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Artigos Originais
Syphilis in parturients: aspects related to the sex partner
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(9):397-402
11-26-2012
Summary
Artigos OriginaisSyphilis in parturients: aspects related to the sex partner
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(9):397-402
11-26-2012DOI 10.1590/S0100-72032012000900002
Views86See morePURPOSES: To analyze the sociodemographic and behavioral profile of sex partners, the proportion of those inadequately treated as well as to verify how many of them were inadequately treated and why some were not treated. METHODS: Quantitative study with data collected from May to October, 2008 at five public maternities in Fortaleza, Ceará. A survey was carried out with parturients who were hospitalized with syphilis and had a stable sex partner. We analyzed sociodemographic variables and those related to communication, diagnosis and treatment of sex partners. The data were entered into the Statistical Package for the Social Sciences and were analyzed using frequency distributions, measures of central tendency and dispersion. RESULTS: The study included 56 pregnant women. Most sexual partners were young adults aged on average 29 years, 50% of them had studied for less than seven years, 82.1 worked and 46.4% had a family income of less than a minimum wage. Of all the partners, 92.9% were the child's father and 69.6% lived with the women. Fifty percent and 12% were alcohol and drug users, respectively. Most partners (75.0%) were told about the diagnosis by the women, and in 78.6% of cases they were aware of the VDRL result before or during the prenatal period. However, 25.0% of the women did not communicate the result to their partners for the following reasons: not knowing the importance of the partner's treatment (50.0%), not being together after the diagnosis (42.9%) and having a quarrel (7.1%). Of the partners who were informed about the result before or during the prenatal period, 56.0% were treated and six (42.8%) were considered to have been properly treated. Among the ones who did not receive treatment, 63.6% refused it because they did not feel sick, because they did not believe in the treatment and because they were afraid of injections. CONCLUSIONS: Partners are told about the syphilis diagnosis of the pregnant women; however, only a few are properly treated.
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Artigos Originais
Prevalence of Chlamydia Trachomatis and Neisseria Gonorrhoea infections in sexual actives young women at a Southern Brazilian city
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(11):328-333
01-23-2011
Summary
Artigos OriginaisPrevalence of Chlamydia Trachomatis and Neisseria Gonorrhoea infections in sexual actives young women at a Southern Brazilian city
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(11):328-333
01-23-2011DOI 10.1590/S0100-72032011001100002
Views91See morePURPOSE: to determine the prevalence of Chlamydia and gonorrhea in a sample of women from Curitiba. METHODS: this was a cross-sectional study with a sample of sexually active non-pregnant women aged between 16 and 23 years-old, with an intact uterus, with up to four sexual partners, without evidence of fever or purulent cervicitis, submitted to pelvic examination and PCR-based urine- testing for Chlamydia and gonorrhea. Exclusion criteria included: vaccination for HPV, vaccination history for the past 21 days, previous abnormal cytology, history of genital warts, splenectomy, immune disorders, and use of immunosuppressive drugs. An interview regarding sociodemographic and obstetric data and gynecological risk behavior for sexual transmitted diseases was applied. For statistical analysis, we used the c2 or Fisher’s exact test to assess the association between variables. RESULTS: the prevalence of Chlamydia and gonorrhea infection in the study group was 10.7 and 1.5%, respectively, and the rate of coinfection was 0.9%. No correlation was found between the age range of the volunteers, the onset of sexual activity, the number of sexual partners and of new sexual partners in the last six months, and the presence of Chlamydia or gonorrhea. In women who had vaginal discharge or ectropion, the prevalence of Chlamydia infection was two times higher than in those without such signs. CONCLUSIONS: the results of this study were similar to national studies using PCR in urine samples for the detection of Chlamydia and gonorrhea in samples of non-pregnant women of the same age groups and with the same background. Since the volunteers with more than four sexual partners and those who had purulent endocervicitis were excluded, it is believed that the prevalence of Chlamydia and gonorrhea infection could have been greater in this population.
