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Manjate A, Sergon G, Kenga D, Golparian D, Tyulenev Y, Loquilha O, Mausse F, Guschin A, Langa JC, Passanduca A, Sacarlal J, Unemo M. Prevalence of sexually transmitted infections (STIs), associations with sociodemographic and behavioural factors, and assessment of the syndromic management of vaginal discharge in women with urogenital complaints in Mozambique. FRONTIERS IN REPRODUCTIVE HEALTH 2024; 6:1323926. [PMID: 38706519 PMCID: PMC11067503 DOI: 10.3389/frph.2024.1323926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 04/04/2024] [Indexed: 05/07/2024] Open
Abstract
In Mozambique, sexually transmitted infections (STIs) are estimated to be prevalent, but diagnosis and treatment of curable STIs rely only on syndromic management. We examined the prevalence of four non-viral STIs and HIV-1/2, based on etiological diagnosis, associations with sociodemographic and behavioural factors, and the STI diagnostic accuracy of the vaginal discharge syndromic management in women with urogenital complaints in Maputo, Mozambique. A cross-sectional study was performed in Maputo, Mozambique, February 2018-January 2019, enrolling 924 women of reproductive age with urogenital complaints. Endocervical/vaginal swabs were sampled and chlamydia, gonorrhoea, trichomoniasis and Mycoplasma genitalium infections were diagnosed using a multiplex real-time PCR (AmpliSens; InterLabServices). Serological testing was performed for HIV-1/2. A structured questionnaire collected metadata. All data were analyzed in STATA/IC 12.1 using descriptive statistics, chi-square tests and logistic regression model. About 40% of the women were less than 24 years old, 50.8% were single, 62.1% had their sexual debut between 12 and 17 years of age, and the main complaint was vaginal discharge syndrome (85%). The prevalence of chlamydia was 15.5%, trichomoniasis 12.1%, gonorrhoea 4.0%, M. genitalium 2.1%, and HIV-1/2 22.3%. The vaginal discharge syndrome flowchart had a sensitivity of 73.0%-82.5% and a specificity of 14%-15% for the detection of any individual non-viral STI in women with urogenital complaints. In total, 19.2% of the symptomatic women with chlamydia, trichomoniasis or gonorrhoea would not be detected and accordingly treated using the vaginal discharge syndromic management (missed treatment) and 70.0% of the women would be treated despite not being infected with any of these three STIs (overtreatment). In conclusion, a high prevalence of especially chlamydia, trichomoniasis, and HIV-1/2 was found in women of childbearing age with urogenital complaints in Maputo, Mozambique. Syndromic management of vaginal discharge revealed low accuracy in the detection of STIs in symptomatic women, especially low specificity, which resulted in under-treatment of STI-positive cases and incorrect or over-treatment of women with urogenital complaints, many of whom were negative for all the non-viral STIs. Etiological diagnosis is imperative for effective management of STIs in symptomatic and asymptomatic women.
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Affiliation(s)
- Alice Manjate
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Departament de Microbiologia, Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique
| | - Gladys Sergon
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Darlenne Kenga
- Departament de Microbiologia, Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique
| | - Daniel Golparian
- WHO Collaborating Centre for Gonorrhoea and Other Sexually Transmitted Infections, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Yuriy Tyulenev
- Department of Healthcare, Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology, Moscow, Russia
| | - Osvaldo Loquilha
- Departamento de Matemática e Informática, Faculdade de Ciências, Universidade Eduardo Mondlane, Maputo, Mozambique
| | - Fabião Mausse
- Departament de Microbiologia, Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique
| | - Alexander Guschin
- Department of Healthcare, Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology, Moscow, Russia
| | - José Carlos Langa
- Departament de Microbiologia, Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique
| | - Alfeu Passanduca
- Departament de Microbiologia, Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique
| | - Jahit Sacarlal
- Departament de Microbiologia, Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique
| | - Magnus Unemo
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- WHO Collaborating Centre for Gonorrhoea and Other Sexually Transmitted Infections, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Institute for Global Health, University College London (UCL), London, United Kingdom
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Khumalo S, Mafulu Y, Williams V, Musarapasi N, Haumba S, Dube N. Secondary syphilis presenting with alopecia and leukoderma in a stable HIV-positive patient in a resource-limited setting: a case report. AIDS Res Ther 2024; 21:19. [PMID: 38561779 PMCID: PMC10986119 DOI: 10.1186/s12981-024-00603-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 03/13/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Syphilis is an infection caused by the bacteria Treponema pallidum. It is mainly transmitted through oral, vaginal and anal sex, in pregnancy and through blood transfusion. Syphilis develops in primary, secondary, latent and tertiary stages and presents with different clinical features at each stage. Infected patients can remain asymptomatic for several years and, without treatment, can, in extreme cases, manifest as damage in several organs and tissues, including the brain, nervous tissue, eyes, ear and soft tissues. In countries with a high human immunodeficiency virus (HIV) burden, syphilis increases the risk of HIV infections. We report the case of a young HIV-positive black woman who presented with alopecia and hypopigmentation as features of secondary syphilis. CASE PRESENTATION A virologically suppressed 29-year-old woman on Anti-retroviral Therapy (ART) presented with a short history of generalized hair loss associated with a non-itchy maculopapular rash and skin depigmentation on the feet. Limited laboratory testing confirmed a diagnosis of secondary syphilis. She was treated with Benzathine Penicillin 2.4MU. After receiving three doses of the recommended treatment, the presenting features cleared, and the patient recovered fully. CONCLUSION This case demonstrates the importance of a high index of clinical suspicion and testing for syphilis in patients presenting with atypical clinical features of secondary syphilis, such as hair loss and hypopigmentation. It also highlights the challenges in diagnosing and clinically managing syphilis in a resource-limited setting.
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Affiliation(s)
| | - Yves Mafulu
- AIDS Healthcare Foundation, Manzini, Eswatini
| | - Victor Williams
- Centre for Global Health Practice and Impact, Georgetown University, Mbabane, Eswatini.
| | - Normusa Musarapasi
- Centre for Global Health Practice and Impact, Georgetown University, Mbabane, Eswatini
| | - Samson Haumba
- Centre for Global Health Practice and Impact, Georgetown University, Mbabane, Eswatini
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Calvert C, Scott R, Palmer M, Dube A, Marston M, Wellings K, Slaymaker E. Rates of sexual partner acquisition from nationally representative surveys: variation between countries and by age, sex, wealth, partner and HIV status. Sex Health 2024; 21:NULL. [PMID: 38105237 DOI: 10.1071/sh23134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 11/28/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Knowing levels and determinants of partnership acquisition will help inform interventions that try to reduce transmission of sexually transmitted infections (STIs) including HIV. METHODS We used population-based, cross-sectional data from 47 Demographic and Health Surveys to calculate rates of partner acquisition among men and women (15-49years), and identified socio-demographic correlates for partner acquisition. Partner acquisition rates were estimated as the total number of acquisitions divided by the person-time in the period covered by the survey. For each survey and by sex, we estimated age-specific partner acquisition rates and used age-adjusted piecewise exponential survival models to explore whether there was any association between wealth, HIV status and partner status with partner acquisition rates. RESULTS Across countries, the median partner acquisition rates were 30/100 person-years for men (interquartile range 21-45) and 13/100 person-years for women (interquartile range 6-18). There were substantial variations in partner acquisition rates by age. Associations between wealth and partner acquisition rates varied across countries. People with a cohabiting partner were less likely to acquire a new one, and this effect was stronger for women than men and varied substantially between countries. Women living with HIV had higher partner acquisition rates than HIV-negative women but this association was less apparent for men. At a population level, partner acquisition rates were correlated with HIV incidence. CONCLUSIONS Partner acquisition rates are variable and are associated with important correlates of STIs and thus could be used to identify groups at high risk of STIs.
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Affiliation(s)
- Clara Calvert
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK; and Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Rachel Scott
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Melissa Palmer
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Albert Dube
- Malawi Epidemiological and Intervention Research Unit, Lilongwe, Malawi
| | - Milly Marston
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Kaye Wellings
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Emma Slaymaker
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
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Demissie E, Amare A, Birhanu M, Gizachew M. Neisseria gonorrhoeae antimicrobial resistance patterns and associated risk factors in women of childbearing potential in northwestern Ethiopia. BMC Womens Health 2024; 24:82. [PMID: 38297305 PMCID: PMC10829321 DOI: 10.1186/s12905-024-02898-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 01/11/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUNDS Neisseria gonorrhoeae causes gonorrhea and poses public health problems, including antimicrobial resistance. Current data on gonorrhea in prenatal participants in the study area are required. Thus, we aimed to identify gonorrhea prevalence, antimicrobial resistance, and risk factors among antenatal care clinic visitors in northwestern Ethiopia. METHODS A cross-sectional study was conducted from March to August 2022 at the University of Gondar Comprehensive Specialized Hospital. We recruited 278 study participants using convenient sampling techniques. Sociodemographic, clinical and behavioral risk factors were recorded using pre-tested questionnaires. Endocervical swabs were collected by a physician, transported to the microbiology laboratory, immediately inoculated into modified Thayer-Martin medium, and it was incubated at 37 °C for 24-48 hours. Gram staining and biochemical tests were used to identify the organism. AMR testing was performed using disc diffusion and E-test methods. Data were entered in EPI-info version 7 and exported and analyzed in SPSS version 26. A p-value ≤0.05 was considered as statistically significant. Results were presented in words, tables and figure. RESULTS Of 278 subjects enrolled, majority (44.6%) were 26-35 years, with a mean age of 29.9 (SD = ±7.2) years, 69.4% were urban residents, and 70.5% were married. Twenty-one (7.6%) participants had gonorrhea. Overall antimicrobial resistance ranged from 19 to 100%. High resistant to tetracycline (100%) and penicillin (85.7%) were observed by both tests. Ciprofloxacin resistance was 52.4% by disc diffusion and 85.7% by E-test. By E-test, all isolates were sensitive to ceftriaxone, cefixime, azithromycin and spectinomycin; however, 7 (33.3%), 9 (42.9%), 9 (42.9%) and 5 (23.8%) isolates showed resistant to these antibiotics with disk method. Prevalence of beta-lactamase producing Neisseria gonorrhoeae was 85.7%. Alcohol consumption (p = 0.032), condom-free sexual practice (p = 0.010), multiple sexual partners (p < 0.001), pelvic pain (p = 0.018), and dysuria (p = 0.021) revealed increased risk of infection. CONCLUSIONS Compared with many previous studies in Ethiopia, we found high prevalence, antimicrobial resistance, and beta-lactamase-positive isolates. Multiple sexual partners, alcohol consumption, not using condom, pelvic pain and dysuria were predictors of this infection. Continuous large-scale monitoring of pathogen is essential for its prevention and control.
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Affiliation(s)
- Engdawork Demissie
- Department of Medical Laboratory Sciences, School of Medicine and Health Sciences, Jigjiga University, Jijiga, Ethiopia
| | - Azanaw Amare
- Department of Medical Microbiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Muluken Birhanu
- Department of Medical Microbiology, Immunology and Parasitology, Addis Ababa University, and Assosa University, Addis Ababa, Ethiopia
| | - Mucheye Gizachew
- Department of Medical Microbiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
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Kawuki J, Nuwabaine L, Namulema A, Asiimwe JB, Sserwanja Q, Gatasi G, Donkor E. Prevalence of risk factors for human immunodeficiency virus among sexually active women in Rwanda: a nationwide survey. BMC Public Health 2023; 23:2222. [PMID: 37950175 PMCID: PMC10638791 DOI: 10.1186/s12889-023-17148-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 11/03/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND The Human Immunodeficiency Virus (HIV) remains a global health burden, and despite the advancements in antiretroviral therapy and various strategies employed to curb HIV infections, the incidence of HIV remains disproportionately high among women. Therefore, this study aimed to determine the prevalence of the risk factors for the acquisition of HIV among sexually active women in Rwanda. METHODS Secondary data from the 2020 Rwanda Demographic Health Survey, comprising 10,684 sexually active women, was used. Multistage stratified sampling was employed to select the study participants. Multivariable logistic regression was conducted to determine the associated risk factors using the SPSS (version 25). RESULTS Of the 10,684 sexually active women, 28.7% (95% confidence interval (CI): 27.5-29.4) had at least one risk factor for HIV acquisition. Having no education (AOR = 3.65, 95%CI: 2.16-6.16), being unmarried (AOR = 4.50, 95%CI: 2.47-8.21), being from female-headed households (AOR = 1.75, 95%CI: 1.42-2.15), not having health insurance (AOR = 1.34, 95%CI: 1.09-1.65), no HIV test history (AOR = 1.44, 95%CI: 1.01-2.08), being from the poorest wealth quintile (AOR = 1.61, 95%CI: 1.14-2.27) and lack of exposure to mass media (AOR = 1.30, 95%CI: 1.07-1.58) were associated with higher odds of exposure to at least one HIV acquisition risk factor. In contrast, age groups of 25-34 (AOR = 0.56, 95%CI: 0.44-0.71) and 35-44 years (AOR = 0.62, 95%CI: 0.48-0.80), rural residence (AOR = 0.63, 95%CI: 0.49-0.81) and being from the western region (AOR = 0.67, 95%CI: 0.48-0.94) were associated with less odds of exposure to at least one HIV acquisition risk factor. CONCLUSION More than a quarter of sexually active women in Rwanda had exposure to at least one risk factor for HIV acquisition. There is a need to maximize the use of mass media in disseminating HIV prevention and behavioral change messages. Engagement of religious leaders and promotion of HIV testing, especially among the never-testers, may be vital strategies in successful HIV prevention programs.
