Methods The study was conducted in Abidjan-Côte d’Ivoire, Bamako-Mali, Lomé-Togo and Ouagadougou-Burkina Faso. Participants (n=507) were tested for the following STIs using the GeneXpert instrument: Chlamydia trachomatis (CT)/Neisseria gonorrhoeae (NG) in Anorectum (A), Urine (U) and Pharynx (P), and Trichomonas vaginalis (TV) in urine. Mycoplasma genitalium (MG) was tested using the S-DiagMGTV multiplex assay in A-U-P samples.
Results The overall prevalence of CT was 17.9% (19.4%, 22.0% 16.4%, and 13.6% in Lomé, Abidjan, Bamako and Ouagadougou, respectively). Most CT infections were anorectal (12.3%, followed by urethral (5.7%). In Bamako, the second most infected sample type was pharyngeal (6.0%) instead of urine (5.0%). Overall prevalence of NG was 15.8% (9.7%; 25.0%; 6.0%, 22.3% in Lomé, Abidjan, Bamako and Burkina, respectively). Most NG infections were found in the anorectum (10.7%), followed by the pharynx (5.7%). In Mali, no pharyngeal NG infections were detected. MG infection was 26.0% for Lomé and 27.6% for Ouagadougou (results for other sites not yet available). The majority of MG infections were found in the anorectum (15.4%). Among all participants, only one urine sample with TV has been found in Bamako.
Conclusion We showed a very high prevalence of extra-genital STIs among PrEP users in West-Africa. We also detected infections which would not have been treated if a syndromic management approach would have been applied (87.9%). In order to limit transmission of infections we recommend to test also extra-genital sites for STIs in this population.