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Artigos Originais
Clinical and epidemiological profile of HIV-infected pregnant women in a service in south Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2010;32(4):184-190
07-02-2010
Summary
Artigos OriginaisClinical and epidemiological profile of HIV-infected pregnant women in a service in south Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2010;32(4):184-190
07-02-2010DOI 10.1590/S0100-72032010000400006
Views90PURPOSE: to analyze the clinical and epidemiological profile, the outcome of pregnancy and the vertical transmission of human immunodeficiency virus (HIV)-infected pregnant women receiving prenatal care at the University Hospital of Santa Maria (HUSM). METHODS: A prospective study was conducted on 139 HIV-infected pregnant women attended at the High-Risk Prenatal Care Outpatient Clinic of HUSM, during the period from August 2002 to August 2007, with at least two prenatal visits in this service. Data were collected by an interview and by filling out a research protocol during a prenatal visit. The protocol was attached to the medical records of the patient and kept until the outcome of gestation. Descriptive analysis of quantitative variables was performed using the SPSS software, version 15.0. RESULTS: The mean age of the 139 pregnant women studied was 25.6 years (±5.8), 79 (56.8%) were white, 81 (58.5%) were married or lived in a stable union, and 90 (65.0%) had less than eight years of schooling. Fifty-one percent of the pregnant women already had two or more children, with a number of children higher than the mean for the state. The infection was diagnosed during the present or a previous pregnancy in more than 70.0% cases. Sexual exposure occurred in 97.0%, and in 59.6% of cases the partner was known to be infected. During the study period, among the cases properly monitored, only one newborn (0.7%) was infected with HIV. CONCLUSIONS: Young women in a socioeconomic situation of vulnerability, with low schooling and multiparous represent the majority of HIV-positive pregnant women attended at the service. Evaluations performed during the prenatal period were relevant for the diagnosis of infection in most cases. An early diagnosis associated with proper clinical, obstetrical and psychological monitoring and with nursing care is important to provide appropriate treatment compliance and a reduction of the rates of vertical transmission.
Key-words HIVHIV infectionsInfectious disease transmissionPrenatal careSexually transmitted diseasesverticalSee more -
Artigos Originais
Prevalence of infection for HIV, HTLV, HBV and of syphilis and chlamydia in pregnant women in a tertiary health unit in the western Brazilian Amazon region
Revista Brasileira de Ginecologia e Obstetrícia. 2010;32(4):176-183
07-02-2010
Summary
Artigos OriginaisPrevalence of infection for HIV, HTLV, HBV and of syphilis and chlamydia in pregnant women in a tertiary health unit in the western Brazilian Amazon region
Revista Brasileira de Ginecologia e Obstetrícia. 2010;32(4):176-183
07-02-2010DOI 10.1590/S0100-72032010000400005
Views101See morePURPOSE: to estimate the prevalence infection of human immunodeficiency virus (HIV), human T-cell lymphotropic vírus (HTLV), hepatitis B virus (HBV), Chlamydia trachomatis (C. trachomatis) and syphilis in pregnant women, as well as risk factors associated with these infections, in Fundação de Medicina Tropical do Amazonas (FMTAM). METHODS: a cross-sectional study was carried including 674 pregnant women consecutively attended of the spontaneous demand of FMTAM between March and September 2008. Demographic, epidemiologic, socioeconomic, clinical and obstetric information have been collected through specific questionnaires. Patients had blood sample collected by peripheral venous for accomplishment of serological tests of HIV, HTLV, HBV and syphilis. Cervical secretion sample has been collected for C. trachomatis antigens detection test. The Odds Ratio has been used to evaluate risk factors associated to infections. Statistical analysis has been done with the t-Student, χ2 and Fisher's exact tests. RESULTS: the average age was 23.9 years old (SD 6.3). The observed prevalence was 0.6% to infection by HIV; 0.7% by HBsAg; 1.0% of syphilis and 2.7% by C. trachomatis. All the samples went negatives to HTLV. There were no variables associated with infection by HIV, HBV and syphilis. Significative statistically association was observed between pregnant woman with age under 20 years and of first pregnancy with C. trachomatis infection. CONCLUSIONS: the study evidenced that the prevalence infection by HIV in pregnant women assisted in FMTAM is similar to the values described in the Brazilian literature, while the prevalence by HTLV, HBV, syphilis and C. trachomatis in the studied population are below found by other authors. The main risk factor for the infection by C. trachomatis was being under 20 years old.