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Affiliation(s)
- Joseph Kawuki
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Lilian Nuwabaine
- School of Nursing and Midwifery, Aga Khan University, Kampala, Uganda.
| | | | | | | | - Ghislaine Gatasi
- Key Laboratory of Environmental Medicine Engineering, School of Public Health, Southeast University, Nanjing, 210009, Jiangsu Province, China
| | - Elorm Donkor
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
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Ghasemian E, Harding-Esch E, Mabey D, Holland MJ. When Bacteria and Viruses Collide: A Tale of Chlamydia trachomatis and Sexually Transmitted Viruses. Viruses 2023; 15:1954. [PMID: 37766360 PMCID: PMC10536055 DOI: 10.3390/v15091954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/02/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023] Open
Abstract
The global incidence of sexually transmitted infections (STIs) remains high, with the World Health Organization (WHO) estimating that over 1 million people acquire STIs daily. STIs can lead to infertility, pregnancy complications, and cancers. Co-infections with multiple pathogens are prevalent among individuals with an STI and can lead to heightened infectivity and more severe clinical manifestations. Chlamydia trachomatis (CT) is the most reported bacterial STI worldwide in both men and women, and several studies have demonstrated co-infection of CT with viral and other bacterial STIs. CT is a gram-negative bacterium with a unique biphasic developmental cycle including infectious extracellular elementary bodies (EBs) and metabolically active intracellular reticulate bodies (RBs). The intracellular form of this organism, RBs, has evolved mechanisms to persist for long periods within host epithelial cells in a viable but non-cultivable state. The co-infections of CT with the most frequently reported sexually transmitted viruses: human immunodeficiency virus (HIV), human papillomavirus (HPV), and herpes simplex virus (HSV) have been investigated through in vitro and in vivo studies. These research studies have made significant strides in unraveling the intricate interactions between CT, these viral STIs, and their eukaryotic host. In this review, we present an overview of the epidemiology of these co-infections, while specifically delineating the underlying mechanisms by which CT influences the transmission and infection dynamics of HIV and HSV. Furthermore, we explore the intricate relationship between CT and HPV infection, with a particular emphasis on the heightened risk of cervical cancer. By consolidating the current body of knowledge, we provide valuable insights into the complex dynamics and implications of co-infection involving CT and sexually transmitted viruses.
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Affiliation(s)
- Ehsan Ghasemian
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK; (E.H.-E.); (D.M.); (M.J.H.)
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Fazlollahpour-Naghibi A, Bagheri K, Almukhtar M, Taha SR, Zadeh MS, Moghadam KB, Tadi MJ, Rouholamin S, Razavi M, Sepidarkish M, Rostami A. Trichomonas vaginalis infection and risk of cervical neoplasia: A systematic review and meta-analysis. PLoS One 2023; 18:e0288443. [PMID: 37437068 DOI: 10.1371/journal.pone.0288443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 06/27/2023] [Indexed: 07/14/2023] Open
Abstract
OBJECTIVES The evidence in the literature regarding the relationship between Trichomonas vaginalis (TV) infection and cervical neoplasia is conflicting. The main aim of this study was to evaluate the magnitude of the risk of cervical neoplasia associated with TV infection. METHODS A meta-analysis of observational studies, which provided raw data on the association of TV infection with cervical neoplasia, was performed. For this aim, we searched scientific databases (PubMed/Medline, Scopus, the Web of Sciences, and Embase) from inception to March 15, 2023. A random-effects model was applied by Stata 17.0 to calculate the pooled and adjusted odds ratios (ORs) with 95% confidence intervals (CI), including subgroup, sensitivity, and cumulative analyses to explore sources of heterogeneity. RESULTS Of the 2584 records initially identified, 35 eligible studies contributed data for 67,856 women with cervical neoplasia, and 933,697 healthy controls from 14 countries were included. The pooled (2.15; 1.61-2.87; I2 = 87.7%) and adjusted (2.17; 1.82-2.60; I2 = 31.27%) ORs indicated a significant positive association between TV infection and the development of cervical neoplasia. There was no significant change in pooled and adjusted ORs by applying sensitivity and cumulative analyses, indicating the robustness of our findings. The pooled OR was significant in most sub-group analyses. There was no publication bias in the included studies. CONCLUSION Our findings indicated that women with a TV infection are at significantly greater risk of cervical neoplasia. Future research, particularly longitudinal and experimental studies, should be done to better understand the various aspects of this association.
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Affiliation(s)
- Andarz Fazlollahpour-Naghibi
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Kimia Bagheri
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | | | - Seyed Reza Taha
- Oncopathology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Kimia Behzad Moghadam
- Independent Researcher, Former University of California, San Francisco (UCSF), San Francisco, CA, United States of America
| | - Mehrdad Jafari Tadi
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Safoura Rouholamin
- Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Razavi
- Department of Obstetrics and Gynecology, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mahdi Sepidarkish
- Department of Biostatistics and Epidemiology, School of Public Health, Babol University of Medical Sciences, Babol, Iran
| | - Ali Rostami
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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Kebede Kassaw AA, Melese Yilma T, Sebastian Y, Yeneneh Birhanu A, Sharew Melaku M, Surur Jemal S. Spatial distribution and machine learning prediction of sexually transmitted infections and associated factors among sexually active men and women in Ethiopia, evidence from EDHS 2016. BMC Infect Dis 2023; 23:49. [PMID: 36690950 PMCID: PMC9872341 DOI: 10.1186/s12879-023-07987-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 01/05/2023] [Indexed: 01/24/2023] Open
Abstract
INTRODUCTION Sexually transmitted infections (STIs) are the major public health problem globally, affecting millions of people every day. The burden is high in the Sub-Saharan region, including Ethiopia. Besides, there is little evidence on the distribution of STIs across Ethiopian regions. Hence, having a better understanding of the infections is of great importance to lessen their burden on society. Therefore, this article aimed to assess predictors of STIs using machine learning techniques and their geographic distribution across Ethiopian regions. Assessing the predictors of STIs and their spatial distribution could help policymakers to understand the problems better and design interventions accordingly. METHODS A community-based cross-sectional study was conducted from January 18, 2016, to June 27, 2016, using the 2016 Ethiopian Demography and Health Survey (EDHS) dataset. We applied spatial autocorrelation analysis using Global Moran's I statistics to detect latent STI clusters. Spatial scan statics was done to identify local significant clusters based on the Bernoulli model using the SaTScan™ for spatial distribution and Supervised machine learning models such as C5.0 Decision tree, Random Forest, Support Vector Machine, Naïve Bayes, and Logistic regression were applied to the 2016 EDHS dataset for STI prediction and their performances were analyzed. Association rules were done using an unsupervised machine learning algorithm. RESULTS The spatial distribution of STI in Ethiopia was clustered across the country with a global Moran's index = 0.06 and p value = 0.04. The Random Forest algorithm was best for STI prediction with 69.48% balanced accuracy and 68.50% area under the curve. The random forest model showed that region, wealth, age category, educational level, age at first sex, working status, marital status, media access, alcohol drinking, chat chewing, and sex of the respondent were the top 11 predictors of STI in Ethiopia. CONCLUSION Applying random forest machine learning algorithm for STI prediction in Ethiopia is the proposed model to identify the predictors of STIs.
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Affiliation(s)
- Abdul-Aziz Kebede Kassaw
- grid.467130.70000 0004 0515 5212Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Tesfahun Melese Yilma
- grid.59547.3a0000 0000 8539 4635Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yakub Sebastian
- grid.1043.60000 0001 2157 559XCharles Darwin University, Casuarina, Australia
| | - Abraham Yeneneh Birhanu
- grid.59547.3a0000 0000 8539 4635Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mequannent Sharew Melaku
- grid.59547.3a0000 0000 8539 4635Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Sebwedin Surur Jemal
- grid.449142.e0000 0004 0403 6115Department of Statistics, Collage of Natural and Computational Science, Mizan Tepi University, MizanTepi, Ethiopia
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Tsega NT, Abebe B, Ebabu T, Asmare T, Kassa M, Haile TT, Seyoum AT, Endalew M, Wondie KY. Sexually transmitted infections and associated factors during pregnancy in Gondar city, Northwest Ethiopia, 2021: A multicenter study. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2022. [DOI: 10.1016/j.cegh.2022.101096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Ruangtragool L, Silver R, Machiha A, Gwanzura L, Hakim A, Lupoli K, Musuka G, Patel H, Mugurungi O, Tippett Barr BA, Rogers JH. Factors associated with active syphilis among men and women aged 15 years and older in the Zimbabwe Population-based HIV Impact Assessment (2015–2016). PLoS One 2022; 17:e0261057. [PMID: 35298475 PMCID: PMC8929562 DOI: 10.1371/journal.pone.0261057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 11/23/2021] [Indexed: 11/28/2022] Open
Abstract
Introduction Ulcerative STIs, including syphilis, increase the risk for HIV acquisition and transmission due to the presence of ulcers/chancres that serve as a point-of-entry and exit for HIV. In Zimbabwe, diagnosis of syphilis often occurs in pregnant women who seek ANC services where syphilis testing is offered, and among men and women who seek health care for STIs. Zimbabwe’s national syphilis estimates are based on these diagnosed cases, with little information available about the prevalence of untreated syphilis among the general population. This analysis uses data from ZIMPHIA (2015–2016) to describe factors associated with active syphilis among men and women ages 15 years and older. Methods ZIMPHIA collected blood specimens for HIV and syphilis testing from 22,501 consenting individuals (ages 15 years and older). Household HIV testing used the national HIV rapid-testing algorithm with HIV-positive results confirmed at satellite laboratories using Geenius HIV-1/2 rapid test (Bio-rad, Hercules, California, USA). Point-of-care non-Treponemal and Treponemal syphilis testing was performed using Chembio’s Dual-Path Platform Syphilis Screen & Confirm Assay. Factors associated with active syphilis were explored using multiple variable, weighted logistic regression and were stratified by gender. Results The likelihood of active syphilis in HIV-positive females was 3.7 times greater in HIV-positive females than HIV-negative females (aOR: 3.7, 95% CI 2.3–5.9). Among males odds of having active syphilis was 5 times higher among those that engaged in transactional sex than those who did not have sex or transactional sex (aOR: 5.3, 95% CI 1.9–14.7), and 6 times higher if HIV positive versus negative (aOR: 5.9, 95% CI 3.0–12.0). Urban residence, province, education (highest attended), marital status, number of sex partners, consistency of condom use, pregnancy status (females), and circumcision status (males) were not significant in the adjusted model for either females or males. Conculsion HIV status was found to be the only factor associated with active syphilis in both females and males. Given the persistent link between HIV and active syphilis, it is prudent to link individuals’ diagnoses and treatments, as recommended by the WHO. Enhanced integration of STI and HIV services in health delivery points such as ANC, reproductive services, or male circumcision clinics, combined with consistent, targeted outreach to high-risk populations and their partners, may assist the MOHCC to eliminate active syphilis in Zimbabwe.
