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RECRUITINGINTERVENTIONAL

Improving Perinatal Outcomes Among Kenyan Pregnant Women With an Integrated STI Testing Model

Important: This information is not medical advice. Talk to your doctor about whether a clinical trial is right for you.

About This Trial

The investigators will conduct a 3-arm individual-level RCT in Kisumu and Siaya, Kenya to compare perinatal outcomes associated with 3 models of STI testing and management in antenatal care. The investigators will enroll 3132 pregnant women and randomize 1:1:1 to receive standard-of-care (syndromic management only without CT, NG, or TV testing) vs. CT, NG, and TV testing using Xpert® assays universally vs. only among women without STI symptoms. All women with STIs detected and/or symptoms per Ministry of Health algorithms will receive immediate treatment, EPT per national guidelines, and tests of cure. All participants will be enrolled during routine antenatal care and followed through 9-months postpartum. The investigators will quantify and compare a composite outcome of pregnancy loss/stillbirth, PTB, LBW, SGA, and neonatal death, between randomization arms, in addition to several secondary and exploratory outcomes.

Who May Be Eligible (Plain English)

Who May Qualify: - Self-identifying as a cisgender woman - Seeking antenatal services from the clinic - Planning to receive antenatal and postnatal care at the clinic - Willingness to receive syndromic STI screening and HIV/syphilis testing per national guidelines - Able and willing to provide willing to sign a consent form for participation Who Should NOT Join This Trial: - Male gender - Not seeking antenatal services from the clinic - Not planning to receive antenatal and postnatal care at the clinic - Not willing to receive syndromic STI screening and HIV/syphilis testing per national guidelines - Not able or willing to provide willing to sign a consent form for participation Always talk to your doctor about whether this trial is right for you.

Original Eligibility Criteria

View original clinical language
Inclusion Criteria: * Self-identifying as a cisgender woman * Seeking antenatal services from the clinic * Planning to receive antenatal and postnatal care at the clinic * Willingness to receive syndromic STI screening and HIV/syphilis testing per national guidelines * Able and willing to provide informed consent for participation Exclusion Criteria: * Male gender * Not seeking antenatal services from the clinic * Not planning to receive antenatal and postnatal care at the clinic * Not willing to receive syndromic STI screening and HIV/syphilis testing per national guidelines * Not able or willing to provide informed consent for participation

Treatments Being Tested

DIAGNOSTIC_TEST

Xpert® CT/NG and TV testing

Participants randomized to universal STI testing will be offered Xpert® CT/NG and TV testing regardless of symptoms, and they will receive a standard syndromic STI assessment. Participants randomized to the asymptomatic only testing will be offered Xpert® CT/NG and TV testing if no signs or symptoms of CT, NG, or TV are identified during STI assessment. Participants assigned to receive Xpert® testing will be counseled on CT/NG/TV testing, including the benefits of testing even in the absence of symptoms to detect asymptomatic infections (as informed by pilot evaluation). If a client accepts Xpert® testing, she will be instructed by the study nurse on how to self-collect a vaginal swab.

Locations (8)

Homa Bay Teaching and Referral Hospital
Homa Bay, Kenya
Rachuonyo South Sub County Hospital
Homa Bay, Kenya
Rangwe Sub County Hospital
Homa Bay, Kenya
Chulaimbo County hospital
Kisumu, Kenya
Kisumu County Hospital
Kisumu, Kenya
Lumumba Sub County hospital
Kisumu, Kenya
Migosi Sub County Hospital
Kisumu, Kenya
Yala sub County Hospital
Yala, Kenya