# Sexually transmitted infections in women in a rural hospital in Sierra Leone: a retrospective database study

## TL;DR

This study found that 5% of women in a rural Sierra Leone hospital had sexually transmitted infections, with high rates of symptoms like vaginal discharge.

## Contribution

The study provides new data on STI prevalence in rural Sierra Leone using a specific diagnostic method.

## Key findings

- 52% of women tested positive for at least one STI pathogen.
- Mycoplasma hominis was the most commonly detected organism at 45%.
- Only 5% tested positive for obligate STI pathogens like chlamydia or gonorrhea.

## Abstract

•Sexually transmitted infections are still a major public health concern.•A total of 5% of our study population tested positive for an obligate sexually transmitted infection pathogen.•A total of 3% of our study population tested positive for Neisseria gonorrhoea.•Loop-mediated isothermal amplification was the method of diagnosis.•A total of 11% of our study population was positive for HIV.

Sexually transmitted infections are still a major public health concern.

A total of 5% of our study population tested positive for an obligate sexually transmitted infection pathogen.

A total of 3% of our study population tested positive for Neisseria gonorrhoea.

Loop-mediated isothermal amplification was the method of diagnosis.

A total of 11% of our study population was positive for HIV.

This study aimed to determine the frequency of sexually transmitted infections among women of reproductive age in a rural hospital in Sierra Leone.

This retrospective cross-sectional database study included vaginal and endocervical swabs from 104 women of childbearing age (March 2023-March 2024) in Masanga Teaching Hospital, rural Sierra Leone. Samples were screened by loop-mediated isothermal amplification (eazyplex STD complete) for Chlamydia trachomatis, Neisseria gonorrhoeae, Ureaplasma urealyticum, Mycoplasma hominis, Mycoplasma genitalium, and Treponema pallidum. Demographic and medical data were obtained from medical records.

The median age was 26 years (range: 21-33 years). HIV status was available for 84 women, of whom nine (11%) were HIV-positive. Of the 75 women with clinical information available, 73 (97%) were symptomatic. Vaginal discharge (n = 66 of 75, 88%) was the most frequently reported symptom. Tests were positive for at least one target organism in the test panel in 54 of 104 cases (52%). M. hominis was most often detected (n = 47 of 104, 45%), followed by U. urealyticum (n = 18 of 104, 17%) and N. gonorrhoeae (n = 3 of 104, 3%), whereas C. trachomatis and T. pallidum were positive in one (1%) sample each. M. genitalium was not detected.

The detection of obligate sexually transmitted infections pathogens (i.e. C. trachomatis, N. gonorrhoeae, T. pallidum; n = 5 of 104, 5%) was rare in our study population and setting.