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Affiliation(s)
- Leala Ruangtragool
- Public Health Institute / CDC Global HIV Surveillance Fellow, Harare, Zimbabwe
| | - Rachel Silver
- Public Health Institute / CDC Global HIV Surveillance Fellow, Harare, Zimbabwe
| | - Anna Machiha
- Ministry of Health and Child Care, Harare, Zimbabwe
| | | | - Avi Hakim
- Division of Global HIV/TB, U.S. Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Katie Lupoli
- Division of Global HIV/TB, U.S. Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | | | - Hetal Patel
- Division of Global HIV/TB, U.S. Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | | | - Beth A. Tippett Barr
- Division of Global HIV/TB, U.S. Centers for Disease Control and Prevention, Harare, Zimbabwe
| | - John H. Rogers
- Division of Global HIV/TB, U.S. Centers for Disease Control and Prevention, Harare, Zimbabwe
- * E-mail:
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11
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Adu C, Mohammed A, Budu E, Frimpong JB, Tetteh JK, Ahinkorah BO, Seidu AA. Sexual autonomy and self-reported sexually transmitted infections among women in sexual unions. Arch Public Health 2022; 80:40. [PMID: 35081983 PMCID: PMC8790891 DOI: 10.1186/s13690-022-00796-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 01/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sexually transmitted infections (STIs) are major public health challenges worldwide. Despite the importance of sexual autonomy in the prevention and control of sexual and reproductive health disorders such as STIs, there are limited studies on the possible relationship between women's sexual autonomy and self-reported STIs, especially in sub-Saharan Africa (SSA). This study, therefore, examined the association between sexual autonomy and self-reported STIs among women in sexual unions in SSA. METHODS Data from the Demographic and Health Survey (DHS) of 31 countries in SSA conducted between 2010 and 2019 were analysed. A total of 234,310 women in sexual unions were included in the study. Data were analysed using binary logistic regression models and the results were presented as crude odds ratios (cORs) and adjusted odds ratios (aORs) at 95% confidence interval (CI). RESULTS The prevalence of self-reported STIs among women in sexual unions in SSA was 5.8%. Approximately 83.0% of the women surveyed had sexual autonomy. Women who had no sexual autonomy were less likely to have self-reported STIs (cOR=0.52, CI: 0.46-0.54), compared to those who had sexual autonomy. Additionally, higher odds of self-reported STIs were found among women aged 25-29, compared to those aged 15-19 (aOR= 1.21, CI: 1.09-1.35); those who reside in urban areas, compared to those who reside in rural areas (aOR= 1.51, CI: 1.37-1.66) and those who were cohabiting, compared to those who were married (aOR= 1.65, CI: 1.52-1.79). On the other hand, lower odds of self-reported STIs were found among women who were exposed to newspapers (aOR= 0.89, CI: 0.82-0.95), those whose partners had primary education (aOR= 0.84, CI: 0.78-0.91), those who were not exposed to radio (aOR= 0.84, CI: 0.79-0.89), and working women (aOR= 0.86, CI: 0.80-0.93). CONCLUSIONS Findings from this study suggest that sexual autonomy is a significant predictor of self-reported STIs among women in sexual unions in SSA. Thus, instituting policies and programs that empower women and improve their levels of sexual autonomy may result in increased self-reporting of symptoms associated with STIs which subsequently help in minimising STI-related complications. Also, policies aimed at enhancing women's sexual autonomy may reduce the burden of STIs in SSA, especially among women in sexual unions.
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Affiliation(s)
- Collins Adu
- Department of Health Promotion, Education and Disability Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Aliu Mohammed
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - Eugene Budu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - James Boadu Frimpong
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - Justice Kanor Tetteh
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Bright Opoku Ahinkorah
- School of public health Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Abdul-Aziz Seidu
- Department of Estate Management, Faculty of Built and Natural Environment, Takoradi Technical University, Takoradi, Ghana.,Centre for Gender and Advocacy, Takoradi Technical University, Takoradi, Ghana.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
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12
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Kawuki J, Kamara K, Sserwanja Q. Prevalence of risk factors for human immunodeficiency virus among women of reproductive age in Sierra Leone: a 2019 nationwide survey. BMC Infect Dis 2022; 22:60. [PMID: 35039011 PMCID: PMC8764866 DOI: 10.1186/s12879-022-07037-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 01/07/2022] [Indexed: 11/30/2022] Open
Abstract
Background and aim For over 40 years of the HIV/AIDS global epidemic, no effective cure nor vaccine is yet available, making the current control strategies focused on curbing new infections through risk reduction. The study aimed to determine the prevalence of HIV risk factors and their associated socio-demographics among women of reproductive age in Sierra Leone. Methods We used weighted data from the Sierra Leone Demographic and Health Survey (SLDHS) of 2019 for 12,005 women aged 15–49 years. Multistage sampling was used to select study participants. Exposure to HIV risk factors was considered if a woman reported at least one of the following; having multiple sexual partners, transactional sex, non-condom use for the unmarried, and having other sexually transmitted infections (STIs). We, then, conducted multivariable logistic regression to explore the associated socio-demographics. All the analyses were done using SPSS (version 25). Results Of the 12,005 women, 38.1% (4577/12005) (95% confidence interval (CI) 37.3–39.0) had at least one of the four risk factors. Women of 15 to 19 years (adjusted odds ratio (AOR) = 1.34, 95% CI 1.00–1.80) and 20 to 34 years (AOR = 1.25, 95% CI 1.05–1.49) had more odds of having HIV risk factors compared to those of 35 to 49 years. Urban residents (AOR = 1.49, 95% CI 1.17–1.89) and those from the Northwestern region (AOR = 1.81, 95% CI 1.26–2.60) were also more likely to encounter HIV risk factors compared to their respective counterparts. Moreover, unmarried women (AOR = 111.17, 95% CI 87.55–141.18) and those working (AOR = 1.38, 95% CI 1.14–1.67) also had higher odds of having HIV risk factors, compared to their respective counterparts. Sex of household head and parity were also significant associates. Conclusions More than a third of women in Sierra Leone had encountered at least one HIV risk factor, and this was associated with age, place of residence, region, marital status, working status, household head and parity. There is a need for strengthening HIV/AIDS education programs, laws and policies targeting the young, working, unmarried and urban-resident women. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07037-7.
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Affiliation(s)
- Joseph Kawuki
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Kassim Kamara
- Directorate of Health Security and Emergencies, Ministry of Health and Sanitation, Sierra Leone, Freetown, Sierra Leone
| | - Quraish Sserwanja
- Programmes Department, GOAL, Arkaweet Block 65 House No. 227, Khartoum, Sudan.
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13
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Widiyanti M, Adiningsih S. The demographic and clinical characteristics of women living with HIV and the opportunistic infections they experience in Manokwari Regency, West Papua. BIO WEB OF CONFERENCES 2022. [DOI: 10.1051/bioconf/20225400001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The number of women living with HIV (WLHIV) in Indonesia, especially Papua, is increasing yearly, along with the increasing number of men who transmit HIV to their partners. WLHIV are susceptible to opportunistic infections, leading to increased morbidity and mortality. This study, aiming to identify the characteristics and opportunistic infections among WLHIV in Manokwari Regency, West Papua, was descriptive with a cross-sectional study design involving 70 WLHIV who routinely received antiretroviral treatment at the VCT of RSUD Manokwari as respondent. Data on demographic and clinical variables were obtained through interviews using structured questionnaires. Data were analyzed by fisher exact tests to measure the association of opportunistic infections with demographic and clinical variables. The results showed that the demographic characteristics of WLHIV: aged18-35 years (47.1%), high school education (42.9%), private employment (47.1%), married (65.7%), ethnic Papuan (65.7%), and heterosexual risk factor (97.1%). Meanwhile, their clinical characteristics were clinical stage III (62.9%), CD4+ ≥350 cell/mm3 (62,9%), detectable viral load (55,7%), and underweight (38.6%). The most opportunistic infections among them were pulmonary tuberculosis (58.6%). The clinical stage of HIV and CD4+ cells was significantly associated with opportunistic infections among WLHIV. For these reasons, it is necessary to intervene by applying antiretroviral administration strategies and specific antimicrobial therapy.
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14
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Dadzie LK, Agbaglo E, Okyere J, Aboagye RG, Arthur-Holmes F, Seidu AA, Ahinkorah BO. OUP accepted manuscript. Int Health 2022; 14:545-553. [PMID: 35134172 PMCID: PMC9623488 DOI: 10.1093/inthealth/ihab088] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 11/17/2021] [Accepted: 01/29/2022] [Indexed: 11/21/2022] Open
Abstract
Background Sexually transmitted infections (STIs) affect individuals of all ages, but adolescent girls and young women are disproportionately affected. We examined the prevalence and factors associated with self-reported STIs (SR-STIs) among adolescent girls and young women in sub-Saharan Africa (SSA). Methods Demographic and Health Survey data of 27 sub-Saharan African countries were used for the study. The sample size comprised 68944 adolescent girls and young women
(15–24 y of age). The outcome variable was SR-STIs. Multilevel binary logistic regression analysis was performed to identify factors associated with SR-STIs. Results On average, the prevalence of SR-STIs among adolescent girls and young women in SSA was 6.92%. The likelihood of SR-STIs was higher among young women aged 20–24 y (adjusted odds ratio [aOR] 1.36 [confidence interval {CI} 1.27 to 1.46]), those not married (aOR 1.64 [CI 1.51 to 1.79]), those working (aOR 1.20 [CI 1.12 to 1.27]), those whose age at first sex was ≤19 y (aOR 1.99 [CI 1.80 to 2.20]), those with two or more sex partners (aOR 1.56 [CI 1.35 to 1.80]), those who listened to radio (aOR 1.26 [CI 1.17 to 1.35]), those in urban areas (aOR 1.42 [CI 1.30 to 1.51]) and those with a wealth index of rich (aOR 1.28 [CI 1.17 to 1.40]) compared with their counterparts. In contrast, those with a primary (aOR 0.86 [CI 0.78 to 0.94]) or secondary/higher level of education (aOR 0.83 [CI 0.75 to 0.92]) compared with those with no formal education and those who were exposed to television (aOR 0.90 [CI 0.84 to 0.98]) compared with those who were not exposed were less likely to report STIs. Conclusions Our findings demonstrate the need for countries in SSA to commit towards reducing the incidence of STIs. Community-based health educational programs are required to intensify the awareness of STIs and their prevention in various sub-Saharan African countries considering the factors that expose adolescent girls and young women to STIs.
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Affiliation(s)
| | - Ebenezer Agbaglo
- Department of English, University of Cape Coast, Cape Coast, Ghana
| | - Joshua Okyere
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | | | - Francis Arthur-Holmes
- Department of Sociology and Social Policy, Lingnan University, 8 Castle Peak Road, Tuen Mun, Hong Kong
| | - Abdul-Aziz Seidu
- Department of Estate Management, Takoradi Technical University, Takoradi, Ghana
- Centre for Gender and Advocacy, Takoradi Technical University, Takoradi, Ghana
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
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15
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Ngobese B, Abbai NS. Sexually transmitted infections in pregnant women from sub-Saharan Africa. S Afr J Infect Dis 2021; 36:312. [PMID: 34917679 PMCID: PMC8664065 DOI: 10.4102/sajid.v36i1.312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 10/06/2021] [Indexed: 11/05/2022] Open
Abstract
Background Sexually transmitted infections (STIs) are a major health problem in most countries of the world, particularly in developing countries where the resources and technology to diagnose and treat them are limited. Currently, there is limited data on STIs and risk factors for these infections in pregnant women living with human immunodeficiency virus (HIV), especially in sub-Saharan Africa (SSA). This review provides data on the prevalence and risk factors for STIs in pregnant women living with HIV from SSA. This review also describes the association between STIs and HIV on pregnancy and birth outcomes as well as highlights the importance of laboratory-based diagnosis of STIs. Method An electronic search of online databases was used to find and collect relevant research articles connected to the prevalence, adverse pregnancy and birth outcomes, health complications and risk factors associated with STIs and HIV in pregnant women from SSA. The search was limited to articles published in English. Relevant studies were identified by searching literature from January 2001 to date. The search yielded 4709 results. Results In SSA, STIs are highly prevalent in pregnant women and are widely known to be linked with an increased risk of poor maternal and neonatal outcomes. These infections are often asymptomatic and highly prevalent in pregnant women. The screening of STIs in pregnant women living with HIV can reduce the risk of mother-to-child transmission (MTCT) and screening and treatment for STIs can also prevent adverse perinatal outcomes. It is important to recognise regional and national STI epidemics in order to promote STI prevention and control interventions considering the test and treat approach as opposed to syndromic management. Conclusion This review highlights the need to use diagnostic screening methods instead of syndromic STI management in SSA. Moreover, more research into effective prevention and treatment measures for STIs in pregnant women is urgently required.
