Evidence map›Paper›PMID 34381845›Full record

ArticleOpen forum infectious diseases2021

The Impact of Syndromic Management of Vaginal Discharge Syndrome on Adverse Birth Outcomes in Botswana.

Christina Fennell, Modeigi Diseko, Rebecca Zash, Gloria Mayondi, Judith Mabuta, Mompati Mmalane, Sonya Davey, Rebecca Luckett, Chelsea Morroni, Eldah N Dintwa and 4 more

Open access · goldAbstract read
In one paragraph

Article in Open forum infectious diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.0field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 7 institutions in 3 countries.

Christina FennellDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0003-2285-6056
Modeigi DisekoBotswana-Harvard AIDS Initiative Partnership for HIV Research and Education, Gaborone, Botswana.
Rebecca ZashBotswana-Harvard AIDS Initiative Partnership for HIV Research and Education, Gaborone, Botswana.
Gloria MayondiBotswana-Harvard AIDS Initiative Partnership for HIV Research and Education, Gaborone, Botswana.
Judith MabutaBotswana-Harvard AIDS Initiative Partnership for HIV Research and Education, Gaborone, Botswana.
Mompati MmalaneBotswana-Harvard AIDS Initiative Partnership for HIV Research and Education, Gaborone, Botswana.
Sonya DaveyBotswana-Harvard AIDS Initiative Partnership for HIV Research and Education, Gaborone, Botswana.
Rebecca LuckettBotswana-Harvard AIDS Initiative Partnership for HIV Research and Education, Gaborone, Botswana.
Chelsea MorroniBotswana-Harvard AIDS Initiative Partnership for HIV Research and Education, Gaborone, Botswana.
Eldah N DintwaBotswana Ministry of Health and Wellness, Gaborone, Botswana.
Shahin LockmanBotswana-Harvard AIDS Initiative Partnership for HIV Research and Education, Gaborone, Botswana.
Joseph MakhemaBotswana-Harvard AIDS Initiative Partnership for HIV Research and Education, Gaborone, Botswana.
Ellen CanigliaDepartment of Population Health, New York University Grossman School of Medicine, New York, New York, USA.
Roger ShapiroBotswana-Harvard AIDS Initiative Partnership for HIV Research and Education, Gaborone, Botswana.
Beth Israel Deaconess Medical Center · USBotswana Harvard AIDS Institute Partnership · BWBrigham and Women's Hospital · USHarvard University · USLiverpool School of Tropical Medicine · GBMinistry of Health · BWNew York University · US

Funding

Botswana Birth Outcomes Surveillance ExtensionR01HD095766 · NICHD · HARVARD SCHOOL OF PUBLIC HEALTH · PI SHAPIRO, ROGER L · 2018 to 2022
$3.3M
Birth Outcomes Surveillance in BotswanaR01HD080471 · NICHD · HARVARD SCHOOL OF PUBLIC HEALTH · PI SHAPIRO, ROGER L · 2014 to 2018
$2.6M
Expansion of research and mentoring to improve birth outcomes and treatment outcomes among HIV-affected children in BotswanaK24AI131924 · NIAID · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI Roger L Shapiro · 2018 to 2026
$1.6M
Iron and folic acid supplementation strategies during pregnancy and adverse pregnancy outcomes in Botswana - Resubmission - 1K01HD100222 · NICHD · UNIVERSITY OF PENNSYLVANIA · PI CANIGLIA, ELLEN CHRISTINA · 2020 to 2024
$632k
NIAID NIH HHS K24 AI131924NICHD NIH HHS K01 HD100222NICHD NIH HHS R01 HD080471NICHD NIH HHS R01 HD095766
6 · The paper itself

Abstract

backgroundVaginal discharge syndrome (VDS) is a common clinical diagnosis during pregnancy in Botswana; it is treated with broad-spectrum antibiotics using a syndromic approach. We evaluated associations between the syndromic management of VDS and adverse birth outcomes.

methodsThe Tsepamo Study performs birth outcomes surveillance at government hospitals throughout Botswana. Obstetric record data collected from August 2014 to March 2019 were analyzed. Chi-square tests were conducted to compare proportions of maternal characteristics and infant outcomes. To avoid immortal time bias, all analyses were conducted among women who presented to care before 24 weeks gestation, with VDS categorized as present or absent by 24 weeks gestation. Log-binomial regression models were generated to determine associations between treated VDS and infant outcomes.

resultsVDS was diagnosed in 36 731 (30.7%) pregnant women, of whom 33 328 (90.7%) received antibiotics. Adjusted analyses yielded a harmful association between treated VDS and very preterm delivery (adjusted risk ratio, 1.11; 95% CI, 1.02-1.21). This association remained when restricting to women with VDS who received the recommended antibiotic treatment regimen. Sensitivity analyses produced nonsignificant associations when women with treated VDS were compared with women without VDS who received antibiotics for other indications.

conclusionsA clinical diagnosis of VDS is common among pregnant women in Botswana, and the majority receive antibiotics in pregnancy. Although analyses of VDS occurring later in pregnancy are precluded by immortal time bias, a modest association between treated VDS and very preterm delivery was observed among women diagnosed with VDS by 24 weeks gestation.

Indexed as

antibioticsinfantpregnancyvaginal discharge

Identifiers

PMID34381845
PMCPMC8351807
OpenAlexW3179469782

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.