Prevalence and Determinants of Common Sexually Transmitted Infections Among Women Presenting with Vaginal Discharge at a Tertiary Care Hospital in Eritrea

Araia Berhane,1 Berhe Tesfai,2,3 Okbu Frezgi,2,3 Khalid Farah Hussein,2,3 Fitsum Kibreab4 1Communicable Division Control (CDC), Ministry of Health, Asmara, Eritrea; 2Department of Obstetrics and Gynecology, Orotta College of Medicine and Health Science, Ministry of Health, Asmara, Eritrea; 3Orotta National Referral Maternity Hospital, Ministry of Health, Asmara, Eritrea; 4Ministry of Health, Health Research and Resources Center Division, Asmara, EritreaCorrespondence: Berhe Tesfai, Email [email protected]: Vaginal discharge is a common symptom of sexually transmitted infections (STIs), and prompt identification is crucial to prevent long-term complications affecting reproductive health. This study aimed to determine the prevalence and associated factors of selected sexually transmitted infections and assess the relevance of syndromic management among patients presenting with vaginal discharge.Methods: An analytic hospital based; cross-sectional study was conducted at a tertiary hospital involving patients with vaginal discharge. Physicians carried out clinical examinations, and serologic assessments were performed for Human Immunodeficiency Virus (HIV), syphilis, and viral hepatitis. Cervical swabs were analysed using Gene Xpert Polymerase Chain Reaction (PCR) for C. trachomatis, T. vaginalis, N. gonorrhoea, and Human papilloma virus (HPV). Univariable and multivariable analyses were conducted, with a P-value < 0.05 considered statistically significant.Results: A total of 362 patients were enrolled. The majority were married (81.5%), multigravida (60.8%), and housewives (59.1%), with 65.5% having completed junior or secondary school. The prevalence of HIV (2.5%), syphilis (0.6%), HBsAg (1.9%), and Anti-HBc (19.1%) was identified through serologic analysis. Molecular testing using Gene Xpert PCR (NAAT) detected T. vaginalis in 4.4% of cases and HPV in 1.7%, while C. trachomatis and N. gonorrhea were not detected. Key associated factors included age (AOR: 4.44, 95% CI: 2.16– 9.11; P< 0.001), genital itching (AOR: 0.51, 95% CI: 0.30– 0.85; P< 0.01), and sexual intercourse under the influence of alcohol (AOR: 0.11, 95% CI: 0.01– 1.06; P< 0.05).Conclusion: The low prevalence of selected Sexually transmitted infections such as syphilis and HPV, and the absence of C. trachomatis and N. gonorrhoea, challenge the effectiveness of syndromic management in this population. Point of care molecular diagnostic approaches are recommended to improve the accuracy of Sexually transmitted infections diagnosis and management.Keywords: STIs, C. trachomatis, N. gonorrhoea, vaginal discharge, prevalence