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Affiliation(s)
- Bongekile Ngobese
- Department of Clinical Medicine Laboratory, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Nathlee S Abbai
- Department of Clinical Medicine Laboratory, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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16
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Kerschberger B, Aung A, Mpala Q, Ntshalintshali N, Mamba C, Schomaker M, Tombo ML, Maphalala G, Sibandze D, Dube L, Kashangura R, Mthethwa-Hleza S, Telnov A, de la Tour R, Gonzalez A, Calmy A, Ciglenecki I. Predicting, Diagnosing, and Treating Acute and Early HIV Infection in a Public Sector Facility in Eswatini. J Acquir Immune Defic Syndr 2021; 88:506-517. [PMID: 34483294 PMCID: PMC8575170 DOI: 10.1097/qai.0000000000002794] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 08/12/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND The lack of acute and early HIV infection (AEHI) diagnosis and care contributes to high HIV incidence in resource-limited settings. We aimed to assess the yield of AEHI, predict and diagnose AEHI, and describe AEHI care outcomes in a public sector setting in Eswatini. SETTING This study was conducted in Nhlangano outpatient department from March 2019 to March 2020. METHODS Adults at risk of AEHI underwent diagnostic testing for AEHI with the quantitative Xpert HIV-1 viral load (VL) assay. AEHI was defined as the detection of HIV-1 VL on Xpert and either an HIV-seronegative or HIV-serodiscordant third-generation antibody-based rapid diagnostic test (RDT) result. First, the cross-sectional analysis obtained the yield of AEHI and established a predictor risk score for the prediction of AEHI using Lasso logistic regression. Second, diagnostic accuracy statistics described the ability of the fourth-generation antibody/p24 antigen-based Alere HIV-Combo RDT to diagnose AEHI (vs Xpert VL testing). Third, we described acute HIV infection care outcomes of AEHI-positive patients using survival analysis. RESULTS Of 795 HIV-seronegative/HIV-serodiscordant outpatients recruited, 30 (3.8%, 95% confidence interval: 2.6% to 5.3%) had AEHI. The predictor risk score contained several factors (HIV-serodiscordant RDT, women, feeling at risk of HIV, swollen glands, and fatigue) and had sensitivity and specificity of 83.3% and 65.8%, respectively, to predict AEHI. The HIV-Combo RDT had sensitivity and specificity of 86.2% and 99.9%, respectively, to diagnose AEHI. Of 30 AEHI-positive patients, the 1-month cumulative treatment initiation was 74% (95% confidence interval: 57% to 88%), and the 3-month viral suppression (<1000 copies/mL) was 87% (67% to 98%). CONCLUSION AEHI diagnosis and care seem possible in resource-limited settings.
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Affiliation(s)
| | - Aung Aung
- Médecins Sans Frontières (OCG), Mbabane, Eswatini
| | | | | | | | - Michael Schomaker
- Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa;
- Institute of Public Health, Medical Decision Making and Health Technology Assessment, UMIT—University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria;
| | | | | | | | - Lenhle Dube
- Ministry of Health (SNAP), Mbabane, Eswatini
| | | | | | - Alex Telnov
- Médecins Sans Frontières (OCG), Geneva, Switzerland;
| | | | - Alan Gonzalez
- Médecins Sans Frontières (OCG), Geneva, Switzerland;
| | - Alexandra Calmy
- HIV/AIDS Unit, Division of Infectious Diseases, Geneva University Hospitals Geneva, Switzerland; and
- Institute of Global Health, University of Geneva, Geneva, Switzerland.
| | - Iza Ciglenecki
- Médecins Sans Frontières (OCG), Geneva, Switzerland;
- Institute of Global Health, University of Geneva, Geneva, Switzerland.
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17
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Holali Ameyapoh A, Katawa G, Ritter M, Tchopba CN, Tchadié PE, Arndts K, Kamassa HE, Mazou B, Amessoudji OM, N'djao A, Agoro S, Vogelbusch C, Omondi MA, Kolou M, Karou SD, Horsnell W, Hoerauf A, Ameyapoh Y, Layland LE. Hookworm Infections and Sociodemographic Factors Associated With Female Reproductive Tract Infections in Rural Areas of the Central Region of Togo. Front Microbiol 2021; 12:738894. [PMID: 34803955 PMCID: PMC8595254 DOI: 10.3389/fmicb.2021.738894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 10/04/2021] [Indexed: 11/26/2022] Open
Abstract
Female reproductive tract infections (FRTIs) have a huge impact on women’s health including their reproductive health in rural areas. Immunomodulation by helminth infections could influence the occurrence of FRTIs. This study aimed to investigate the association between FRTIs, hookworm infections, and sociodemographic factors in six rural areas of the central region of Togo. A semi-structured questionnaire was used to collect sociodemographical information, and parasitological assessments were used to diagnose helminth infections. Moreover, cytobacteriological examination of vaginal swabs was performed for the diagnosis of candidiasis and bacterial vaginosis (BV), and real-time PCR method was used to determine sexually transmitted infections (STIs). Finally, a logistic regression analysis was performed to assess the relationship and association of these factors to FRTIs. The prevalence of FRTIs was 82.3% including STIs (74.38%), BV (31.79%), and vulvovaginal candidiasis (9.85%). In detail, FRTIs were caused by bacteria such as Ureaplasma parvum (50%), Ureaplasma urealyticum (26.5%), and Mycoplasma hominis (17.5%) and viruses such us cytomegalovirus (5%) and human papilloma virus (HPV) (20%). No cases of Haemophilus ducreyi, Treponema pallidum, or varicella-zoster virus (VZV) were observed. Interestingly, women who had hookworm infections were at high risk of HPV. The use of condoms was a protective factor [adjusted odds ratio (aOR) = 0.23; 95% CI [0.11–0.51)], while the use of contraceptive methods was a risk factor [aOR = 2.49; 95% CI (1.19–5.19)] for STIs. The risk of BV was lower among participants who had more than four pregnancies [aOR = 0.27; 95% CI (0.11–0.65)]. Furthermore, women who had ever been paid for sexual intercourse were at high probability risk of vulvovaginal candidiasis [aOR = 16.92; 95% CI (1.46–196.48)]. This study highlighted risk factors associated with FRTIs, the control of which would help to reduce the incidence of these diseases. Health-care professionals could develop education and sensitization strategies based on these risk factors, and anti-hookworm treatment concepts may be taken into consideration to minimize the risk of HPV infections.
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Affiliation(s)
- Adjoa Holali Ameyapoh
- Laboratoire de Microbiologie et de Contrôle de Qualité des Denrées Alimentaires, Unité de Recherche en Immunologie et Immunomodulation (UR2IM), Ecole Supérieure des Techniques Biologiques et Alimentaires (ESTBA), Université de Lomé, Lomé, Togo
| | - Gnatoulma Katawa
- Laboratoire de Microbiologie et de Contrôle de Qualité des Denrées Alimentaires, Unité de Recherche en Immunologie et Immunomodulation (UR2IM), Ecole Supérieure des Techniques Biologiques et Alimentaires (ESTBA), Université de Lomé, Lomé, Togo
| | - Manuel Ritter
- Institute for Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn (UKB), Bonn, Germany
| | - Christèle Nguepou Tchopba
- Laboratoire de Microbiologie et de Contrôle de Qualité des Denrées Alimentaires, Unité de Recherche en Immunologie et Immunomodulation (UR2IM), Ecole Supérieure des Techniques Biologiques et Alimentaires (ESTBA), Université de Lomé, Lomé, Togo
| | - Pélagie Edlom Tchadié
- Laboratoire de Microbiologie et de Contrôle de Qualité des Denrées Alimentaires, Unité de Recherche en Immunologie et Immunomodulation (UR2IM), Ecole Supérieure des Techniques Biologiques et Alimentaires (ESTBA), Université de Lomé, Lomé, Togo
| | - Kathrin Arndts
- Institute for Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn (UKB), Bonn, Germany
| | - Hélène E Kamassa
- Laboratoire de Microbiologie et de Contrôle de Qualité des Denrées Alimentaires, Unité de Recherche en Immunologie et Immunomodulation (UR2IM), Ecole Supérieure des Techniques Biologiques et Alimentaires (ESTBA), Université de Lomé, Lomé, Togo
| | - Bassimtou Mazou
- Laboratoire de Microbiologie et de Contrôle de Qualité des Denrées Alimentaires, Unité de Recherche en Immunologie et Immunomodulation (UR2IM), Ecole Supérieure des Techniques Biologiques et Alimentaires (ESTBA), Université de Lomé, Lomé, Togo
| | - Oukoe M Amessoudji
- Laboratoire de Microbiologie et de Contrôle de Qualité des Denrées Alimentaires, Unité de Recherche en Immunologie et Immunomodulation (UR2IM), Ecole Supérieure des Techniques Biologiques et Alimentaires (ESTBA), Université de Lomé, Lomé, Togo
| | - Akawulu N'djao
- Hôpital du District de Tchaoudjo, Direction Préfectorale de la Santé, Sokodé, Togo
| | - Sibabe Agoro
- Direction Régionale de la Santé, Région la Kara, Kara, Togo
| | - Celina Vogelbusch
- Institute for Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn (UKB), Bonn, Germany
| | - Millicent A Omondi
- Division of Immunology, Faculty of Health Science, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Malewe Kolou
- Faculté des Sciences de la Santé, Université de Lomé, Lomé, Togo
| | - Simplice D Karou
- Laboratoire de Microbiologie et de Contrôle de Qualité des Denrées Alimentaires, Unité de Recherche en Immunologie et Immunomodulation (UR2IM), Ecole Supérieure des Techniques Biologiques et Alimentaires (ESTBA), Université de Lomé, Lomé, Togo
| | - William Horsnell
- Division of Immunology, Faculty of Health Science, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.,Wellcome Centre for Infectious Diseases Research in Africa (CIDRI), University of Cape Town, Cape Town, South Africa.,Institute of Microbiology and Infection, University of Birmingham, Birmingham, United Kingdom
| | - Achim Hoerauf
- Institute for Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn (UKB), Bonn, Germany.,German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Bonn, Germany.,German-West African Centre for Global Health and Pandemic Prevention (G-WAC), Partner Site, Bonn, Bonn, Germany
| | - Yaovi Ameyapoh
- Laboratoire de Microbiologie et de Contrôle de Qualité des Denrées Alimentaires, Unité de Recherche en Immunologie et Immunomodulation (UR2IM), Ecole Supérieure des Techniques Biologiques et Alimentaires (ESTBA), Université de Lomé, Lomé, Togo
| | - Laura E Layland
- Institute for Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn (UKB), Bonn, Germany.,German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Bonn, Germany
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18
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Berrada M, Holl R, Ndao T, Benčina G, Dikhaye S, Melhouf A, Chiheb S, Guelzim K. Healthcare resource utilization and costs associated with anogenital warts in Morocco. Infect Agent Cancer 2021; 16:64. [PMID: 34775980 PMCID: PMC8591871 DOI: 10.1186/s13027-021-00403-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 10/31/2021] [Indexed: 12/24/2022] Open
Abstract
Background Human papillomavirus (HPV), primarily genotypes 6 and 11, cause the majority of cases of anogenital warts (AGW). Although benign, AGW are associated with a substantial economic and psychosocial burden. Several vaccines have been developed to prevent HPV. The objective of this study was to describe the epidemiology and healthcare resource utilization of AGW in Morocco, as well as the associated costs of treatment from the public healthcare perspective. Methods This was a descriptive analysis of questionnaire data obtained via a Delphi panel. The panel consisted of 9 physicians practicing in public hospitals in Morocco (4 dermatologists and 5 obstetricians/gynecologists). The questionnaire collected data on physician and practice characteristics, diagnostic tests and procedures, treatments, and follow-up (including recurrence) of patients with AGW. Questionnaire items on which ≥ 70% of respondents agreed were considered as having consensus. Costs associated with diagnosis, treatment, and follow-up were calculated in Moroccan dirham (MAD) and converted to euros (€) based on official national price lists for public hospitals and the HCRU estimates from the questionnaire. Results The physician-estimated prevalence of AGW in Morocco was 1.6%-2.6% in women and 2.0%-5.3% in men. A mean (median) of 6.4 (4) patients per month per physician sought medical attention for AGW. Simple observation was the most common diagnostic method for AGW in both men and women, and excision was the most prescribed therapy (75%), requiring a mean of 2 visits. Recurrence occurred in approximately 27% of patients. The cost per case of managing AGW, including recurrence, was estimated at 2182–2872 MAD (€207–272) for women and 2170–2450 MAD (€206–233) for men. The total annual cost of medical consultations for AGW in Morocco ranged from 3,271,877 MAD to 4,253,703 MAD (€310,828–404,102). Conclusions Expert consensus indicates that AGW represent a significant burden to the Moroccan public healthcare system. These data can inform policy makers regarding this vaccine-preventable disease. Supplementary Information The online version contains supplementary material available at 10.1186/s13027-021-00403-1.
