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Article wk 7
1. YOUNG PREGNANT WOMEN’S VIEWS
ON THE ACCEPTABILITY OF
SCREENING FOR CHLAMYDIA AS
PART OF ROUTINE ANTENATAL CARE
2010 Bilardi et al; licensee BioMed Central Ltd.
2. Source :
Journal : BMC Public Health 2010, 10:505
Researchers : Jade E Bilardi, Deborah L De
Guingand, Meredith J Temple-Smith, Suzanne
Garland, Christopher K Fairley, Sonia Grover6, Euan
Wallace6, Jane S Hocking, Sepehr Tabrizi, Marie
Pirotta, Marcus Y Chen.
3. Introduction
Genital Chlamydia trachomatis infection is one of the most
common bacterial sexually transmitted infection (STI)
worldwide
In pregnancy, untreated Chlamydia infection has been
associated with adverse outcomes for both mother and infant.
Like most women, pregnant women infected with chlamydia do
not report genital symptoms, and are therefore unlikely to be
aware of their infection.
4. Aim of the study
The aim of this study was to determine the acceptability of
screening pregnant women aged 16-25 years for chlamydia as
part of routine antenatal care
5. Method
As part of a larger prospective, cross-sectional study of pregnant women aged 16-
25 years attending antenatal services across Melbourne, Australia, 100 women
were included.
All interviews were conducted face-to-face by JB using a semi-structured interview
on the acceptability of screening for Chlamydia during pregnancy.
Women were provided information and informed by a research nurse about
Chlamydia and the associated adverse maternal and neonatal outcomes of
untreated chlamydia infection.
Women were asked to provide a first void urine specimen for chlamydia testing by
polymerase chain reaction and complete a brief questionnaire providing basic
demographic information, recent sexual behavior, genital symptoms and recent
antibiotic use.
6. Results
100 women participated with median age of 22 yo.
69 had tested negative for Chlamydia and 31 positive for
Chlamydia.
Women who tested positive were more likely to be under 20
yo, have more than one recent sexual partner and unmarried
status.
In general, women had low levels of awareness of Chlamydia with
many misconceptions.
All women supported testing for Chlamydia as part of their
routine antenatal care with preference of urine testing over any
other forms.
The main motivation factor in the acceptability was concern for
health of the baby.
7. Women reported that they wouldn’t mind their physician asking
for a sexual history to assess their risk of Chlamydia.
Women who tested positive were relieved and grateful to have
been diagnosed and receive treatment and reported high levels
of partner support.
8. Discussion
Common barriers to Chlamydia testing include:
Denial by women of sexual activity or risk of infection
A reluctance to be tested because of moral connections and stigma
Feeling of shame, guilt, embarrassment and anger
Fear and anxiety around future reproductive health and the effects
on partner relationships
Concerns around privacy and confidentiality
9. Conclusion
Chlamydia screening as part of routine antenatal care was
considered highly acceptable among young pregnant women
who recognized the benefits of screening and strongly
supported its implementation as part of routine antenatal care.
For antenatal chlamydia testing to be broadly accepted it is
important that pregnant women are well informed about
chlamydia and the benefits of screening.