<b>Prevalence and risk factors of</b> <i>Mycoplasma genitalium</i>, <i>Chlamydia trachomatis</i>, <i>Neisseria gonorrhoeae</i> and <i>Trichomonas vaginalis</i> <b>infections in pregnant women in seven hospitals in N'Djamena, Chad: a cross-sectional study</b>.

Abstract

<i>Mycoplasma genitalium</i>, <i>Chlamydia trachomatis</i>, <i>Neisseria gonorrhoeae</i> and <i>Trichomonas vaginalis</i> are sexually transmitted pathogens that are highly prevalent in developing countries and are strongly associated with pregnancy complications. In Chad, screening for these sexually transmitted infections (STIs) in pregnant women is based solely on patient-reported symptoms, even though these infections are frequently asymptomatic. This study aims to determine the prevalence of <i>M. genitalium</i>, <i>C. trachomatis</i>, <i>N. gonorrhoeae</i> and <i>T. vaginalis</i> infections, as well as their associated risk factors. In this cross-sectional study, we recruited pregnant women attending antenatal clinics at seven hospitals in N'Djamena. Endocervical swabs were collected, and DNA was extracted. <i>Infections were diagnosed using PCR</i>. Risk factors were identified using a structured questionnaire, and associations were assessed using logistic regression. A total of 525 pregnant women were enrolled, of whom 78.5% resided in urban areas, with a mean age of 25.16±5.54 years. Overall, 23.99% of the study population were diagnosed with at least one STI. The individual prevalence of <i>M. genitalium</i>, <i>N. gonorrhoeae</i>, <i>C. trachomatis</i> and <i>T. vaginalis</i> infections was 13.33%, 5.14%, 0.95% and 4.57%, respectively. Coinfections were low, with <i>M. genitalium-T. vaginalis</i> at 0.95%, <i>M. genitalium-N. gonorrhoeae</i> at 0.38% and other combinations at 0.19% each. Women residing in rural areas had nearly two times the odds of <i>M. genitalium</i> infection compared with urban residents (OR=1.98), indicating a higher risk. Age<25 years (OR=1.76), employment outside the home (OR=1.70), lack of STI awareness (OR=6.74) and no prior history of <i>M. genitalium</i> infection (OR=1.71) were also associated with significantly increased risk. This study demonstrates a high prevalence of STIs among pregnant women in Chad, underscoring the need for systematic screening rather than solely relying on syndromic management.