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Affiliation(s)
| | | | | | - Goran Benčina
- Center for Observational and Real-World Evidence, MSD, Madrid, Spain
| | - Siham Dikhaye
- Department of Dermatology, Mohammed VI University Hospital of Oujda, Oujda, Morocco.,Laboratory of Epidemiology, Clinical Research and Public Health, Faculty of Medicine and Pharmacy, Mohammed the First University of Oujda, Oujda, Morocco
| | - Abdelilah Melhouf
- Department of Gynecology - Obstetrics, Faculty of Medicine and Pharmacy Hassan II, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Soumiya Chiheb
- Department of Dermatology, University Hospital Ibn Rochd of Casablanca, Casablanca, Morocco
| | - Khalid Guelzim
- Department of Gynecology and Obstetrics, Military and Training Hospital Mohammed V, Rabat, Morocco
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19
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Lafferty L, Smith K, Causer L, Andrewartha K, Whiley D, Badman SG, Donovan B, Anderson L, Tangey A, Mak D, Maher L, Shephard M, Guy R. Scaling up sexually transmissible infections point-of-care testing in remote Aboriginal and Torres Strait Islander communities: healthcare workers' perceptions of the barriers and facilitators. Implement Sci Commun 2021; 2:127. [PMID: 34743760 PMCID: PMC8572571 DOI: 10.1186/s43058-021-00232-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 10/26/2021] [Indexed: 11/30/2022] Open
Abstract
Background Sexually transmissible infections (STIs), such as gonorrhoea and chlamydia, are highly prevalent, particularly in remote Aboriginal and Torres Strait Islander communities in Australia. In these settings, due to distance to centralised laboratories, the return of laboratory test results can take a week or longer, and many young people do not receive treatment, or it is considerably delayed. Point-of-care testing (POCT) provides an opportunity for same day diagnosis and treatment. Molecular POC testing for STIs was available at 31 regional or remote primary health care clinic sites through the Test-Treat-And-GO (TANGO2) program. This qualitative study sought to identify barriers and facilitators to further scaling up STI POCT in remote Aboriginal communities within Australia. Methods A total of 15 healthcare workers (including nurses and Aboriginal health practitioners) and five managers (including clinic coordinators and practice managers) were recruited from remote health services involved in the TTANGO2 program to participate in semi-structured in-depth interviews. Health services’ clinics were purposively selected to include those with high or low STI POCT uptake. Personnel participants were selected via a hybrid approach including nomination by clinic managers and purposive sampling to include those in roles relevant to STI testing and treatment and those who had received TTANGO2 training for POCT technology. Milat’s scaling up guide informed the coding framework and analysis. Results Acceptability of STI POCT technology among healthcare workers and managers was predominantly influenced by self-efficacy and perceived effectiveness of POCT technology as well as perceptions of additional workload burden associated with POCT. Barriers to integration of STI POCT included retention of trained staff to conduct POCT. Patient reach (including strategies for patient engagement) was broadly considered an enabler for STI testing scale up using POCT technology. Conclusions Remote healthcare clinics should be supported by both program and clinic management throughout scaling up efforts to ensure broad acceptability of STI POCT as well as addressing local health systems’ issues and identifying and enhancing opportunities for patient engagement. Supplementary Information The online version contains supplementary material available at 10.1186/s43058-021-00232-8.
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Affiliation(s)
- Lise Lafferty
- The Kirby Institute, UNSW Sydney, Sydney, NSW, 2052, Australia. .,Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2052, Australia.
| | - Kirsty Smith
- The Kirby Institute, UNSW Sydney, Sydney, NSW, 2052, Australia
| | - Louise Causer
- The Kirby Institute, UNSW Sydney, Sydney, NSW, 2052, Australia
| | - Kelly Andrewartha
- Flinders University International Centre for Point-of-Care Testing, Flinders University, Adelaide, SA, 5042, Australia
| | - David Whiley
- University of Queensland, Brisbane, QLD 4006, Australia
| | - Steven G Badman
- The Kirby Institute, UNSW Sydney, Sydney, NSW, 2052, Australia
| | - Basil Donovan
- The Kirby Institute, UNSW Sydney, Sydney, NSW, 2052, Australia
| | | | - Annie Tangey
- The Kirby Institute, UNSW Sydney, Sydney, NSW, 2052, Australia.,Ngaanyatjarra Health Service, Alice Springs, NT, 0870, Australia
| | - Donna Mak
- Department of Health, Western Australia, East Perth, WA, 6004, Australia.,School of Medicine, University of Notre Dame Australia, Fremantle, WA, 6160, Australia
| | - Lisa Maher
- The Kirby Institute, UNSW Sydney, Sydney, NSW, 2052, Australia.,Burnet Institute, Melbourne, VIC, 3004, Australia
| | - Mark Shephard
- Flinders University International Centre for Point-of-Care Testing, Flinders University, Adelaide, SA, 5042, Australia
| | - Rebecca Guy
- The Kirby Institute, UNSW Sydney, Sydney, NSW, 2052, Australia
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20
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Mabaso N, Abbai NS. A review on Trichomonas vaginalis infections in women from Africa. S Afr J Infect Dis 2021; 36:254. [PMID: 34485502 PMCID: PMC8377975 DOI: 10.4102/sajid.v36i1.254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 04/13/2021] [Indexed: 12/02/2022] Open
Abstract
Background Trichomoniasis is the most common sexually transmitted infection (STI) with an estimated annual incidence of 276.4 million cases globally and about 30 million cases in sub-Saharan Africa. Trichomoniasis has been found to be associated with various health complications including pelvic inflammatory disease (PID), significant pregnancy complications, cervical cancer, prostatitis, infertility and the acquisition of human immunodeficiency virus (HIV). Aim Despite being a highly prevalent infection in the African continent, there is no review article published that solely focusses on Trichomonas vaginalis (T. vaginalis) infections in women from Africa. This review aims to fill this gap in the literature. Method An electronic search of online databases was used to identify and extract relevant research articles related to the epidemiology, health complications and treatment associated with T. vaginalis in women from Africa. Results Within the African continent, South Africa has reported the highest prevalence rate for this infection. A combination of sociodemographic, behavioural and biological factors has been shown to be associated with infection. Trichomonas vaginalis infection is associated with the acquisition of HIV, cervical cancer and PIDs in various female populations across the continent. Emerging patterns of resistance to metronidazole have been reported in women from South Africa. Currently, there is no effective vaccine against this pathogen despite efforts at vaccine development. Conclusion Based on the high prevalence and health consequences associated with T. vaginalis, there is a need for improved screening programmes that will lead to early diagnosis, detection of asymptomatic infections and effective treatment regimens.
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Affiliation(s)
- Nonkululeko Mabaso
- School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Nathlee S Abbai
- School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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21
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Self-reported syndromes of sexually transmitted infections and its associated factors among reproductive (15-49 years) age women in Ethiopia. Heliyon 2021; 7:e07524. [PMID: 34401559 PMCID: PMC8353284 DOI: 10.1016/j.heliyon.2021.e07524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 06/05/2021] [Accepted: 07/06/2021] [Indexed: 11/22/2022] Open
Abstract
Background Sexually Transmitted Infections (STIs) are among the most important causes of maternal and neonatal morbidity and mortality. It remains a significant public health problem and disproportionately affects women posing a large public health burden in low and middle-income countries. However, there is little information on the magnitude of self-reported syndromes of STIs among reproductive-age women in Ethiopia. Aim This study aimed to determine the magnitude of self-reported syndromes of sexual transmitted infections and its associated factors among women of reproductive age in Ethiopia. Methods The study was based on the data from the Ethiopian Demographic Health Survey of 2016. The data on the status of self-reported STIs were extracted from the individual women dataset, and a total of 15,683 reproductive-age women were involved in the study. Since the data has a hierarchical and cluster nature sampling weight was applied for all analysis procedures to account for complex survey design. Rao-scot chi-square test that adjusts for complex sample design was used to examine the association of outcome and independent variables. In, multivariable analysis, the level of statistical significance was declared at P-value ≤ 0.05. Findings and conclusions The magnitude of self-reported STIs was 3.0 % (95% CI: 2.92–3.08). Among self-reported syndromes of STIs only, 33.3 % (158) seek care for sexually transmitted infections. Age (Adjusted Odds Ratio (AOR = 2.15; 95%CI:1.4, 3.4)), marital status (AOR = 1.72; 95%CI:1.02, 2.90), women attending higher education and above (AOR = 2.67; 95%CI:1.57,4.57), history of termination of pregnancy (AOR = 2.85; 95%CI:2.0,4.08), and risky sexual behavior (AOR = 1.72; 95%CI:1.02,2.90) were found to be associated with self-reported syndrome of sexually transmitted infections. The magnitude of self-reported syndromes of STI and health care seeking behaviors among reproductive-age women was found low. Therefore, the government should enhance the awareness of women for sexually transmitted syndromes, and increase accessibility of STI services. Moreover, qualitative studies should be done to identify the demand, supply, and barriers related to STI among women of reproductive age women in Ethiopia.
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22
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Yosef T. Sexually transmitted infection associated syndromes among pregnant women attending antenatal care clinics in southwest Ethiopia. Heliyon 2021; 7:e07576. [PMID: 34345743 PMCID: PMC8319023 DOI: 10.1016/j.heliyon.2021.e07576] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 04/22/2021] [Accepted: 07/12/2021] [Indexed: 11/30/2022] Open
Abstract
Background Sexually transmitted infections (STIs) are widely reported in pregnant women in Africa and can cause significant maternal and perinatal morbidity. The availability of epidemiologic data on STIs and their associated factors in pregnant women is critical to developing effective prevention strategies. Therefore, this study aimed to assess the prevalence and factors associated with sexually transmitted infection-associated syndromes among pregnant women attending antenatal care clinics at selected public health facilities in southwest Ethiopia. Methods A cross-sectional study was carried out with 303 pregnant women who attended ANC between November 1 and 30, 2018. The consecutive sampling technique was employed until the required sample size was reached. The data were collected using a structured and pre-tested questionnaire. Bi-variable and multivariate logistic regressions were used to identify independent variables associated with the outcome of interest. The level of significance was declared at a p-value < 0.05. Results Of the 303 respondents surveyed, STI-associated syndromes had a prevalence of 19.1% (95% CI: 14.7%–23.5%). Nearly one-tenth (8.9%) of the respondents had vaginal discharge syndrome followed by lower abdominal or pelvic pain (7.6%). The study also found that being unmarried (AOR = 5.61, 95% CI [2.34–9.36]), not formally educated (AOR = 2.24, 95% CI [1.58–3.86]), having multiple sexual partners in the past 3 months (AOR = 3.93, 95% CI [1.44–5.23]), history of spontaneous abortion (AOR = 4.48, 95% CI [2.21–7.72]), and history of STI (AOR = 3.76, 95% CI [2.24–6.46]) were the factors associated with STI-associated syndromes. Conclusion The prevalence of STI-associated syndromes among respondents was 19.1%. The study found that being unmarried, not formally educated, having multiple sexual partners, history of spontaneous abortion, and history of STI were largely accountable for the occurrence of STI-associated syndromes in the study sample. Therefore, in addition to the one-time assessment of HIV and syphilis at the first ANC visit, there is a need to emphasize the syndromic approach diagnosis of STIs among pregnant women during each ANC visit to reduce and ultimately prevent both vertical and horizontal transmissions of STIs.
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Affiliation(s)
- Tewodros Yosef
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan Teferi, Ethiopia
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23
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Belfort IKP, Cunha APA, Mendes FPB, Galvão-Moreira LV, Lemos RG, de Lima Costa LH, Monteiro P, Ferreira MB, Dos Santos GRB, Costa JL, de Sá Ferreira A, Brito LGO, Brito LMO, Vidal FCB, Monteiro SCM. Trichomonas vaginalis as a risk factor for human papillomavirus: a study with women undergoing cervical cancer screening in a northeast region of Brazil. BMC WOMENS HEALTH 2021; 21:174. [PMID: 33892709 PMCID: PMC8066958 DOI: 10.1186/s12905-021-01320-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 04/19/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Human papillomavirus (HPV) and Trichomonas vaginalis (TV) infections are the most common sexually transmitted infections (STIs) globally. The latter has contributed to a variety of adverse outcomes for both sexes. Moreover, in Brazil, epidemiological studies on patients with STIs are limited. Therefore, this study aimed to determine the prevalence of TV and its association with HPV in women undergoing cervical cancer screening. METHODS Women with a normal cervix were recruited from a community-based cervical cancer screening program. Gynecological examinations were conducted, and questionnaires were provided. Vaginal canal and uterine cervix samples were collected for cytological examinations (reported using the 2001 Bethesda System) and tested for the presence of TV and HPV DNA. RESULTS In total, 562 women who attended public primary healthcare were included in the study. The T. vaginalis was present in 19.0% (107) and HPV DNA was present in 46.8% (263) of women. Among the women of TV 73.8% (79) had a co-infection with HPV (p = 0.001). CONCLUSIONS We concluded that a TV infection is associated with an HPV infection of the cervix as well as with the cervical cytological abnormalities. Further studies could reveal the mechanisms by which these two organisms interact at the cellular level, with control for shared behavioral risk factors.
