To clinically and microbiologically identify reproductive tract infections (RTI), including sexually transmitted infections (STI), and to monitor the antibiotic susceptibility of Neisseria gonorrhoeae among women attending a gynecology outpatient department in Vientiane, Laos.
Clinical and laboratory-based cross-sectional study. Women aged 15 to 49 years underwent a pelvic examination, and specimens were taken for laboratory testing.
Of 1125 study participants, 82% clinically presented with an RTI syndrome. However, only 64% had an etiologically diagnosed RTI, including 11% with an STI. Endogenous infections were most prevalent (candidiasis 40%; bacterial vaginosis 25%), followed by STI [Chlamydia trachomatis 4.1%; N. gonorrhoeae (NG) and Trichomonas vaginalis, both 3.7%]. The 41 NG isolates showed 20% resistance to ciprofloxacin, 98% to penicillin, and complete to tetracycline.
High RTI/STI level combined with high NG resistance emphasizes that concurrent with syndromic case management, periodic evaluations of etiological diagnosis should be available to ensure adequacy of treatment algorithms and prescribed medications.
One of 8 women attending a gynecology clinic in Vientiane had a sexually transmitted infection. Resistance of Neisseria gonorrhoeae was nearly total to some common drugs used in Laos.
From the *Division of International Health (IHCAR), Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden; †Vientiane Capital Health Department, Ministry of Health (MOH), Lao PDR; ‡Center of Laboratory and Epidemiology, MOH, Lao PDR; §National Committee for the Control of AIDS Bureau, MOH, Lao PDR; ¶Food and Drug Department, MOH, Lao PDR; ∥Nordic School of Public Health, Goteborg, Sweden; and **Apoteket AB, Goteborg, Sweden
The study was performed in collaboration between the Sethathirath Hospital (SH), the Center of Laboratory and Epidemiology (CLE), and the MOH/European Union/STI project, including technical advice and financial support for the laboratory investigations. We thank directors and staff at the SH and the CLE for their support and contributions. Special thanks to Dr. Vanphenh Pholsena, Dr. Chanhmy Sramany, Dr. Manisone Khennavong, Dr. John Gallwey, and Professor Staffan Bergström, who also commented on the manuscript.
Correspondence: Amphoy Sihavong, MD, MMedSc, IHCAR, Karolinska Institutet, SE-171 77 Stockholm, Sweden. E-mail: firstname.lastname@example.org or email@example.com.
Received for publication August 30, 2006, and accepted February 5, 2007.