1 Dhabhai N, et al. BMJ Open 2022;12:e059583. doi:10.1136/bmjopen-2021-059583 Open access Prevalence of reproductive tract infections including sexually transmitted infections among married women in urban and peri-urban mid to low socioeconomic neighbourhoods of Delhi, North India: an observational study protocol Neeta Dhabhai, 1 Ritu Chaudhary, 1 Teodora Wi, 2 Gitau Mburu, 2 Ranadip Chowdhury , 1 Deepak More, 1 Leena Chatterjee, 3 Devjani De, 3 Rita Kabra , 2 James Kiarie, 2 Ndema Habib, 2 Arjun Dang, 3 Manvi Dang, 3 Sarmila Mazumder 1 To cite: Dhabhai N, Chaudhary R, Wi T, et al. Prevalence of reproductive tract infections including sexually transmitted infections among married women in urban and peri-urban mid to low socioeconomic neighbourhoods of Delhi, North India: an observational study protocol. BMJ Open 2022;12:e059583. doi:10.1136/ bmjopen-2021-059583 ► Prepublication history for this paper is available online. To view these fles, please visit the journal online (http://dx.doi. org/10.1136/bmjopen-2021- 059583). Received 26 November 2021 Accepted 18 February 2022 For numbered affliations see end of article. Correspondence to Dr Sarmila Mazumder; sarmila.mazumder@sas.org.in Protocol © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ. ABSTRACT Introduction The Global Health Sector Strategy on sexually transmitted infections (STIs), endorsed by the World Health Assembly in 2016 aims to end STIs as public health threat by 2030. WHO conducts global estimates of prevalence to monitor progress towards achieving the same. However, limited laboratory confrmed data exist of STIs and reproductive tract infections (RTIs) apart from few prevalence surveys among key populations and clinic- based reports, including in India. Syndromic approach is the cornerstone of RTI/STI management and to maximise the diagnostic accuracy, there is a need to determine the main aetiologies of vaginal discharge. This study aims to estimate the prevalence of common STIs and RTIs and their aetiological organisms in symptomatic and asymptomatic women living in the urban and peri-urban, mid to low socioeconomic neighbourhoods of Delhi, North India. Methods and analysis A cross-sectional study will be conducted among 440 married women who participated in the ‘Women and Infants Integrated Interventions for Growth Study (WINGS)’. Information on sociodemographic profle, sexual and reproductive health will be collected, followed by examination and collection of vaginal swabs for nucleic acid amplifcation tests to diagnose Neisseria gonorrhoeae, Chlamydia trachomatis and Trichomonas vaginalis and microscopy to identify bacterial vaginosis and Candida albicans. Treatment will be as per the syndromic approach recommendations in the Indian National Guidelines. Data will be analysed to estimate prevalence, presence of symptoms and signs associated with laboratory confrmed RTIs/STIs using STATA V.16.0 (StataCorp). Ethics and dissemination This study protocol has been approved by the ethics review committees of the WHO and Society for Applied Studies (SAS/ERC/RHR-RTI/STI/2020). Approval has been obtained by the WINGS investigators from SAS ethics research committee to share the contact details of the participants with the investigators. The fndings will be published in peer-reviewed journals and disseminated through scientifc conferences. Trial registration number CTRI/2020/03/023954. INTRODUCTION Sexually transmitted infections (STIs) and reproductive tract infections (RTIs) are a significant cause of global burden of disease. 1 Of the eight pathogens of highest public Strengths and limitations of this study ► Recent data on the prevalence of reproductive tract infection (RTI)/sexually transmitted infection (STI) and aetiologies of symptomatic RTI/STI in India are limited; this study responds to this research gap. ► It will provide crucial information on prevalence of laboratory confrmed Neisseria gonorrhoeae, Chlamydia trachomatis and Trichomonas vaginalis among asymptomatic woman, in addition to those with symptoms. ► This study addresses the WHO’s recommendation to periodically ascertain the aetiology of vaginal dis- charge syndrome every 2–3 years in order to update or modify the national guideline. ► This is not a community-based prevalence survey, which would require randomised sampling and would be costly. ► Participants in this study are limited to a prespeci- fed cohort of women hence, generalisability of the fndings and conclusions will need to be interpreted with care. on July 17, 2022 by guest. Protected by copyright. http://bmjopen.bmj.com/ BMJ Open: first published as 10.1136/bmjopen-2021-059583 on 18 March 2022. Downloaded from