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Affiliation(s)
- Ilka Kassandra Pereira Belfort
- Doctoral Program in Biotechnology - Northeast Biotechnology Network (RENORBIO), Federal University of Maranhão (UFMA), Rua 4 Quadra 9 Casa 3 Residencial Primavera, São Luis, MA, 65052-850, Brazil.
| | | | | | | | - Renata Gaspar Lemos
- Department of Pharmacy, Federal University of Maranhão (UFMA), São Luís, MA, Brazil
| | | | - Pablo Monteiro
- Department of Pharmacy, Federal University of Maranhão (UFMA), São Luís, MA, Brazil
| | | | | | - Joyce Leal Costa
- Postgraduate Program in Adult Health, Federal University of Maranhão, São Luís, MA, Brazil
| | - Alice de Sá Ferreira
- Postgraduate Program in Adult Health, Federal University of Maranhão, São Luís, MA, Brazil
| | - Luiz Gustavo Oliveira Brito
- Department of Tocogynecology (DTG), Faculty of Medical Sciences (FCM), State University of Campinas (UNICAMP), Campinas, Brazil
| | | | | | - Sally Cristina Moutinho Monteiro
- Postgraduate Program in Adult Health, Federal University of Maranhão, São Luís, MA, Brazil.,Department of Pharmacy, Federal University of Maranhão (UFMA), São Luís, MA, Brazil
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24
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Semwogerere M, Dear N, Tunnage J, Reed D, Kibuuka H, Kiweewa F, Iroezindu M, Bahemana E, Maswai J, Owuoth J, Crowell TA, Ake JA, Polyak CS, Esber A. Factors associated with sexually transmitted infections among care-seeking adults in the African Cohort Study. BMC Public Health 2021; 21:738. [PMID: 33863295 PMCID: PMC8052711 DOI: 10.1186/s12889-021-10762-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 04/01/2021] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVES Sexually transmitted infections (STIs) are a major cause of morbidity. Understanding drivers of transmission can inform effective prevention programs. We describe STI prevalence and identify factors associated with STIs in four African countries. METHODS The African Cohort Study is an ongoing, prospective cohort in Kenya, Nigeria, Tanzania and Uganda. At enrollment, a physical exam was conducted and STI diagnosis made by a clinician using a syndromic management approach. Multivariable logistic regression was used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) for factors associated with an STI diagnosis. RESULTS As of June 2020, 3544 participants were enrolled. STI prevalence was 7.7% and did not differ by HIV status (p = 0.30). Prevalence differed by syndrome (3.5% vaginal discharge, 1.5% genital ulcer, 2.1% lower abdominal pain, 0.2% inguinal bubo). The odds of having an STI were higher at all sites compared to Kisumu West, Kenya, and among those with a primary level education or below compared to those with secondary or higher (aOR: 1.77; 95% CI: 1.32-2.38). The odds of an STI diagnosis was higher among participants 18-29 years (aOR: 2.29; 95% CI: 1.35-3.87), females (aOR: 2.64; 95% CI: 1.94-3.59), and those with depression (aOR: 1.78; 95% CI: 1.32-2.38). Among PLWH, similar factors were independently associated with an STI diagnosis. Viral suppression was protective against STIs (aOR: 2.05; 95% CI: 1.32-3.20). CONCLUSIONS Prevalence of STIs varied by site with young people and females most at risk for STIs. Mental health is a potential target area for intervention.
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Affiliation(s)
| | - Nicole Dear
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Joshua Tunnage
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Domonique Reed
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Hannah Kibuuka
- Makerere University Walter Reed Project, Kampala, Uganda
| | - Francis Kiweewa
- Strengthening Institutional Capacity for Research Administration (SICRA), Makerere University Lung Institute, Kampala, Uganda
| | - Michael Iroezindu
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- HJF Medical Research International, Abuja, Nigeria
| | - Emmanuel Bahemana
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- HJF Medical Research International, Mbeya, Tanzania
| | - Jonah Maswai
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Kenya Medical Research Institute/U.S. Army Medical Research Directorate - Africa/Kenya, Nairobi, Kenya
- HJF Medical Research International, Kericho, Kenya
| | - John Owuoth
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Kenya Medical Research Institute/U.S. Army Medical Research Directorate - Africa/Kenya, Nairobi, Kenya
- HJF Medical Research International, Kisumu, Kenya
| | - Trevor A Crowell
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Julie A Ake
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Christina S Polyak
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Allahna Esber
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA.
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA.
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25
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Aggarwal S, Singh AK, Balaji S, Ambalkar D. Sexually transmitted infections (STIs) and its changing scenario: A scoping review. Comb Chem High Throughput Screen 2021; 25:1630-1638. [PMID: 33645477 DOI: 10.2174/1386207324666210301093001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 01/28/2021] [Accepted: 02/18/2021] [Indexed: 11/22/2022]
Abstract
Sexually transmitted infections (STIs) and reproductive tract infections (RTIs) have existed worldwide since ancient time, causing significant morbidity and mortality. To maintain healthy sexual and reproductive life, it is highly essential to prevent STIs, RTIs and related illnesses. STIs are transmitted by swapping body fluids among people during sexual intercourse. The etiological agents for STIs are bacteria, virus and parasites for most cases, but proportions by different aetiology are changing. Various studies have shown that STIs are increasing, and its primary aetiology is changing worldwide. That should be considered seriously and needs necessary actions. Several factors related to hosts and disease-causing agents have identified to influence STIs' current strategies in the prevention and control program. The present assessment attempts to review the history, changing aetiology and antimicrobial resistance in STIs. This review has also highlighted the prevalence of STIs at the global level and their past and present trends in India, emphasising its future challenges and perspectives for making effective public health policies to prevent and control STIs.
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Affiliation(s)
- Sumit Aggarwal
- Epidemiology and Communicable Diseases Division, Indian Council of Medical Research-Headquarters, Ansari Nagar, New Delhi-110029. India
| | - Amit Kumar Singh
- ICMR-National JALMA Institute for Leprosy and other Mycobacterial diseases, Tajgani, Agra-282004. India
| | - Sivaraman Balaji
- Epidemiology and Communicable Diseases Division, Indian Council of Medical Research-Headquarters, Ansari Nagar, New Delhi-110029. India
| | - Deepti Ambalkar
- Department of lab medicine, Max Super speciality hospital, Saket Delhi -110017. India
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26
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Zango SH, Lingani M, Valea I, Samadoulougou OS, Bihoun B, Rouamba T, Derra K, Rouamba E, Donnen P, Dramaix M, Tinto H, Robert A. Malaria and curable sexually transmitted infections in pregnant women: A two-years observational study in rural Burkina Faso. PLoS One 2020; 15:e0242368. [PMID: 33196665 PMCID: PMC7668607 DOI: 10.1371/journal.pone.0242368] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 10/30/2020] [Indexed: 01/26/2023] Open
Abstract
Background Malaria and curable sexually transmitted infections (STI) are the most common curable infections known to have a severe impact on pregnancy outcomes in sub-Saharan Africa. This study aims to assess the marginal and joint prevalence of symptomatic cases of malaria and STI in pregnant women living in rural settings of Burkina Faso and their associated factors, after more than a decade of the introduction of intermittent preventive treatment (IPT-SP). Methods We carried out an observational study in two health districts in rural Burkina, namely Nanoro and Yako. Routine data were collected during antenatal and delivery visits for all women who delivered in the year 2016 and 2017. Logistic regression models were used to assess factors associated with infections. Results We collected data from 31639 pregnant women attending health facilities. Malaria, curable STI and their coinfections were diagnosed in 7747 (24.5%; 95%CI: 24.0–25.0%), 1269 (4.0%; 95%CI: 3.8–4.2%) and 388 (1.2%; 95%CI: 1.1–1.4%) women, respectively. In multivariate logistic regression, malaria occurrence was significantly higher in pregnant women < 20 years (Adjusted OR = 2.36; 95% CI: 2.07–2.69) than in women ≥30 years. The prevalence of curable STI was also significantly higher in students (Adjusted OR = 1.93; 95% CI: 1.26–2.95) and compensated workers (Adjusted OR = 1.52; 95% CI: 1.01–2.17) than in uncompensated workers. Women who received no IPT-SP had higher prevalence of malaria (Adjusted OR = 3.33; 95%CI: 3.00–3.70), curable STI (Adjusted OR = 1.96 95%CI: 1.60–2.39) and coinfections (Adjusted OR = 2.11; 95% CI: 1.50–2.95) compared to women who received SP. Conclusion Malaria and curable STI remain highly prevalent in rural settings of Burkina Faso, with young pregnant women and women who received no IPT-SP being the most affected. Prevention must be reinforced to improve maternal and infant health.
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Affiliation(s)
- Serge Henri Zango
- Pôle d’Epidémiologie et biostatistique, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain (UCLouvain), Brussels, Belgique
- Institut de Recherche en Sciences de la Santé, Direction Régionale du Centre Ouest (IRSS/DRCO), Bobo-Dioulasso, Burkina Faso
- Centre MURAZ, Institut National de Santé Publique (INSP), Bobo-Dioulasso, Burkina Faso
- * E-mail: ,
| | - Moussa Lingani
- Institut de Recherche en Sciences de la Santé, Direction Régionale du Centre Ouest (IRSS/DRCO), Bobo-Dioulasso, Burkina Faso
- École de santé publique, Université Libre de Bruxelles, Bruxelles, Belgique
| | - Innocent Valea
- Institut de Recherche en Sciences de la Santé, Direction Régionale du Centre Ouest (IRSS/DRCO), Bobo-Dioulasso, Burkina Faso
- Centre MURAZ, Institut National de Santé Publique (INSP), Bobo-Dioulasso, Burkina Faso
| | - Ouindpanga Sékou Samadoulougou
- Pôle d’Epidémiologie et biostatistique, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain (UCLouvain), Brussels, Belgique
| | - Biebo Bihoun
- Pôle d’Epidémiologie et biostatistique, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain (UCLouvain), Brussels, Belgique
- Institut de Recherche en Sciences de la Santé, Direction Régionale du Centre Ouest (IRSS/DRCO), Bobo-Dioulasso, Burkina Faso
| | - Toussaint Rouamba
- Institut de Recherche en Sciences de la Santé, Direction Régionale du Centre Ouest (IRSS/DRCO), Bobo-Dioulasso, Burkina Faso
- École de santé publique, Université Libre de Bruxelles, Bruxelles, Belgique
| | - Karim Derra
- Institut de Recherche en Sciences de la Santé, Direction Régionale du Centre Ouest (IRSS/DRCO), Bobo-Dioulasso, Burkina Faso
| | - Eli Rouamba
- Institut de Recherche en Sciences de la Santé, Direction Régionale du Centre Ouest (IRSS/DRCO), Bobo-Dioulasso, Burkina Faso
| | - Phillipe Donnen
- École de santé publique, Université Libre de Bruxelles, Bruxelles, Belgique
| | - Michele Dramaix
- École de santé publique, Université Libre de Bruxelles, Bruxelles, Belgique
| | - Halidou Tinto
- Institut de Recherche en Sciences de la Santé, Direction Régionale du Centre Ouest (IRSS/DRCO), Bobo-Dioulasso, Burkina Faso
- Centre MURAZ, Institut National de Santé Publique (INSP), Bobo-Dioulasso, Burkina Faso
| | - Annie Robert
- Pôle d’Epidémiologie et biostatistique, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain (UCLouvain), Brussels, Belgique
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Davis R, Xiong X, Althabe F, Lefante J, Cafferata ML, Mwenechanya M, Mwanakalanga FH, Chomba E, Buekens P. Factors associated with HIV and syphilis screenings among pregnant women at first antenatal visit in Lusaka, Zambia. BMC Res Notes 2020; 13:423. [PMID: 32894196 PMCID: PMC7487891 DOI: 10.1186/s13104-020-05266-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 09/01/2020] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To identify characteristics associated with obtaining HIV and syphilis screenings of pregnant women attending a first antenatal visit in Lusaka, Zambia. RESULTS Among 18,231 participants from April 2015 to January 2016, 95% obtained HIV screening, 29% obtained syphilis screening, and 4% did not obtain antenatal HIV or syphilis screenings. Divorced/separated women were associated with a moderate decrease in prevalence of obtaining HIV (adjusted prevalence ratio (aPR) 0.88, 95% confidence interval (95% CI) 0.82, 0.95) and syphilis (aPR 0.51, 95% CI 0.27, 0.96) screenings compared to married women. Women with previous pregnancies were associated with a slight decrease in prevalence of obtaining HIV screening (aPR 0.97, 95% CI 0.95, 0.99) compared to women without previous pregnancy. Older women ≥ 35 years were associated with a slight decrease in prevalence of obtaining HIV screening (aPR 0.96, 95% CI 0.92, 0.99) compared to younger women. The statistically significant differences were not of clinical relevance as defined by a proportional difference of 10 percent. Findings of this study show that a vast majority of pregnant women are obtaining HIV screenings but not syphilis screenings during first antenatal visit. Provision of antenatal HIV and syphilis screening at first visit is only weakly related to patient level factors.
