or conventional bacteriologic diagnostic tools are employed.

METHODS

We assessed the performance of a multiplex real time PCR assay to describe other potential pathogens that could be missed by conventional bacteriological techniques in 200 women attending a routine STI clinic in Kumasi, Ghana.

RESULTS

Although a total 78.00% of the women were asymptomatic, 77.1% of them tested positive for at least one bacterial STI pathogen. Mycoplasma genitalium was the most commonly detectable pathogen present in 67.5% of all women. Of those testing positive, 25.0% had single infections, while 38.0% and 19.5% had double and triple infections respectively. Altogether, 86.54% and 90.91% of the symptomatic and asymptomatic women respectively tested positive for at least one pathogen (p<0.05). There were no significant associations (p<0.05) between the clinical manifestations of the symptomatic women and the pathogens detected in their samples.

CONCLUSIONS

Our study confirmed the importance of complementing the syndromic approach to STI management with pathogen detection and most importantly recognise that STIs in women are asymptomatic and regular empirical testing even for both symptomatic and asymptomatic patients is critical for complete clinical treatment.

FUNDING

EOD (Ellis Owusu-Dabo Research working group, KCCR).

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  • Authors+Show Affiliations

    ,

    Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana; Department of Theoretical and Applied Biology, KNUST, Kumasi, Ghana.

    ,

    Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana; School of Public Health, KNUST, Kumasi, Ghana.

    ,

    Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana.

    ,

    Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana; Department of Biochemistry and Biotechnology, KNUST, Kumasi, Ghana.

    ,

    Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana.

    ,

    Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana.

    ,

    Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana.

    Suntreso Government Hospital, Ghana Health Services, Kumasi, Ghana.

    Source

    Ghana medical journal 50:3 2016 Sep pg 142-148

    MeSH

    Adolescent
    Adult
    Aged
    Asymptomatic Infections
    Child
    Female
    Ghana
    Humans
    Middle Aged
    Multiplex Polymerase Chain Reaction
    Mycoplasma Infections
    Mycoplasma genitalium
    Sexually Transmitted Diseases, Bacterial
    Young Adult

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    27752188

    Citation

    Sylverken, Augustina A., et al. "Bacterial Etiology of Sexually Transmitted Infections at a STI Clinic in Ghana; Use of Multiplex Real Time PCR." Ghana Medical Journal, vol. 50, no. 3, 2016, pp. 142-148.
    Sylverken AA, Owusu-Dabo E, Yar DD, et al. Bacterial etiology of sexually transmitted infections at a STI clinic in Ghana; use of multiplex real time PCR. Ghana Med J. 2016;50(3):142-148.
    Sylverken, A. A., Owusu-Dabo, E., Yar, D. D., Salifu, S. P., Awua-Boateng, N. Y., Amuasi, J. H., ... Agyarko-Poku, T. (2016). Bacterial etiology of sexually transmitted infections at a STI clinic in Ghana; use of multiplex real time PCR. Ghana Medical Journal, 50(3), pp. 142-148.
    Sylverken AA, et al. Bacterial Etiology of Sexually Transmitted Infections at a STI Clinic in Ghana; Use of Multiplex Real Time PCR. Ghana Med J. 2016;50(3):142-148. PubMed PMID: 27752188.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Bacterial etiology of sexually transmitted infections at a STI clinic in Ghana; use of multiplex real time PCR. AU - Sylverken,Augustina A, AU - Owusu-Dabo,Ellis, AU - Yar,Denis D, AU - Salifu,Samson P, AU - Awua-Boateng,Nana Yaa, AU - Amuasi,John H, AU - Okyere,Portia B, AU - Agyarko-Poku,Thomas, PY - 2016/10/19/pubmed PY - 2017/3/31/medline PY - 2016/10/19/entrez KW - Etiology KW - Multiplex real time PCR KW - Sexually Transmitted Infections KW - Syndromic SP - 142 EP - 148 JF - Ghana medical journal JO - Ghana Med J VL - 50 IS - 3 N2 - BACKGROUND: Most sexually transmitted infection (STI) management efforts focus on the syndromic approach to diagnose and treat patients. However, most women with STIs have been shown to be entirely asymptomatic, or if symptoms exist, are often missed when either clinical or conventional bacteriologic diagnostic tools are employed. METHODS: We assessed the performance of a multiplex real time PCR assay to describe other potential pathogens that could be missed by conventional bacteriological techniques in 200 women attending a routine STI clinic in Kumasi, Ghana. RESULTS: Although a total 78.00% of the women were asymptomatic, 77.1% of them tested positive for at least one bacterial STI pathogen. Mycoplasma genitalium was the most commonly detectable pathogen present in 67.5% of all women. Of those testing positive, 25.0% had single infections, while 38.0% and 19.5% had double and triple infections respectively. Altogether, 86.54% and 90.91% of the symptomatic and asymptomatic women respectively tested positive for at least one pathogen (p<0.05). There were no significant associations (p<0.05) between the clinical manifestations of the symptomatic women and the pathogens detected in their samples. CONCLUSIONS: Our study confirmed the importance of complementing the syndromic approach to STI management with pathogen detection and most importantly recognise that STIs in women are asymptomatic and regular empirical testing even for both symptomatic and asymptomatic patients is critical for complete clinical treatment. FUNDING: EOD (Ellis Owusu-Dabo Research working group, KCCR). SN - 0016-9560 UR - https://www.unboundmedicine.com/medline/citation/27752188/Bacterial_etiology_of_sexually_transmitted_infections_at_a_STI_clinic_in_Ghana L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/27752188/ DB - PRIME DP - Unbound Medicine ER -