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Artigos Originais
Chlamydia trachomatis and Neisseria gonorrhoeae among women in a family planning clinic
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(5):235-240
07-29-2009
Summary
Artigos OriginaisChlamydia trachomatis and Neisseria gonorrhoeae among women in a family planning clinic
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(5):235-240
07-29-2009DOI 10.1590/S0100-72032009000500006
Views64PURPOSE: to study infection prevalence by Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG), among adolescent and young women in a family planning outpatient clinic. METHODS: a total of 230 women up to 24 years old and history of up to four sexual partners have been followed-up for 48 months, with urine collection to search CT and NG, by the polymerase chain reaction method at the 1st, 12nd, 24th, 36th and 48th months. The variables studied were age group, schooling, marital status, number of gestations, abortions and children alive, age at the onset of sexual life, previous and present use of condom, previous use of intrauterine device, number of sexual partners in the previous six months and follow-up time. Bivariate analysis of variables according to positive tests for CT and NG, and multiple analyses by logistic regression were done. RESULTS: the ratio of infections by CT was 13.5% and by NG, 3%. Two women presented both tests as positive. The previous intrauterine device use was associated with positive tests for NG. CONCLUSIONS: the prevalence of infections by CT and NG was higher among the age group studied and the screening of young women must be taken into consideration in our services, to control the dissemination of sexually transmitted diseases and prevention of sequels.
Key-words Chlamydia trachomatisFamily planningNeisseria gonorrhoeaePrevalenceSexually transmitted diseasesWomen's healthSee more -
Artigos Originais
Prevalence of Chlamydia and Neisseria gonorrhoeae infections in pregnant women in six Brazilian cities
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(12):614-619
02-06-2008
Summary
Artigos OriginaisPrevalence of Chlamydia and Neisseria gonorrhoeae infections in pregnant women in six Brazilian cities
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(12):614-619
02-06-2008DOI 10.1590/S0100-72032008001200005
Views44PURPOSE: This paper has aimed at estimating the prevalence of infections by Chlamydia trachomatis and by Neisseria gonorrhoeae in pregnant women from six Brazilian cities, identifying its association with socio-economical and demographic variables. METHODS: This study has been part of a multicentric nationwide transversal research, with samples of pregnant women attended from 2004 to 2005 in basic attention pre-natal services from six Brazilian cities (Manaus, Fortaleza, Goiânia, Rio de Janeiro, São Paulo and Porto Alegre). Cervico-vaginal samples have been collected from all the pregnant women, and have afterwards been submitted to the hybrid capture technique in order to identify chlamydia and gonococcus. Socio-demographic, medical, sexual and obstetric information have been collected through specific questionnaires. The Odds Ratio (OR) has been used to evaluate risk factors associated to infection by gonorrhea and chlamydia. Statistical analysis has been done with the t-Student, χ2 and Fisher's exact tests. RESULTS: Three thousand and three pregnant women with an average age of 23.8 years old (±6.9) took part in the study. Infection prevalence by chlamydia and gonococcus were 9.4 and 1.5, respectively. Ten per cent of the pregnant women with chlamydia have presented gonococcus simultaneously. The risk of presenting one of those infections was two times higher for the women under 20. The infection main predictors have been: age under 20, race/black, single/separated and report of over one partner in the previous year. CONCLUSIONS: This study has observed high prevalence of infection by Chlamydia trachomatis and by Neisseria gonorrhoeae in Brazilian pregnant women. The main risk factor for the infection has been to be under 20 years old.
