{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T11:07:28Z","timestamp":1784200048781,"version":"3.55.0"},"reference-count":26,"publisher":"BMJ","issue":"2","funder":[{"DOI":"10.13039\/100000027","name":"National Institute on Alcohol Abuse and Alcoholism","doi-asserted-by":"publisher","award":["K01 AA027733-01A1"],"award-info":[{"award-number":["K01 AA027733-01A1"]}],"id":[{"id":"10.13039\/100000027","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"publisher","award":["D43TW009610"],"award-info":[{"award-number":["D43TW009610"]}],"id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["R21 HD100821-01"],"award-info":[{"award-number":["R21 HD100821-01"]}]},{"name":"Open Philanthropy USA","award":["No grant number"],"award-info":[{"award-number":["No grant number"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2024,9,9]]},"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p><jats:italic>Chlamydia trachomatis<\/jats:italic>and<jats:italic>Neisseria gonorrhoeae<\/jats:italic>are common sexually transmitted infections (STIs). Untreated infection in pregnancy can result in adverse neonatal outcomes, including vertical transmission. Screening for these infections is not routine in low- and middle-income countries (LMICs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The Maduo Study was a non-randomised cluster crossover trial in Botswana to provide preliminary data on the effect of antenatal<jats:italic>C. trachomatis<\/jats:italic>and<jats:italic>N. gonorrhoeae<\/jats:italic>screening and treatment on postdelivery prevalence and vertical transmission to infants. Pregnant women asymptomatic for STIs were enrolled at four clinics (seven clusters). The intervention arm received<jats:italic>C. trachomatis<\/jats:italic>and<jats:italic>N. gonorrhoeae<\/jats:italic>screening at first antenatal care, third trimester and postdelivery. The standard-of-care arm received postdelivery screening only. Infants of women with a positive test postdelivery in both arms were screened. A cluster-level analysis was performed to compare the risk of postdelivery infection between intervention and standard-of-care arms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study enrolled 500 women; 206 (82.1%) and 187 (75.1%) were retained in the intervention and standard-of-care arms, respectively and screened \u226412 weeks postdelivery.<jats:italic>C. trachomatis<\/jats:italic>prevalence in the intervention arm reduced from 22.7% at first antenatal care to 1.0% postdelivery.<jats:italic>N. gonorrhoeae<\/jats:italic>prevalence reduced from 1.2% at first antenatal care to 0% postdelivery. The risk of<jats:italic>C. trachomatis<\/jats:italic>and\/or<jats:italic>N. gonorrhoeae<\/jats:italic>was lower in the intervention arm postdelivery (0.6%) compared with the standard-of-care arm (15.7%); adjusted risk difference: \u221214.7% (95% CI \u221223.0%, \u22126.4%). Among 26 infants born to women with either infection postdelivery, 10 (38.5%) tested positive (<jats:italic>C. trachomatis<\/jats:italic>: 9;<jats:italic>N. gonorrhoeae<\/jats:italic>: 1).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Postdelivery prevalence of<jats:italic>C. trachomatis<\/jats:italic>was significantly lower among pregnant women in Botswana who received diagnostic antenatal screening. Among women with<jats:italic>C. trachomatis<\/jats:italic>and\/or<jats:italic>N. gonorrhoeae<\/jats:italic>postdelivery, more than one-third transmitted the infection to their infants. This exploratory study suggests antenatal STI screening has the potential to reduce infection in newborns in similar LMIC settings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial registration number<\/jats:title><jats:p><jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT04955717\">NCT04955717<\/jats:ext-link>.<\/jats:p><\/jats:sec>","DOI":"10.1136\/sextrans-2023-055965","type":"journal-article","created":{"date-parts":[[2024,10,4]],"date-time":"2024-10-04T17:21:05Z","timestamp":1728062465000},"page":"81-87","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Effect of antenatal<i>Chlamydia trachomatis<\/i>and<i>Neisseria gonorrhoeae<\/i>screening on postdelivery prevalence and vertical transmission in Gaborone, Botswana: findings from an exploratory study"],"prefix":"10.1136","volume":"101","clinical-trial-number":[{"clinical-trial-number":"nct04955717","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct04955717","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9152-5686","authenticated-orcid":false,"given":"Aamirah","family":"Mussa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriane","family":"Wynn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Ryan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chibuzor M","family":"Babalola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9375-8675","authenticated-orcid":false,"given":"Emily","family":"Hansman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Selebaleng","family":"Simon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bame","family":"Bame","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neo","family":"Moshashane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maitumelo","family":"Masole","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa L","family":"Wilson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey D","family":"Klausner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chelsea","family":"Morroni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,10,4]]},"reference":[{"key":"2025032404400815000_101.2.81.1","unstructured":"World Health Organization . 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