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Because of concerns about pe lv.i..c inflamma t o ry disease
(P lO) rates generally, a large n umber o f stndies have being
done on sexually t r an smitt ed disease agents Africa and t he
other develop i ng count r ies. These s tudies have f requent ly
included pregnant, parturient an d pu erperal SUbjects [ 47 , 48 ) ,
and their findings have r-e vee Ied the much higher risk for
puerperal geni tal sepsis f r om t he s e age nts i n the tropics
( 54, 5 5 ) .
High rates of go nococcal a nd chlamydia infection of t he
r e pr od ucti ve trac t s are r eported allover Africa (54 -56] .
Studies screening asymptomati c pregnant pa tients in Cameroon,
Gambia, Zambia, Senegal, Zimbabwe and Ghana have reported
gonorrhoea and chlamydia infection r a t e s ranging from 2 t o 25\
[ 47 , 5 6 - 6 0 ] . In t h e other develop i ng countries of Asia and
South America, the reported prevalence rates are also
similarly high in antenatal patients [61]. For examp le,
gonococcal i nfection r ates reported i n Thailand, Jamaica and
Chile were 1 2%, 1 1 % and 2% r e s pectively ( 59,62 ,63 ] . These
levels are far greater tha n the l.0% an d 0 .2% reported in
Scotland a nd Switzerland r e s pe c t ively [ 59] .
A vaginal flora s urvey o f 214 l ab our patients i n Harare
Zimbabwe, showed t hat 7% h ad gonorrhoea, 13% ha d c hlamydia,
and 19% had t r i chomona s ( 5 6 J . Another survey of t he microbial
flora of 1 8 7 women a dmitt e d in l ab ou r i n Zaria, Ni geria found
that 63 .6% o f the women h ad a positive cu l tur e for at least
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