Integration of point-of-care diagnostics for sexually transmitted infections in antenatal care in Zimbabwe

There were 376 million curable sexually transmitted infections (STIs), namely chlamydia, gonorrhoea, trichomoniasis and syphilis, in 2016 among people aged 15 to 49-years. STIs can cause serious harm including infertility, miscarriage and infection of newborn babies. In low-income countries, STIs are treated using syndromic management.

This is providing treatment to cover most infections that could cause a set of symptoms, without testing for a specific infection. However, many STIs do not cause symptoms, and these infections would therefore remain untreated. In recent years, new STI testing technologies have been developed that do not require complicated infrastructure.

We will provide diagnostic testing for these curable STIs and hepatitis B for pregnant women when they register for antenatal care at three clinics in Zimbabwe. The results will be available on the same day allowing for treatment of women before they leave the clinic. We will also arrange to treat their partners to prevent re-infection of the women.

The aim of this study is to determine the proportion of pregnant women who have STIs and also determine whether this package of services is acceptable, feasible, and cost-effective. This will provide evidence on how best to utilise these technologies in the real world.