Invited Speaker Australian Society for Microbiology Annual Scientific Meeting 2021

High burden of Mycoplasma genitalium and other reproductive tract infections in pregnant and postpartum women in Papua New Guinea (#143)

Michelle Scoullar 1 2 , Philippe Boeuf 2 , Elizabeth Peach 2 , Ellen Kearney 2 , Ruth Fidelis 2 , Kerryanne Tokmun 2 , Pele Melepia 2 , Catriona S Bradshaw 1 3 4 , Arthur Elijah 5 , Glenda Fehler 3 , Peter M Siba 6 , Simon Erskine 7 , Elisa Mokany 7 , Elissa Kennedy 2 , Alexandra J Umbers 2 , Stanley Luchters 2 8 9 , Leanne J Robinson 1 2 4 10 , Nicholas C Wong 4 , Andrew J Vallely 10 11 , Steven G Badman 9 11 , Lisa M Vallely 11 12 , Freya J. I. Fowkes 1 2 4 , Chris Morgan 2 , William Pomat 10 , Brendan S Crabb 1 2 4 , James G Beeson 1 2 4
  1. University of Melbourne, Melbourne, VIC, Australia
  2. Burnet Institute, Melbourne, VIC, Australia
  3. Melbourne Sexual Health Centre, Alfred Hospital, Melbourne, VIC, Australia
  4. Monash University, Clayton, VIC, Australia
  5. School of Medicine and Health Sciences, University of Papua New Guinea, Papua New Guinea
  6. Center for Health Research and Diagnostics, Divine Word University, Madang, Papua New Guinea
  7. SpeeDx Pty Ltd, Australia
  8. Department of Population Health, Aga Khan University, Nairobi, Kenya
  9. International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, Belgium
  10. Papua New Guinea Institute of Medical Research, Papua New Guinea
  11. The Kirby Institute, University of New South Wales, Australia
  12. Australian Institute of Tropical Health and Medicine, James Cook University, Townsville

There is a pressing need for detailed knowledge of the range of pathogens, extent of co-infection and clinical impact of reproductive tract infections (RTIs) among pregnant women. We present prevalence and correlates of RTIs (Mycoplasma genitalium, Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Treponema pallidum subspecies pallidum, bacterial vaginosis and vulvovaginal candidiasis) among 699 pregnant women in Papua New Guinea (PNG), with follow up at birth, 1-, 6- and 12-months postpartum.

This first report of M. genitalium in PNG found a high prevalence (12.5%) among pregnant women, decreasing to 6.1% at six months postpartum, with no evidence of macrolide resistance. Most pregnant women (74.1%) had at least one RTI, with a curable current sexually-transmitted infection (STI) detected in 37.7%. Prevalence of other curable STIs (C. trachomatis, N. gonorrhoeae and T. vaginalis) were all high in in pregnancy, with prevalence decreasing immediately postpartum but rising again by 12 months postpartum. Syndromic management missed at least 75% of infections and there was little use of contraception.

Most of these infections are curable if diagnosis is made available and syndromic management alone is insufficient. This high prevalence of disease negatively affects sexual and reproductive health and these findings have important public health implications in PNG and the region.