scholarly journals The Syndromic versus Laboratory Diagnosis of Sexually Transmitted Infections in Resource-Limited Settings

ISRN AIDS ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Musie Ghebremichael
Keyword(s):  
Sexually Transmitted Infections ◽  
High Specificity ◽  
Laboratory Diagnosis ◽  
Sub Saharan Africa ◽  
Resource Limited Settings ◽  
Sexually Transmitted ◽  
Resource Limited ◽  
Patient Reported ◽  
Syndromic Diagnosis ◽  
Sub Saharan

Sexually transmitted infections (STIs) are highly prevalent in sub-Saharan Africa, where there is a severe HIV epidemic. Thus, accurate recognition and diagnosis of STIs are essential for successful HIV prevention programs in the region. Due to lack of trained personnel and adequate laboratory infrastructure in the region, information regarding the profile of STIs relies essentially on self-reported or physician-diagnosed symptoms. The main objective of the study was to assess the effectiveness of the syndromic diagnosis of STIs, which is often used as a proxy for laboratory diagnosis of STIs in sub-Saharan Africa and other resource-limited settings. The study builds on previously collected data from a community-based survey in Northern Tanzania. We found no significant agreements between patient-reported STIs symptoms and laboratory-confirmed STIs tests. The reported STIs symptoms had high specificity (range = 85–99%) and poor sensitivity (range = 2–17%). Knowledge gained from our study will have significant public health implications, and can help improve the syndromic diagnosis of STIs.

scholarly journals Syndromic versus Laboratory Diagnosis of Sexually Transmitted Infections in Men in Moshi District of Tanzania

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Yuwei Cheng ◽  
Elijah Paintsil ◽  
Musie Ghebremichael
Keyword(s):  
Sexually Transmitted Infections ◽  
Laboratory Testing ◽  
High Specificity ◽  
Cost Effective ◽  
Laboratory Diagnosis ◽  
Receiver Operating Curve ◽  
Sexually Transmitted ◽  
Resource Limited ◽  
Syndromic Diagnosis ◽  
Low Sensitivity

The syndromic diagnosis of sexually transmitted infections (STIs) is widely recognized as the most practical, feasible, and cost-effective diagnostic tool in resource-limited settings. This study assessed the diagnostic accuracy of syndromic versus laboratory testing of STIs among 794 men randomly selected from the Moshi district of Tanzania. Participants were interviewed with a questionnaire that included questions on history of STIs symptoms. Blood and urine samples were taken from the participants for laboratory testing. Only 7.9% of the men reported any symptoms of STI; however, 46% of them tested positive for at least one STI. There was little agreement between syndromic and laboratory-confirmed diagnoses, with low sensitivity (0.4%–7.4%) and high specificity (96%–100%) observed for each individual symptom. The area under the receiver-operating curve was 0.528 (95% CI: 0.505–0.550), indicating that the syndromic approach has a 52.8% probability of correctly identifying STIs in study participants. In conclusion, whenever possible, laboratory diagnosis of STI should be favored over syndromic diagnosis.

scholarly journals International Radiotherapy Referrals From Rural Rwanda: Implementation Processes and Early Clinical Outcomes

2018 ◽  
pp. 1-12
Author(s):  
Maud Hanappe ◽  
Lowell T. Nicholson ◽  
Shekinah N.C. Elmore ◽  
Alexandra E. Fehr ◽  
Jean Bosco Bigirimana ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Head And Neck ◽  
Low Income ◽  
Cancer Care ◽  
Sub Saharan Africa ◽  
Resource Limited Settings ◽  
Cancer Centre ◽  
Resource Limited ◽  
Centre Of Excellence ◽  
Sub Saharan

Purpose Low- and middle-income countries disproportionately comprise 65% of cancer deaths. Cancer care delivery in resource-limited settings, especially low-income countries in sub-Saharan Africa, is exceedingly complex, requiring multiple modalities of diagnosis and treatment. Given the vast human, technical, and financial resources required, access to radiotherapy remains limited in sub-Saharan Africa. Through 2017, Rwanda has not had in-country radiotherapy services. The aim of this study was to describe the implementation and early outcomes of the radiotherapy referral program at the Butaro Cancer Centre of Excellence and to identify both successful pathways and barriers to care. Methods Butaro District Hospital is located in a rural area of the Northern Province and is home to the Butaro Cancer Centre of Excellence. We performed a retrospective study from routinely collected data of all patients with a diagnosis of cervical, head and neck, or rectal cancer between July 2012 and June 2015. Results Between 2012 and 2015, 580 patients were identified with these diagnoses and were potential candidates for radiation. Two hundred eight (36%) were referred for radiotherapy treatment in Uganda. Of those referred, 160 (77%) had cervical cancer, 31 (15%) had head and neck cancer, and 17 (8%) had rectal cancer. At the time of data collection, 101 radiotherapy patients (49%) were alive and had completed treatment with no evidence of recurrence, 11 (5%) were alive and continuing treatment, and 12 (6%) were alive and had completed treatment with evidence of recurrence. Conclusion This study demonstrates the feasibility of a rural cancer facility to successfully conduct out-of-country radiotherapy referrals with promising early outcomes. The results of this study also highlight the many challenges and lessons learned in providing comprehensive cancer care in resource-limited settings.