Key-words BrazilChlamydia infectionsGonorrheaNeisseria gonorrhoeaePregnancyPregnancy complications, infectiousPrevalenceSexually transmitted diseasesSee more -
Artigos Originais
Genital infections in women attending a Primary Unit of Health: prevalence and risk behaviors
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(7):349-354
10-07-2008
Summary
Artigos OriginaisGenital infections in women attending a Primary Unit of Health: prevalence and risk behaviors
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(7):349-354
10-07-2008DOI 10.1590/S0100-72032008000700005
Views51See morePURPOSE: to describe the prevalence and behavioral profile of genital infections in women attended at a Primary Health Unit in Vitoria, ES. METHODS: a transversal study including 14 to 49-year-old women attended by the Family Health Program (FHP). Exclusion criteria were: having been submitted to gynecological examination in less than one year before, and history of recent treatment (in the last three months) for genital infections. An interview including socio-demographic, clinical and behavioral data was applied. Genital specimens were collected for cytology, GRAM bacterioscopy and culture, and urine sample for molecular biological test for Chlamydia trachomatis. RESULTS: two hundred and ninety-nine women took part in the study. The median age was 30.0 (interquartile interval: 24;38) years old; the average age of the first intercourse was 17.3 (sd=3.6) years old. The first pregnancy average age was 19.2 (3.9) years old. About 70% reported up to 8 years of schooling; 5% reported previous Sexually Transmitted Diseases (STD), and 8%, the use of illicit drugs. Only 23.7% reported consistent use of condoms. Clinical complaints were: genital ulcer (3%); dysuria (7.7%); vaginal discharge (46.6%): pruritus (20%) and pelvic pain (18%). Prevalence rates were: Chlamydia trachomatis 7.4%; gonorrhea 2%; trichomoniasis 2%; bacterial vaginosis 21.3%; candidiasis 9.3%; and cytological changes suggestive of HPV 3.3%. In the final logistic regression model, the factors independently associated to genital infections were: abnormal cervical mucus, OR=9.7 (CI95%=5.6-13.7), previous HIV testing, OR=6.5 (CI95%=4.0-8.9), having more than one partner during the previous year, OR=3.9 (CI95%=2.7-5.0), and having more than one partner in life, OR=4.7 (CI95%=2.4-6.8). CONCLUSIONS: results show a high rate of genital infections and the need of preventive measures, such as STD surveys and risk reduction programs for women that look for routine gynecological service.
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Artigos Originais
Identification of papillomavirus types and other risk factors for cervical intraepithelial neoplasia
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(5):285-291
08-28-2006
Summary
Artigos OriginaisIdentification of papillomavirus types and other risk factors for cervical intraepithelial neoplasia
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(5):285-291
08-28-2006DOI 10.1590/S0100-72032006000500004
Views90PURPOSE: to identify risk factors for cervical intraepithelial neoplasia (CIN) and human papillomavirus (HPV) types among women with CIN, and to compare with HPV types among patients with normal cervix. METHODS: a total of 228 patients were studied, of whom 132 with CIN (cases) and 96 with normal cervix (controls). In the two groups consisting of women selected among outpatients attended in the same hospital, living near the place of the research, mean ages were similar (34.0±8.3 years) and there was a predominance of married women. Possible risk factors for CIN were investigated with the application of a questionnaire surveying age, marital status, level of schooling, age at first coitus, number of pregnancies, number of sexual partners, method of used contraception, reference of previously sexually transmitted diseases (STDs) and smoking habits, with a comparison between the studied groups. Samples were collected for oncologic colpocytology and HPV search through polymerase chain reaction (PCR), using MY09/MY11 primers; then colposcopic and histopathological examinations were performed. For statistical analysis of the association between risk factors and CIN, odds ratio with 95% confidence interval and chi2 and Fisher tests were used at a significance level of 0.05. The logistic regression method with the significance expressed by the p value with maximum likelihood was also applied. RESULTS: the following variables remained in the logistic regression model: HPV infection of high oncogenic risk (OR=12.32; CI 95%: 3.79-40.08), reference of previous STDs (OR=8.23; CI 95%: 2.82-24.04), early age at first coitus (OR=4.00; CI 95%: 1.70-9.39) and smoking habit (OR=3.94; CI 95%: 1.73-8.98). PCR was positive in 48.5 and 14.6% in the case and control groups, respectively. CONCLUSIONS: the main risk factor for CIN was oncogenic HPV infection, with types 16, 18, 33, 35, 51, 52, 58, and 83. Among patients with a high-degree lesion, there was a predominance of HPV-16 or type 16 variant. In patients with normal cervix oncogenic, HPV types 51, 58, and 51 variant were also identified.
Key-words Cervical intra-epithelial neoplasiaPolymerase chain reactionRisk factorsSexually transmitted diseasesSmokingSee more