Reproductive tract infections among women attending primary health care facilities in Moshi, Tanzania

Abstract

Objectives: To determine the prevalence and risk factors for reproductive tract infections (RTIs), the frequency of asymptomatic genital tract infections, the frequency of genitourinary symptoms and signs and to assess their associations with vaginal and cervical infections. Design: A cross sectional study carried out between September and December 1999. Setting: Three primary healthcare centres in Moshi, Tanzania. Subjects: A total of 382 consenting women attending Maternal Child Health (MCH) and Family planning clinics (FP). Interventions: Women were interviewed and then pelvic examination was performed. Blood and genital specimens were collected for laboratory diagnosis of RTIs. Results: Of the 382 women, 64% had at least one RTI (33.9% bacterial vaginosis, 27% C. albicans, 21.2% T. vaginalis, 5% C. trachomatis, 4% syphilis and 0.5% N. gonorrhoea) and 26% had at least one STI. Nearly 43% of laboratory diagnosed RTIs were asymptomatic. Although none of the women had reported abnormal urogenital symptoms during routine clinical consultation, 64% revealed such symptoms on direct questioning. Reported genital symptoms and signs were significantly associated with vaginal, but not cervical infection. Conclusions: Curable RTIs are prevalent among women attending the MCH and FP clinics. Symptomatic infections were frequently not recognised or reported. We recommend introduction of routine RTI screening and treatment service in the MCH and FP clinics. Strategies to improve women's awareness and knowledge of urogenital symptoms should be instituted.