Diagnosis and management of antiretroviral-therapy failure in resource-limited settings in sub-Saharan Africa: challenges and perspectives

2010 ◽  
Vol 10 (1) ◽  
pp. 60-65 ◽  
Author(s):  
Anthony D Harries ◽  
Rony Zachariah ◽  
Joep J van Oosterhout ◽  
Steven D Reid ◽  
Mina C Hosseinipour ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Sub Saharan Africa ◽  
Therapy Failure ◽  
Resource Limited Settings ◽  
Diagnosis And Management ◽  
Resource Limited ◽  
Sub Saharan

scholarly journals Sexual Autonomy and Self-reported Sexually Transmitted Infections Among Sub-saharan African Women in Sexual Unions

2021 ◽  
Author(s):  
Collins Adu ◽  
Aliu Mohammed ◽  
Eugene Budu ◽  
James Boadu Frimpong ◽  
Justice Kannor Tetteh ◽  
...  
Keyword(s):  
Sexually Transmitted Infections ◽  
Rural Areas ◽  
Urban Areas ◽  
Study Data ◽  
Sub Saharan Africa ◽  
African Women ◽  
Odds Ratios ◽  
Sexual Autonomy ◽  
Sexually Transmitted ◽  
Sub Saharan

Abstract Background Sexually transmitted infections (STIs) remain a major public health challenge 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). Conclusion 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.

scholarly journals Sexually transmitted infections in an African migrant population in Portugal: a base-line study

2007 ◽  
Vol 1 (03) ◽  
pp. 326-328 ◽  
Author(s):  
Luis Távora-Tavira ◽  
Rosa Teodósio ◽  
Jorge Seixas ◽  
Emília Prieto ◽  
Rita Castro ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Sexually Transmitted Infections ◽  
Sub Saharan Africa ◽  
Chlamydia Infection ◽  
Base Line ◽  
Transmitted Infection ◽  
Prevalence Studies ◽  
Sexually Transmitted ◽  
Starting Point ◽  
Sub Saharan

Background: For geographical and recent historic reasons, Portugal is a gateway and home for immigration from sub-Saharan countries. Misconceptions related to these populations often lead to consider them as high-frequency clusters for dissemination of sexually transmitted infections (STIs). Epidemiological evidence-based data is needed to elucidate these issues and baseline prevalence studies are the starting point for this. Methodology: A prospective study was conducted in 220 African migrants (171 men and 49 women), recently arrived in Portugal, at the time of their first consultation. The presence of STIs was evaluated using a clinical syndromic approach and biological confirmation for gonorrhoea, Chlamydia trachomatis genital infection, syphilis, Hepatitis B and Human Immunodeficiency Virus (HIV) infection. Results: Global prevalence of the targeted infections were 1.8% for gonorrhoea, 0 % for Chlamydia infection, 4.1% for Syphilis, 5.9% for HBsAg presence and 7.3% for HIV infection. Globally, 16.4% of the studied persons had at least one sexually transmitted infection. Conclusions: We concluded that prevalence rates encountered in this population is similar to that of non-migrant Portuguese populations with a high risk for sexually transmitted diseases. Therefore migration from sub-Saharan Africa doesn’t seem to constitute a particularly critical isolated factor for public health risk of STIs in the community.

scholarly journals Exploring enablers of sexually transmitted infections among illegal gold miners in the midlands region of Zimbabwe

2021 ◽  
Vol 10 (4) ◽  
pp. 1321
Author(s):  
Nyanshanu Mattew ◽  
Chireshe Rumbidzai ◽  
Jidong Dung ◽  
Nyashanu Wendy ◽  
Ekpenyong Mandu Stephen
Keyword(s):  
Sexual Health ◽  
Sexually Transmitted Infections ◽  
Health Knowledge ◽  
Sub Saharan Africa ◽  
Health Concern ◽  
Structured Interviews ◽  
Prolonged Stay ◽  
Sexually Transmitted ◽  
Gold Miners ◽  
Sub Saharan

Background: Sub-Saharan Africa faces by far the highest rate of HIV and other Sexually Transmitted Infections (STIs). Illegal mineworkers are considered at risk for HIV and sexually transmitted infections (STIs). Men are generally not receptive to health promotion messages.Methods: This study explored the enablers of sexually transmitted infections. The study utilized a qualitative approach. A total of 40 participants were recruited. Semi structured interviews were used to collect data. A thematic approach was used to analyze the data. Zimbabwe, like any other country in the sub-Saharan region of Africa, has been affected by the epidemic of HIV/AIDS and other STIs, because of poor sexual health education.Results: The study found that the enablers of STIs included poor sexual health knowledge, substance misuse, prolonged stay from family, stigma, lack of entertainment, cultural status, and poor sexual health services.Conclusions: STIs among illegal gold miners is a public health concern that needs urgent attention in many developing countries.

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