SUAB0401 | EPIDEMIOLOGICAL AND MOLECULAR PROFILE OF SEXUALLY TRANSMITTED INFECTIONS IN PREGNANT WOMEN IN KINSHASA (DEMOCRATIC REPUBLIC OF CONGO)

Ruth Nsuka Yanga¹, Sébastien Bontems², Pierre Akilimali Zalagile³, Dieudonné Mvumbi Makaba¹, Doudou Yobi Malekita¹, Vicky Lokomba Bolamba⁴, Octavie Lungiya Metila⁵, Pius Kabututu Zakayi¹, Gilles Darcis⁶, Georges Mvumbi Lelo¹, Marie-Pierre Hayette² | ¹Molecular Biology Service, Department of Basic Sciences, Faculty of Medicine, University of Kinshasa, Kinshasa, Congo (Democratic Republic); ²Service of Clinical Microbiology, Center for Interdisciplinary Research on Medicines (CIRM), University Hospital of Liège, Belgium; ³Department of Epidemiology and Biostatistics, Kinshasa School of Public Health, Faculty of Medicine, University of Kinshasa, Congo (Democratic Republic); ⁴Department of Gynecology and Obstetrics, Kinshasa University Hospital, University of Kinshasa, Congo (Democratic Republic); ⁵Microbiology Service, Department of Medical Biology, Kinshasa University Hospital, Kinshasa, Congo (Democratic Republic); ⁶Department of Infectious Diseases and General Internal Medicine, Center for Interdisciplinary Research on Medicines (CIRM), University Hospital of Liège, Belgium

The World Health Organization recommends a syndromic approach for the management of sexually transmitted infections (STIs) in resource-limited countries. However, an etiological diagnosis seems to be a more realistic option and helps combat the burden that STIs represent for public health within sexually active populations, including fetuses, while reducing the rate of antimicrobial resistance imposed by the overtreatment of patients. This research aimed to determine the epidemiology and molecular profile of STIs in pregnant women. In this descriptive cross-sectional pilot study conducted in April 2024 on 325 pregnant women attending a maternity hospital in Kinshasa, cervico-vaginal secretions and blood samples were collected. Genital swabs were analyzed using a fresh microscope and Gram stain, while RT-PCR was performed on the Alinity m instrument (Abbott). Molecular tests were used to detect Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Trichomonas vaginalis (TV), and Mycoplasma genitalium (MG). Serological tests for HIV and Treponema pallidum were performed using the Liaison XL automated system and confirmed by immunoblot. Molecular and serological analyses were carried out at Liège University Hospital. The microscopic profile of the 325 pregnant women yielded the following results: 10.2 % (n = 33) were TV positive and 0.3% (n = 1) showed the presence of Gram-negative cocci in the Gram stain test. Molecular analysis revealed a 13.5 % prevalence of four non-viral STIs (CT, MG, NG and TV), with four cases of mixed infections involving MG and TV. The prevalence of each pathogen was as follows: CT = 2.5% (n = 8); MG = 6.8% (n = 22); NG = 0.3% (n = 1); and TV = 5.2% (n = 17). Serological tests showed an HIV prevalence of 0.3% (n = 1), and no cases of syphilis were detected. The etiological approach is a crucial tool in the management of non-viral STIs. Although costly, the molecular diagnostics offer a highly sensitive and rapid alternative to conventional methods. It is essential to integrate molecular testing into STI management in sub-Saharan Africa to effectively combat AMR caused by patient overtreatment.