Screening and Treatment for Chlamydia and Gonorrhoea During Pregnancy to Prevent Preterm Birth in Botswana

What this Trial Is About

Researchers are investigating whether routine screening and treatment for two common sexually transmitted infections, chlamydia and gonorrhoea, during pregnancy can reduce the risk of preterm birth and other poor birth outcomes in Botswana. The study also assesses if this screening approach is affordable and cost-effective for the health system. Approximately 2,000 pregnant women attending their first antenatal care visit at several government clinics will be invited to participate. Participants will be randomly assigned to either receive routine antenatal care or additional screening and treatment for chlamydia and gonorrhoea during pregnancy. Participants in the intervention group will be screened for chlamydia and gonorrhoea using self-collected vaginal swabs at their first antenatal care visit and again in the third trimester between 28 and 32 weeks. Women who test positive will receive treatment following recommended guidelines, counseling on partner notification, and a test-of-cure about four weeks after treatment. The standard of care group will receive routine antenatal care, with urine specimens collected and tested retrospectively after delivery to assess infection prevalence. Both groups will undergo routine health checks, HIV and syphilis testing, ultrasounds, and other standard antenatal procedures. Throughout the study, participants will complete questionnaires about their health, socio-economic status, and pregnancy progress. Researchers will review medical records after birth to collect data on birth outcomes like preterm birth, birth weight, and maternal health conditions such as hypertension and preeclampsia. Study staff will support participant retention by providing reimbursements for time and travel and maintaining contact through multiple communication methods. The study will monitor outcomes until delivery and conduct detailed cost and cost-effectiveness analyses to evaluate the impact of screening and treatment on health and healthcare expenses.

Healthy Expectancy Through Routine Antenatal STI Screening