Management of sexually transmitted infections and precancerous lesions

OBJECTIVES

To assess strategies for an efficient detection and treatment of cervical cancer and STDs among Nicaraguan women.

METHODS

Consecutive women attending women's health clinics in different regions (Managua, Rivas and Matagalpa) were interviewed and examined for STI, HIV, and cervical neoplasia

RESULTS

Of the 1185 women, 30.4% attended the clinics because of STI related complaints and 77.0% reported symptoms after probing.
Nearly one out of five women attending the clinics had an STI: clinical cervicitis was diagnosed in 32.8%, Chlamydia trachomatis in 4.1%, gonorrhoea in 0.4%, trichomoniasis in 10.2%. Antibodies for syphilis were found in 0.7%, for hepatitis B in 3.7%, and none were HIV seropositive. The STI prevalence was 21.8% in women offending with complaints, 17.3% in symptomatic women after probing, and 14.8% in asymptomatic women.
Abnormal Papanicolaou (Pap) smears were found in 7.7%, with high risk human papilloma virus (HPV) types in almost 60%. Male promiscuity was associated with high grade squamous intraepithelial lesions (HSIL) and reported former screening was not shown to be protective
The conclusions of this study were that women's health clinics in Nicaragua provide an opportunity to improve the RH of women by probing for STI symptoms, especially in young women, and by offering cervical screening to casual attendees. Of concern is the high rate of cervical lesions in women with a screening history, underlining the need for proper quality control.
The study results have been published in Sex Trans Inf 2002 Jun;78 (3):204-207.