Intervention
Participants in the intervention clinics received C. trachomatisand N. gonorrhoeae screening (GeneXpert® CT/NG assay, Cepheid, Sunnyvale, CA, USA) at the first antenatal care visit, the third trimester visit (approximately 36-38 weeks’ gestation), and at the postnatal care visit, 6-8 weeks post-delivery. Vaginal samples were self-collected by participants and then transported to a central site for same-day processing according to the manufacturer’s instructions. Women were provided with results in-person or by telephone within 24 hours. Participants testing positive for C. trachomatis and/orN. gonorrhoeae were treated by a study nurse according to US Centers for Disease Control and Prevention 2021 STI Treatment guidelines(12) and were counselled on partner notification. Participants in the standard-of-care arm were tested only at their postnatal visit. If results were positive, they received similar case and partner management.