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Content archived on 2024-04-19

Studies on maternal and neonatal morbidity due to sexually transmitted diseases in pregnancy

Objective



The major aim of the proposed studies is to assess interventions to reduce complications in mother and child due to sexually transmitted diseases. Selected specific objectives include 1) the development of a simplified approach to the diagnosis of gonorrhoea (Go) in pregnancy; 2) to assess the cost-effectiveness of an intervention during pregnancy to prevent perinatal complications related to GO; 3) to examine the feasibility and cost-effectiveness of syphilis prevention during pregnancy; 4) to assess the aetiology and risk factors for post-partum infections (PPI);5) to develop diagnostic criteria for PPI for developing countries. Over 3000 pregnant Women seen at health centres in Nairobi Will be enrolled in a first controlled trial, to asses the risk factors for preterm delivery and PPI;to determine the accuracy of various approaches for the diagnosis of GO during pregnancy; and to define whether an intervention consisting of active detect. and treatment of go during pregnancy results in a reduced incident ceof perinatal complications, particularly prematurity and PPI. In a second prospective study, the impact on pregnancy outcome and child morbidity of a active case detection and treatment programme for syphilis during pregnancy will be compared with current preventive procedures in Nairobi. A total of 1.500 pregnant women will be enrolled in a demonstration intervention healt centre and in a control site With no additional intervention. Women and neonates will be assessed at delivery, and followed for one year. The main outcome measures include the rate of stillbirth, prematurity,and congenital l syphilis. In addition risk factors for syphilis in pregnant Women will be determined, and for pregnancy wastage. A third project consists of a case control study involving 600 women with and without clinical signs and symptoms suggestive of PPI. In this study the incidence, microbial aetiology, and the clinical and histologic features of PPI will be defined and diagnostic criteria for PPI will be developed. Furthermore, the impact of HIV infection on the clinical course of PPI and on the response to treatment will be evaluated. Finally, as part of a risk factor assessment of PPI, antibodies to gonococcal outer membrane peptides will be determined in women with and without PPI. The findings of these studies should allow the development and implementation of simplified interventions for the control of Stds and its complications in pregnancy in the developing world.

Topic(s)

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Call for proposal

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Coordinator

INSTITUTE OF TROPICAL MEDICINE PRINCE LEOPOLD
EU contribution
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Address
155,Nationalestraat 155
2000 ANVERS /ANTWERPEN
Belgium

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Total cost
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Participants (2)