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Affiliation(s)
- Rindcy Davis
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
- , New York, USA.
| | - Xu Xiong
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Fernando Althabe
- Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| | - John Lefante
- Department of Global Biostatistics and Data Science, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | | | | | | | | | - Pierre Buekens
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
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Solomon H, Moraes AN, Williams DB, Fotso AS, Duong YT, Ndongmo CB, Voetsch AC, Patel H, Lupoli K, McAuley JB, Mulundu G, Kasongo W, Mulenga L. Prevalence and correlates of active syphilis and HIV co-Infection among sexually active persons aged 15-59 years in Zambia: Results from the Zambia Population-based HIV Impact Assessment (ZAMPHIA) 2016. PLoS One 2020; 15:e0236501. [PMID: 32706823 PMCID: PMC7380641 DOI: 10.1371/journal.pone.0236501] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 07/07/2020] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES The main objectives of the study are to estimate HIV prevalence, active syphilis prevalence, and correlates of co-infection with HIV in Zambia, among recently sexually active individuals aged 15 to 59 years old. METHODS We used data from the 2016 Zambia Population-based HIV Impact Assessment (ZAMPHIA), a national household survey that included biomarker testing for HIV and syphilis. Chembio DPP® Syphilis Screen and Confirm Assay was used to distinguish between active and older syphilis infections. This is the first time Chembio DPP® has been used in a national survey. Log-binominal modelling was utilized to understand the risk of acquiring HIV/active syphilis co-infection using select socio-demographic and sexual behavior variables. Multivariable analysis compared those with co-infection and those with no infection. All reported results account for the complex survey design and are weighted. RESULTS A total of 19,114 individuals aged 15-59 years responded to the individual interview and had a valid syphilis and/or HIV test. The prevalence for those sexually active in the 12 months preceding ZAMPHIA 2016 was 3.5% and 13% for active syphilis and HIV, respectively. The prevalence of HIV/active syphilis co-infection was 1.5%. Factors associated with higher prevalence of co-infection versus no infection among females included, but were not limited to, those living in urban areas (adjusted prevalence ratio (aPR) = 3.0, 95% CI = 1.8, 4.8), those had sexual intercourse before age 15 years (aPR = 1.8, 95% CI = 1.1, 2.9), and those who had two or more sexual partners in the 12 months preceding the survey (aPR = 2.7, 95% CI = 1.6, 4.7). CONCLUSION These findings show high prevalence for both mono-infection with HIV and syphilis, as well as co-infection with HIV/active syphilis in Zambia. There is a need for better screening and partner services, particularly among those engaging in high-risk sexual behaviors (e.g., engaging in transactional sex).
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Affiliation(s)
- Hiwote Solomon
- Doctor of Public Health Program, School of Public Health, Boston University, Boston, MA, United States of America
- Ministry of Health Zambia, Ndeke House, Lusaka, Zambia
- National Health Research Authority, Lusaka, Zambia
| | - Albertina Ngomah Moraes
- Ministry of Health Zambia, Ndeke House, Lusaka, Zambia
- Zambia National Public Health Institute, Lusaka, Zambia
| | - Daniel B. Williams
- Division of Global HIV & TB, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Arlette Simo Fotso
- DPS University of the Witwatersrand, Johannesburg, South Africa
- ICAP at Columbia University, Mailman School of Public Health, Pretoria, South Africa
| | - Yen T. Duong
- ICAP at Columbia University, Mailman School of Public Health, New York, NY, United States of America
| | - Clement B. Ndongmo
- USAID Global Health Supply Chain Program, United States Agency for International Development, Arlington, Virginia, United States of America
| | - Andrew C. Voetsch
- Division of Global HIV & TB, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Hetal Patel
- Division of Global HIV & TB, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Kathryn Lupoli
- Division of Global HIV & TB, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - James B. McAuley
- Rush University Medical Center, Chicago, Illinois, United States of America
| | - Gina Mulundu
- University Teaching Hospital, Lusaka, Zambia
- School of Medicine, University of Zambia, Lusaka, Zambia
| | | | - Lloyd Mulenga
- Ministry of Health Zambia, Ndeke House, Lusaka, Zambia
- University Teaching Hospital, Lusaka, Zambia
- School of Medicine, University of Zambia, Lusaka, Zambia
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Salia JG, Sidat M, Dias SF, Martins MRO, Craveiro I. High Mobility and STIs/HIV among Women Informal Cross Border Traders in Southern Mozambique: Exploring Knowledge, Risk Perception, and Sexual Behaviors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17134724. [PMID: 32630097 PMCID: PMC7369930 DOI: 10.3390/ijerph17134724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 06/13/2020] [Accepted: 06/16/2020] [Indexed: 11/16/2022]
Abstract
High circular mobility creates vulnerability and elevates risk for sexually transmitted infections (STIs) including Human Immunodeficiency Virus (HIV). We aim to explore knowledge, perceptions of risk, and sexual behaviors in relation to STIs/HIV, in Mozambican women involved in an informal cross border trade (ICBT) and residing in South Mozambique. A cross-sectional quantitative study, in 200 women cross border traders (WICBT), affiliated to the Mukhero Association, using a structured, face-to-face questionnaire, was conducted. Descriptive statistics and Pearson’s Chi-square test were used. The median age of participants was 37.0 years (interquartile range (IQR): 31.0–43.0), 100% were literate, travelled on average six times a month. WICBT with a high education level were more likely to have awareness of Gonorrhea, Syphilis, and Candidiasis; to self-perceive being at risk of getting HIV, Syphilis, and Human Papilloma Virus (HPV); and to test for HIV and Syphilis. Those with a low education level were more likely to have misconceptions about HIV and ever have sex in exchange for money/goods/services. Married participants were more likely to know how to prevent HIV. Participants with a high income were more likely to know about HPV; to self-perceive being at risk of getting Syphilis; to point sex workers as being at higher risk of getting HPV; and to ever test for HIV. WICBT with a low income were more likely to have sex in exchange for money/goods/services. Low and inconsistent knowledge and misconceptions of STIs/HIV, high sexual risky behavior, low perception of risk of getting STIs/HIV among this neglected and key population suggests their increased vulnerability to the STIs/HIV.
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Affiliation(s)
- Joana G Salia
- Instituto Superior de Ciências de Saúde—ISCISA, 0101 Maputo, Mozambique
- International Public Health and Biostatistics Unit, Institute of Hygiene and Tropical Medicine, NOVA, University of Lisbon, 1349-008 Lisbon, Portugal; (M.S.); (M.R.O.M.); (I.C.)
- Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade NOVA de Lisboa, UNL, 1349-008 Lisboa, Portugal
- Correspondence: ; Tel.: +258-846-882-229
| | - Mohsin Sidat
- International Public Health and Biostatistics Unit, Institute of Hygiene and Tropical Medicine, NOVA, University of Lisbon, 1349-008 Lisbon, Portugal; (M.S.); (M.R.O.M.); (I.C.)
- Faculty of Medicine, Eduardo Mondlane University, 0101 Maputo, Mozambique
| | - Sónia F Dias
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa & Comprehensive Health Research Center (CHRC), 1600-560 Lisboa, Portugal;
| | - Maria R O Martins
- International Public Health and Biostatistics Unit, Institute of Hygiene and Tropical Medicine, NOVA, University of Lisbon, 1349-008 Lisbon, Portugal; (M.S.); (M.R.O.M.); (I.C.)
- Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade NOVA de Lisboa, UNL, 1349-008 Lisboa, Portugal
| | - Isabel Craveiro
- International Public Health and Biostatistics Unit, Institute of Hygiene and Tropical Medicine, NOVA, University of Lisbon, 1349-008 Lisbon, Portugal; (M.S.); (M.R.O.M.); (I.C.)
- Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade NOVA de Lisboa, UNL, 1349-008 Lisboa, Portugal
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Majzoobi MM, Sobhan MR, Zamani M, Moradi A, Khosravi S, Saadatmand A. The Prevalence of Human Immunodeficiency Virus Infection in Patients with Sexually Transmitted Diseases. Adv Biomed Res 2020; 9:11. [PMID: 32318360 PMCID: PMC7147514 DOI: 10.4103/abr.abr_233_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 01/08/2020] [Accepted: 01/28/2020] [Indexed: 11/05/2022] Open
Abstract
Background: Human immunodeficiency virus (HIV) transmission pattern in Iran has been changed from injection drug to sexual contact. Lack of accurate assessment of HIV in people with sexually transmitted diseases (STDs) in Iran prompted us to conduct this study to determine the frequency of HIV infection in these patients. Materials and Methods: In this cross-sectional study which conducted in 2016–2017, overall, 190 patients with STDs referring to two hospitals of Hamadan were enrolled in the study. All of the patients were examined for HIV in the first visit by rapid test and then 1 and 4 months later by the 4th generation ELISA. A questionnaire including demographic data, clinical manifestations, and high-risk behaviors was completed for all of the referring people. The collected data were analyzed using appropriate statistical tests. Results: Of 190 patients, 126 (66.3%) were female with a mean age of 34.1 ± 10.1 years and 64 (33.7%) were male with a mean age of 30.8 ± 7.8 years. One hundred twenty-eight (67.4%) got married, 73 (38.4%) and 76 (40%) had a diploma and postgraduate education, respectively, 32 (16.8%) mentioned the history of unsafe sex, and 23 (12.1%) had used condoms continuously during sexual contacts. The most common STDs were reported genital warts, 107 patients (56.3%), vaginal discharge (28, 14.7%), and genital ulcer (33, 17.4%). Two (1%) patients were positive for HIV at the first visit. Conclusion: Patients with STDs should be considered as an important source of HIV transmission, so clinicians should pay more attention to screening these patients for HIV infection.
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Affiliation(s)
- Mohammad Mahdi Majzoobi
- Department of Infectious Diseases, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.,Brucellosis Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohammad Reza Sobhan
- Psoriasis Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.,Department of Dermatology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mehrangiz Zamani
- Department of Obstetrics and Gynecology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Abbas Moradi
- Department of Community Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Sahar Khosravi
- Department of Infectious Diseases, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ali Saadatmand
- Brucellosis Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
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Jasumback CL, Perry SH, Ness TE, Matsenjwa M, Masangane ZT, Mavimbela M, Mthethwa N, Dlamini L, Mphaya J, Kirchner HL, Mandalakas A, Kay AW. Point-of-Care Testing to Guide Treatment and Estimate Risk Factors for Sexually Transmitted Infections in Adolescents and Young People With Human Immunodeficiency Virus in Eswatini. Open Forum Infect Dis 2020; 7:ofaa052. [PMID: 32190707 PMCID: PMC7071112 DOI: 10.1093/ofid/ofaa052] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 02/11/2020] [Indexed: 12/27/2022] Open
Abstract
Background The World Health Organization (WHO) estimates 127 million new cases of Chlamydia trachomatis (CT), 87 million new cases of Neisseria gonorrhea (NG), and 156 million new cases of Trichomonas vaginalis (TV) each year, which corresponds to 355 (219-606), 303 (216-468), and 243 (97.6-425) thousand disability-adjusted life-years. In low-resource settings, however, sexually transmitted infections (STIs) are treated syndromically and many individuals with asymptomatic infection may be missed, especially adolescents and young adults with human immunodeficiency virus (HIV). Methods We enrolled patients aged 15-24 with HIV (N = 300) attending a family-centered HIV clinic in Mbabane, Eswatini. Participants completed a sexual history questionnaire and provided urine as well as oropharyngeal and/or vaginal swabs, if sexually active, for testing with Xpert CT/NG and TV tests. Analysis included bivariate and multivariate odds ratios and test sensitivity and specificity. Results Sexually transmitted infection rates were highest (25.0%; 95% confidence interval [CI], 15.2-37.3) in females ages 20-24 who were ever sexually active. In patients with confirmed STIs, NG (15 of 32, 47%) was more common than CT (9 of 32, 28%) and TV (8 of 32, 25%). Syndromic screening alone had a sensitivity of 32.0% (95% CI, 14.9-53.3) and specificity of 86.0% (95% CI, 79.0-91.4) but varied by gender. The presence of an STI was associated with reporting new sexual partner(s) (OR = 2.6; 95% CI, 1.1-6.4), sometimes to never using condoms (OR = 4.2; 95% CI, 1.7-10.2), most recent sexual partner >25 years old (OR = 3.2; 95% CI, 1.3-7.9), and HIV diagnosis at age ≥15 years (OR = 3.4; 95% CI, 1.4-8.2). Conclusions Syndromic screening alone performed poorly. Routine diagnostic testing significantly increases STI detection and should be considered in high-risk populations, such as adolescents and young adults with HIV.
