Bacterial sexually transmitted infections and syndromic approach: a study conducted on women at Moroccan University Hospital

Safae Karim; Chahrazed Bouchikhi; Abdelaziz Banani; Hinde El Fatemi; Tiatou Souho; Sanaa Erraghay; Bahia Bennani

doi:10.18683/germs.2021.1289

Bacterial sexually transmitted infections and syndromic approach: a study conducted on women at Moroccan University Hospital

Germs. 2021 Dec 29;11(4):544-553. doi: 10.18683/germs.2021.1289. eCollection 2021 Dec.

Authors

Safae Karim¹, Chahrazed Bouchikhi², Abdelaziz Banani², Hinde El Fatemi³, Tiatou Souho⁴, Sanaa Erraghay², Bahia Bennani⁵

Affiliations

¹ PhD, URL-CNRST, Laboratory of Human Pathology, Biomedicine and Environment, Faculty of Medicine and Pharmacy Fez, Sidi Mohammed Ben Abdellah University, Sidi Harazem Road, Fez, 30070, Morocco.
² MD, Department of Gynecology, Hassan II University Hospital Center, Sidi Harazem Road, Fez, 30070, Morocco.
³ MD, Department of Anatomopathology, Hassan II University Hospital Center, Sidi Harazem Road, Fez, 30070, Morocco.
⁴ PhD, URL-CNRST, Laboratory of Human Pathology, Biomedicine and Environment, Faculty of Medicine and Pharmacy Fez, Sidi Mohammed Ben Abdellah University, Fez, 30070, Morocco.
⁵ PhD, Head of URL-CNRST, Laboratory of Human Pathology, Biomedicine and Environment, Faculty of Medicine and Pharmacy Fez, Sidi Mohammed Ben Abdellah University, Sidi Harazem Road, Fez, 30070, Morocco.

Abstract

Introduction: In Morocco, a syndromic approach has been implemented for sexually transmitted infections (STIs) management. However, those infections can be asymptomatic and the use of the syndromic approach to their management can be inappropriate and lead to dissemination of infection. Therefore, it would be important to determine the epidemiology and risk factors of bacterial STIs (Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT) and Mycoplasma genitalium (MG)) in a Moroccan population and their association with symptoms to assess the appropriacy of the use of the syndromic approach.

Methods: Cervical samples were collected from symptomatic and asymptomatic consenting women attending the University Hospital of Fez and were tested by PCR for NG, CT and MG using specific primers. We assessed the infection status and its association with different risk factors and genital STIs-related symptoms.

Results: Of 809 tested for CT, NG and MG, 16.6% tested positive for at least one STI. Of the 134 participants who tested positive for at least one bacterial STI, 74.2% had no genital STIs-related symptoms. Moreover, the results showed a significantly high rate of NG and MG infections in asymptomatic women. However, the determined risk factors for NG, MG and CT infections were menopause (p=0.002), oral contraception (p=0.036) and a high number of parities (p=0.048), respectively.

Conclusions: This investigation shows a predominance of NG infection and a high prevalence of STIs in asymptomatic patients. These results highlight that the adopted syndromic approach will not be adapted in the management of these STIs. Thus, the implementation of a systematic diagnostic program in order to enhance their management is needed.

Keywords: Chlamydia trachomatis; Mycoplasma genitalium; Neisseria gonorrhoeae; molecular diagnosis; risk factors.

GERMS.