{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:30:04Z","timestamp":1787020204962,"version":"build-2736575974"},"reference-count":50,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,1,30]],"date-time":"2021-01-30T00:00:00Z","timestamp":1611964800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,1,30]],"date-time":"2021-01-30T00:00:00Z","timestamp":1611964800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pregnancy Childbirth"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study estimated the prevalence of curable sexually transmitted and reproductive tract infections (STIs\/RTIs) among pregnant women attending antenatal care (ANC) in rural Zambia, evaluated the effectiveness of syndromic management of STIs\/RTIs versus reference-standard laboratory diagnoses, and identified determinants of curable STIs\/RTIs during pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 1086 pregnant women were enrolled at ANC booking, socio-demographic information and biological samples were collected, and the provision of syndromic management based care was documented. The Piot-Fransen model was used to evaluate the effectiveness of syndromic management versus etiological testing, and univariate and multivariate logistic regression analyses were used to identify determinants of STIs\/RTIs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants had a mean age of 25.6\u2009years and a mean gestational age of 22.0\u2009weeks. Of 1084 women, 700 had at least one STI\/RTI (64.6%; 95% confidence interval [CI], 61.7, 67.4). Only 10.2% of infected women received any treatment for a curable STI\/RTI (excluding syphilis). Treatment was given to 0 of 56 women with chlamydia (prevalence 5.2%; 95% CI, 4.0, 6.6), 14.7% of participants with gonorrhoea (prevalence 3.1%; 95% CI, 2.2, 4.4), 7.8% of trichomoniasis positives (prevalence 24.8%; 95% CI, 22.3, 27.5) and\u00a07.5% of women with bacterial vaginosis (prevalence 48.7%; 95% CI, 45.2, 51.2). An estimated 7.1% (95% CI, 5.6, 8.7) of participants had syphilis and received treatment. Women &lt;\u200920\u2009years old were more likely (adjusted odds ratio [aOR]\u2009=\u20095.01; 95% CI: 1.23, 19.44) to have gonorrhoea compared to women \u226530. The odds of trichomoniasis infection were highest among primigravidae (aOR\u2009=\u20092.40; 95% CI: 1.69, 3.40), decreasing with each subsequent pregnancy. Women 20 to 29\u2009years old were more likely to be diagnosed with bacterial vaginosis compared to women \u226530 (aOR\u2009=\u20091.58; 95% CI: 1.19, 2.10). Women aged 20 to 29 and\u2009\u2265\u200930\u2009years had higher odds of infection with syphilis, aOR\u2009=\u20093.96; 95% CI: 1.40, 11.20 and aOR\u2009=\u20093.29; 95% CI: 1.11, 9.74 respectively, compared to women under 20.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Curable STIs\/RTIs were common and the majority of cases were undetected and untreated. Alternative approaches are urgently needed in the ANC setting in rural Zambia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12884-021-03573-3","type":"journal-article","created":{"date-parts":[[2021,1,30]],"date-time":"2021-01-30T06:02:53Z","timestamp":1611986573000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Assessment of syndromic management of curable sexually transmitted and reproductive tract infections among pregnant women: an observational cross-sectional study"],"prefix":"10.1186","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8958-2451","authenticated-orcid":false,"given":"Enesia Banda","family":"Chaponda","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Bruce","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Michelo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Chandramohan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. 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Rockville: Central Statistical Office\/Zambia, Ministry of Health\/Zambia, and ICF International; 2015."}],"container-title":["BMC Pregnancy and Childbirth"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12884-021-03573-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12884-021-03573-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12884-021-03573-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,1,30]],"date-time":"2021-01-30T06:04:36Z","timestamp":1611986676000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpregnancychildbirth.biomedcentral.com\/articles\/10.1186\/s12884-021-03573-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,30]]},"references-count":50,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["3573"],"URL":"https:\/\/doi.org\/10.1186\/s12884-021-03573-3","relation":{},"ISSN":["1471-2393"],"issn-type":[{"value":"1471-2393","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,30]]},"assertion":[{"value":"21 April 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 January 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 January 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The study protocol was reviewed and approved by the University of Zambia Biomedical Research Ethics Committee, reference number 004\u201302-13 and the London School of Hygiene and Tropical Medicine Observational\/Interventions Research Ethics Committee (reference number 6292) before the research was carried out. In addition, the Ministry of Health in Zambia also reviewed the research proposal after ethical approval had been granted. The research project was then discussed with relevant local authorities in the study district such as the District Health Management Team, community leaders and the in-charge personnel at the two health centres that were used as recruitment sites.At the beginning of each ANC booking session an explanation of the project was given to the group of first ANC attendees and their spouses\/guardians\/partners in addition to the routine weekly health talk. The information included the aims of the study, the methods of data and sample collection, number of participants required, potential advantages and disadvantages of participation and the expected benefits of carrying out the research. Potential participants were informed that participation was voluntary and participants could withdraw at any time. First ANC attendees who were willing to know more about the study were given the information sheet translated into the local language (Bemba).There was no age cut off for exclusion because inclusion of younger pregnant women was considered to be important in order to have better representation of pregnant women. The study was performed in accordance with the Declaration of Helsinki and all included participants signed informed consent. In the case of women aged below 18\u2009years written consent was signed by their guardians after they assented. To ensure confidentiality interviews were conducted privately and each participant was assigned a unique identity number that was used to anonymise biological samples, questionnaires, and result record forms.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"98"}}