Prevalence of Curable Sexually Transmitted Infections in Pregnant Women in Low- and Middle-Income Countries From 2010 to 2015: A Systematic Review.

BACKGROUND: Current literature comparing the prevalence rates of curable sexually transmitted infections (STIs) in pregnant women in various global regions is limited. As a result, antenatal screening practices for curable STIs in pregnant women, specifically Treponema pallidum (syphilis), Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT), and Trichomonas vaginalis (TV) vary around the world, differing by country and particular STI. METHODS: We conducted a systematic review of publications on STI prevalence among pregnant women in 30 different low- and middle-income countries. We searched PubMed for studies reporting prevalence of syphilis, CT, NG, and TV in pregnant women. English language studies published between January 1, 2010, and March 1, 2015, were included. The adjusted mean STI prevalence by region was calculated via multivariable linear regression adjusting for health care setting, women's mean age, study sample size, and sensitivity of diagnostic test. RESULTS: We identified 75 studies that met inclusion criteria, providing 116 point prevalence estimates for curable STIs among 3,489,621 pregnant women. Adjusted mean prevalence for NG ranged from 1.2% (95% confidence interval [CI], 1.0-1.3) in Latin America to 4.6% (95% CI, 4.0-5.2) in Southern Africa; syphilis prevalence ranged from 1.1% (95% CI, 0.5-1.6) in Asia to 6.5% (95% CI, 4.7-6.3) in Southern Africa; CT ranged from 0.8% (95% CI, 0.4-1.1) in Asia to 11.2% (95% CI, 6.0-16.4) in Latin America; and TV ranged from 3.9% (95% CI, 2.2-5.6) in Latin America to 24.6% (95% CI, 17.9-31.4) in Southern Africa. CONCLUSIONS: Although we observed a wide variation in STI burden in pregnancy after adjusting for age, test, and health care setting, further valid comparison may depend on adjustment for access to care and screening practices.

Mammography and breast pain.

Two hundred and three consecutive patients underwent mammography at both public and private facilities. Their patients were asked to complete a questionnaire which recorded their assessments of pain. There was a very low incidence of significant pain (4%). The rate was highest (10.9%) in those with pre-existing breast pain. This compared with a rate of 1.4% in those without pre-existing breast pain. A larger number of premenopausal women suffered from breast pain (69%). Breast pain was particularly common in the week prior to onset of menstruation. Therefore, routine mammography should be scheduled in a pain-free interval and, if possible, the week prior to onset of menstruation should be avoided.

A comparison of different doses of non-ionic contrast media in i.v. urography.

This study attempts to find out what is the appropriate dose of non-ionic contrast media to provide an acceptable study at the lowest possible cost. 139 adults with normal renal function were studied. Four different dose regimes were employed and a standardised set of I.V.U. films were obtained. These were reviewed by two independent assessors who were unaware of the dose regime used. Each I.V.U. was scored on a modified Fry regime. This survey showed a clear relationship between quality and dosage.

Assessment of D dimer assays for the diagnosis of deep vein thrombosis.

Sixty-two patients with suspected deep vein thrombosis were subjected to venography and to plasma D dimer assay by both rapid latex agglutination and enzyme immunoassay methods. The latex agglutination method was insensitive to the presence of deep vein thrombosis. In contrast, the enzyme immunoassay method was sensitive although of low specificity and for technical reasons not suitable for performance as an emergency test.

Narcotics and spasm of the sphincter of Oddi. A retrospective study of operative cholangiograms.

The operative cholangiograms of 112 patients undergoing elective cholecystectomy were reviewed independently and retrospectively by two radiologists who were not aware of the anaesthetic technique used. Fifty four patients who received opioid drugs either pre- and/or intra-operatively comprised one study group whilst 58 patients who received no opioids comprised the other. Spasm of the sphincter of Oddi was observed in two patients in the opioid group and in one patient in the non-opioid group. The use of opioid drugs as part of the anaesthetic management for cholecystectomy did not appear to interfere with the radiological interpretation of operative cholangiography nor to increase the low incidence of spasm of the sphincter of Oddi.