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Affiliation(s)
- Caitlyn L Jasumback
- Extension, Community Health, United States Peace Corps, Mbabane, Eswatini.,Baylor College of Medicine Children's Foundation, Mbabane, Eswatini
| | - Sarah H Perry
- Baylor College of Medicine Children's Foundation, Mbabane, Eswatini.,Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Tara E Ness
- Pediatrics, Baylor College of Medicine, Houston, Texas, USA.,Texas Children's Hospital, Houston, Texas, USA
| | - Martha Matsenjwa
- Baylor College of Medicine Children's Foundation, Mbabane, Eswatini
| | | | | | - Nobuhle Mthethwa
- Swaziland National AIDS Program Paediatric ART Advisor, Ministry of Health, Mbabane, Eswatini
| | | | - Joyce Mphaya
- Young Child Survival and Development Program, UNICEF, Mbabane, Eswatini
| | - H Lester Kirchner
- Pediatrics, Baylor College of Medicine, Houston, Texas, USA.,Department of Population Health Sciences, Geisinger, Danville, Pennsylvania, USA
| | | | - Alexander W Kay
- Baylor College of Medicine Children's Foundation, Mbabane, Eswatini.,Pediatrics, Baylor College of Medicine, Houston, Texas, USA
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Rowley J, Vander Hoorn S, Korenromp E, Low N, Unemo M, Abu-Raddad LJ, Chico RM, Smolak A, Newman L, Gottlieb S, Thwin SS, Broutet N, Taylor MM. Chlamydia, gonorrhoea, trichomoniasis and syphilis: global prevalence and incidence estimates, 2016. Bull World Health Organ 2019; 97:548-562P. [PMID: 31384073 PMCID: PMC6653813 DOI: 10.2471/blt.18.228486] [Citation(s) in RCA: 851] [Impact Index Per Article: 170.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 04/08/2019] [Accepted: 05/03/2019] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To generate estimates of the global prevalence and incidence of urogenital infection with chlamydia, gonorrhoea, trichomoniasis and syphilis in women and men, aged 15-49 years, in 2016. METHODS For chlamydia, gonorrhoea and trichomoniasis, we systematically searched for studies conducted between 2009 and 2016 reporting prevalence. We also consulted regional experts. To generate estimates, we used Bayesian meta-analysis. For syphilis, we aggregated the national estimates generated by using Spectrum-STI. FINDINGS For chlamydia, gonorrhoea and/or trichomoniasis, 130 studies were eligible. For syphilis, the Spectrum-STI database contained 978 data points for the same period. The 2016 global prevalence estimates in women were: chlamydia 3.8% (95% uncertainty interval, UI: 3.3-4.5); gonorrhoea 0.9% (95% UI: 0.7-1.1); trichomoniasis 5.3% (95% UI:4.0-7.2); and syphilis 0.5% (95% UI: 0.4-0.6). In men prevalence estimates were: chlamydia 2.7% (95% UI: 1.9-3.7); gonorrhoea 0.7% (95% UI: 0.5-1.1); trichomoniasis 0.6% (95% UI: 0.4-0.9); and syphilis 0.5% (95% UI: 0.4-0.6). Total estimated incident cases were 376.4 million: 127.2 million (95% UI: 95.1-165.9 million) chlamydia cases; 86.9 million (95% UI: 58.6-123.4 million) gonorrhoea cases; 156.0 million (95% UI: 103.4-231.2 million) trichomoniasis cases; and 6.3 million (95% UI: 5.5-7.1 million) syphilis cases. CONCLUSION Global estimates of prevalence and incidence of these four curable sexually transmitted infections remain high. The study highlights the need to expand data collection efforts at country level and provides an initial baseline for monitoring progress of the World Health Organization global health sector strategy on sexually transmitted infections 2016-2021.
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Affiliation(s)
- Jane Rowley
- Department of Reproductive Health and Research, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Stephen Vander Hoorn
- School of Mathematics and Statistics, University of Melbourne, Melbourne, Australia
| | | | - Nicola Low
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Magnus Unemo
- WHO Collaborating Centre for Gonorrhoea and Other STIs, Örebro University, Örebro, Sweden
| | - Laith J Abu-Raddad
- Department of Healthcare Policy and Research, Weill Cornell Medical College - Qatar, Doha, Qatar
| | - R Matthew Chico
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, England
| | - Alex Smolak
- Department of Healthcare Policy and Research, Weill Cornell Medical College - Qatar, Doha, Qatar
| | - Lori Newman
- Enteric and Sexually Transmitted Infections Branch, National Institute of Allergy and Infectious Diseases, Washington DC, United States of America
| | - Sami Gottlieb
- Department of Reproductive Health and Research, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Soe Soe Thwin
- Department of Reproductive Health and Research, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Nathalie Broutet
- Department of Reproductive Health and Research, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Melanie M Taylor
- Department of Reproductive Health and Research, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
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Diadhiou M, Ba Diallo A, Barry MS, Alavo SC, Mall I, Gassama O, Ndiaye Guèye MD, Ndao Fall A, Gawa E, Gaye Diallo A, Moreau JC. Prevalence and Risk Factors of Lower Reproductive Tract Infections in Symptomatic Women in Dakar, Senegal. Infect Dis (Lond) 2019; 12:1178633719851825. [PMID: 31210732 PMCID: PMC6545636 DOI: 10.1177/1178633719851825] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 04/28/2019] [Indexed: 11/15/2022] Open
Abstract
Background: Lower reproductive tract infections in women are important causes of morbidity but can also lead to complications and sequelae. This study aimed to establish the prevalence and risk factors of lower genital tract infections among women of reproductive age in Dakar (Senegal). Methods: This was a prospective study conducted in 6 maternity hospitals from July to November 2015. Participants ranged in age from 18 to 49 years and presented at health facilities with signs and symptoms of genital infection. Consenting individuals who met the inclusion criteria were recruited for the study. Results: During the reporting period, 276 patients were enrolled. According to the laboratory results, the prevalence of any genital infection was 69.6% (192 of 276). The most common vaginal infections were bacterial vaginosis (39.5%) and vaginal candidiasis (29%), with the third most common cause, trichomoniasis, trailing behind in terms of prevalence (2.5%). Among the microorganisms responsible for cervical infections, Ureaplasma urealyticum was the most frequent (27.5%), followed by Mycoplasma hominis (14.5%), Chlamydia trachomatis (4.7%), and Neisseria gonorrhoeae (1.1%). Multivariate analysis showed that young women and women with low levels of education were at increased risk for vaginal/cervical infections. Conclusions: This study revealed a high prevalence of bacterial vaginosis and vaginal candidiasis and suggests that health care providers should increase awareness and communication to improve vaginal hygiene practices. If infection with Trichomonas vaginalis, C trachomatis or N gonorrhoeae is suspected, we also recommend systematically performing laboratory diagnostic confirmation.
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Affiliation(s)
- Mohamed Diadhiou
- Centre Régional de Formation, de Recherche et de Plaidoyer en Santé de la Reproduction (CEFOREP), Dakar, Sénégal
| | - Awa Ba Diallo
- Laboratoire de Bactériologie-Virologie, CHU Aristide Le Dantec, Dakar, Sénégal
| | - Mamadou Saidou Barry
- SANOFI Afrique Subsaharienne Francophone, Dakar, Sénégal
- Mamadou Saidou Barry, Département Médical, SANOFI Afrique Subsaharienne Francophone, 43 Rue de Ziguinchor, Point E, BP 3529 Dakar, Senegal.
| | | | - Ibrahima Mall
- Centre Régional de Formation, de Recherche et de Plaidoyer en Santé de la Reproduction (CEFOREP), Dakar, Sénégal
| | - Omar Gassama
- Centre Régional de Formation, de Recherche et de Plaidoyer en Santé de la Reproduction (CEFOREP), Dakar, Sénégal
| | - Mame Diarra Ndiaye Guèye
- Centre Régional de Formation, de Recherche et de Plaidoyer en Santé de la Reproduction (CEFOREP), Dakar, Sénégal
| | - Amy Ndao Fall
- SANOFI Afrique Subsaharienne Francophone, Dakar, Sénégal
| | - Epainete Gawa
- SANOFI Afrique Subsaharienne Francophone, Dakar, Sénégal
| | | | - Jean Charles Moreau
- Centre Régional de Formation, de Recherche et de Plaidoyer en Santé de la Reproduction (CEFOREP), Dakar, Sénégal
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Banong-le M, Ofosu SK, Anto F. Factors associated with syphilis infection: a cross-sectional survey among outpatients in Asikuma Odoben Brakwa District, Ghana. BMC Infect Dis 2019; 19:360. [PMID: 31035953 PMCID: PMC6489217 DOI: 10.1186/s12879-019-3967-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 04/08/2019] [Indexed: 11/15/2022] Open
Abstract
Background Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum. The disease affects all ages and both sexes but more prevalent among the sexually active age group of 15–49 years. The purpose of the current study was to determine the prevalence and factors associated with syphilis infection among outpatients 15–49 years in the Asikuma Odoben Brakwa District of Ghana where high levels of infection were earlier reported among antenatal women. Methods A descriptive cross-sectional study was carried out in 13 randomly selected health facilities. Blood samples were collected and tested for syphilis infection and a questionnaire administered to determine factors associated with the disease. Results A total 277 patients aged 15–49 years participated in the study. The overall prevalence of syphilis infection was 3.2% (9/277), with 5.7% (6/105) and 1.7% (3/172) among males and females respectively. Significant factors associated with syphilis infection included sub-district of residence, (χ2 (4) = 31.20, p < 0.001) and history of coerced sexual intercourse (χ2 (1) =7.49, p = 0.006). Conclusions The prevalence of syphilis infection was high among male patients who lived in rural areas. Having a history of coerced sexual intercourse was a strong predictor for syphilis infection. Access to sexually transmitted infection control interventions in rural communities including health education may help control the disease. Electronic supplementary material The online version of this article (10.1186/s12879-019-3967-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Martin Banong-le
- School of Public Health, University of Ghana, Legon, Accra, Ghana.,Ministry of Health, College of Nursing and Midwifery, Nalerigu, Northern Region, Ghana
| | - Samuel Kwabena Ofosu
- District Health Directorate, Ghana Health Service, Breman Asikuma, Central Region, Ghana
| | - Francis Anto
- School of Public Health, University of Ghana, Legon, Accra, Ghana.
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Behzadi MA, Davarpanah MA, Namayandeh M, Pourabbas B, Allahyari S, Ziyaeyan M. Molecular diagnosis of genital tract infections among HIV-positive women in Iran. IRANIAN JOURNAL OF MICROBIOLOGY 2018; 10:233-241. [PMID: 30483375 PMCID: PMC6243152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND AND OBJECTIVES Human immunodeficiency virus (HIV)-infected women are usually at a higher risk of sexually transmitted infections (STIs) than others. The objective of this study was to characterize the prevalence of human papilloma virus (HPV), herpes simplex virus (HSV), Chlamydia trachomatis (CT), and Neisseria gonorrhoeae (NG), and associated risk factors among HIV-infected women in Fars province, Iran. MATERIALS AND METHODS In this cross-sectional study, cervical swab samples were collected from 71 HIV-infected women, aged 17-45 years (mean ± standard deviation: 31.11 ± 6.58 years), and tested for HPV, HSV, CT, and NG using PCR assays. RESULTS Overall, 77.5% of patients were positive for the tested STIs with the following distribution: 36 (50.7%) HPV, 7 (9.9%) HSV, 4 (5.6%) NG, and 27 (38%) CT. From those, 39 (55%) were positive for only one infection, while 16 (22.5%) were positive for multiple infections. We observed that the prevalence of all tested STIs increased by age, except for HSV which showed a slight decrease, although not statistically significant. Socio-economic factors such as low educational level, multiple sex partners, and being a sex worker significantly correlated with higher positive prevalence of STIs in the studied population. CONCLUSION A high prevalence of STIs was observed among HIV-infected women in this region. These data might prompt policy makers and STI experts to focus on providing a comprehensive sex education, including participation in screening programs for STIs among high-risk groups.
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Affiliation(s)
- Mohammad Amin Behzadi
- Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Mandana Namayandeh
- Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Bahman Pourabbas
- Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Soheyla Allahyari
- HIV Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mazyar Ziyaeyan
- Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran,Corresponding author: Mazyar Ziyaeyan, Ph.D, Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. Tel: +98-71-36474304, Fax: +98-71-36474303,
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Abstract
PURPOSE OF REVIEW Syphilis continues to cause morbidity and mortality worldwide. While syphilis infection is easily identifiable and treatable, rates of syphilis infection continue to increase among select populations in high-income countries and remain at endemic levels in low- and middle-income counties. RECENT FINDINGS World Health Organization recommended strategies have led to the dual elimination of mother-to-child transmission of syphilis and HIV in several countries, however outbreaks among select populations need to be adequately addressed. SUMMARY Continued vigilance and investment is needed to address syphilis worldwide. The epidemiology of syphilis differs in high-income and low- and middle-income counties.
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Affiliation(s)
- Noah Kojima
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, 90095
| | - Jeffrey D Klausner
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, 90095
- Fielding School of Public Health, University of California Los Angeles, Los Angeles, 90024
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