计划生育门诊人工流产妇女生殖道感染流行状况及危险因素分析

Prevalence of and risk factors for sexually transmitted infections among women seeking induced abortions in two urban family planning clinics

目的 : 确定计划生育门诊人工流产妇女生殖道感染的流行状态及其危险因素 ,以建立简便筛查方法和预防治疗措施。方法 : 为横断面研究。在研究期内 ,对所有到两家计划生育门诊做人工流产的妇女进行体检和问卷调查 ,并取阴道和宫颈管标本进行病原体检测。同时取静脉血做梅毒血清和HIV检测。对危险因素应用单变量和逻辑回归方程进行多变量分析。结果 : 在 2 0 2 0名人工流产妇女的检测中 ,衣原体感染率为 4 .8% ,淋球菌 0 .4 % ,阴道毛滴虫 2 .5 % ,细菌性阴道病 3.4 % ,白念珠菌病 6 .5 % ,累计梅毒流行率为 1% (TPPA阳性者 ) ,1例妇女HIV抗体阳性。虽然在多变量分析中发现一些与感染相关的危险因素 ,但阳性预测值较差。结论 : 人工流产妇女可作为性传播感染的干预人群 ,特别是衣原体感染。但由于多数感染妇女为无症状者 ,且无法建立选择性筛查标准 ,因此 ,必须探讨其它方法以检测该人群中生殖道性传播感染者。

Objective: To determine the prevalence and t o assess the factors associated with STIs in order to set up simple diagnostic p rocedures and/or prophylactic therapy among women seeking induced abortions. Methods: Women seeking induced abortions were recruited in two urban family planning clinics in Jinan,Shandong in a cross sectional study. A s tandardized questionnaire was used to collect demographic characteristics,obste tric and abortion history,condom use and risk sexual behaviors. Vaginal and cer vical samples were taken for the diagnosis of STIs and blood samples were collec ted for the testing of syphilis and HIV. Univariate and multivariate ORs and 95% CIs of risk factors for several STIs were determined using logistic regression. Results: Out of 2020 women seeking induced abortions in t wo family planning clinics,the prevalence of C trachomatis infection was 4.8%,N gonorrhoea 0.4%,trichomoniasis 2.5%,bacterial vaginosis 3.4% and candidiasis 6.5%. Cumulative seroprevalence of syphilis was 1%. and one blood sample was po sitive for HIV test out of 787 women tested. Although some risk factors were associated with the infections in logistic regression models,the positive pred ictive value was poor in this 'low risk' population of women. Concl usion :Women attending for induced abortions could be a targeted gro up for STIs,especially for chlamydial infection. Since most infections are asym ptomatic and no criteria for the screening can be used in practice,strategies t o detect and treat these genital infections need to be developed.