Aetiology of sexually transmitted infections in Maputo, Mozambique

Introduction: The study sought to ascertain the prevalence of the aetiological agents of genital discharge and genital ulcer diseases in Maputo, Mozambique. Methodology: Consecutive consenting patients presenting to the Centro de Saúde do Porto in Maputo between March and April 2005 with genital discharge syndrome and/or genital ulcer diseases were recruited. Specimens were collected for the identification of STI pathogens. Results: Of 346 recruited patients, 164 were male and 182 female. The prevalence of confirmed single aetiological agents for male urethritis was as follows: N. gonorrhoeae, 35%; C. trachomatis, 10%; and M. genitalium 4%. For vaginal discharge, N. gonorrhoeae was found in11% of the women tested, followed by C. trachomatis (6.5%), bacterial vaginosis (34%), and T. vaginalis (2%). The prevalence of genital ulcers was as follows: Herpes simplex virus type 2, 62%; H. ducreyi 4 %; and C. trachomatis biovar LGV, 4%. Five percent of patients with genital ulcers had a positive syphilis serology (RPR ≥ 1:8 and confirmed by TPHA) and 35% of all tested patients were HIV-1/2 infected. Cases of mixed infections were present in 5%, 11% and 3% of patients with male urethritis, vaginal discharge, and genital ulcers respectively. Conclusion: The classic sexually transmitted infection aetiologies are still prevalent in Maputo. The study highlights the need for a periodic surveillance to inform syndromic management protocols.

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Prevalence and Incidence of Sexually Transmitted Infection in Injectable Progestin Contraception Users in South Africa

Frontiers in Reproductive Health ◽

10.3389/frph.2021.668685 ◽

2021 ◽

Vol 3 ◽

Author(s):

Lisa M. Noguchi ◽

Jeanne M. Marrazzo ◽

Barbara Richardson ◽

Sharon L. Hillier ◽

Jennifer E. Balkus ◽

...

Keyword(s):

South Africa ◽

South African ◽

Sexually Transmitted Infection ◽

Proportional Hazards ◽

Reproductive Health Services ◽

Transmitted Infection ◽

Sexually Transmitted ◽

Simplex Virus ◽

Hiv 1

Introduction: Whether intramuscular depot medroxyprogesterone acetate (DMPA-IM) and norethisterone enanthate (NET-EN) have a differential impact on the incidence of sexually transmitted infection (STI) remains unclear. In the Vaginal and Oral Interventions to Control the Epidemic (VOICE) trial, HIV-1 acquisition was higher for DMPA-IM users vs. NET-EN users. We compared DMPA-IM and NET-EN users with regard to chlamydia, gonorrhea, trichomoniasis, syphilis, and herpes simplex virus type 2 (HSV-2) infection.Materials and Methods: Prospective data were analyzed from VOICE, a randomized trial of HIV-1 chemoprophylaxis. Participants were evaluated annually and as indicated for chlamydia, gonorrhea, trichomoniasis, and syphilis. Stored specimens were tested for HSV-2. Proportional hazards models compared the risk of STI between DMPA-IM and NET-EN users.Results: Among 2,911 injectable contraception users in South Africa, 1,800 (61.8%) used DMPA-IM and 1,111 used NET-EN (38.2%). DMPA-IM and NET-EN users did not differ in baseline chlamydia: 15.1 vs. 14.3%, p = 0.54; gonorrhea: 3.4 vs. 3.7%, p = 0.70; trichomoniasis: 5.7 vs.5.0%, p = 0.40; or syphilis: 1.5 vs. 0.7%, p = 0.08; but differed for baseline HSV-2: (51.3 vs. 38.6%, p < 0.001). Four hundred forty-eight incident chlamydia, 103 gonorrhea, 150 trichomonas, 17 syphilis, and 48 HSV-2 infections were detected over 2,742, 2,742, 2,783, 2,945, and 756 person-years (py), respectively (chlamydia 16.3/100 py; gonorrhea 3.8/100 py; trichomoniasis 5.4/100 py; syphilis 0.6/100 py; HSV-2 6.4/100 py). Comparing DMPA-IM with NET-EN users, no difference was noted in the incidence of chlamydia, gonorrhea, trichomoniasis, syphilis, or HSV-2 infections, including when adjusted for confounders [chlamydia (aHR 1.03, 95% CI 0.85–1.25), gonorrhea (aHR 0.88, 95% CI 0.60–1.31), trichomoniasis (aHR 1.07, 95% CI 0.74–1.54), syphilis (aHR 0.41, 95% CI 0.15–1.10), and HSV-2 (aHR 0.83, 95% CI 0.45–1.54, p = 0.56)].Discussion: Among South African participants enrolled in VOICE, DMPA-IM and NET-EN users differed in prevalence of HSV-2 at baseline but did not differ in the incidence of chlamydia, gonorrhea, trichomoniasis, syphilis, or HSV-2 infection. Differential HIV-1 acquisition, previously demonstrated in this cohort, does not appear to be explained by differential STI acquisition. However, the high incidence of multiple STIs reinforces the need to accelerate access to comprehensive sexual and reproductive health services.

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Herpes Simplex Virus Type 2, Genital Ulcers and HIV-1 Disease Progression in Postpartum Women

PLoS ONE ◽

10.1371/journal.pone.0019947 ◽

2011 ◽

Vol 6 (5) ◽

pp. e19947 ◽

Cited By ~ 6

Author(s):

Alison C. Roxby ◽

Alison L. Drake ◽

Grace John-Stewart ◽

Elizabeth R. Brown ◽

Daniel Matemo ◽

...

Keyword(s):

Herpes Simplex Virus ◽

Herpes Simplex ◽

Disease Progression ◽

Virus Type ◽

Herpes Simplex Virus Type ◽

Postpartum Women ◽

Genital Ulcers ◽

Simplex Virus ◽

Hiv 1

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Clinical and Virologic Response to Episodic Acyclovir for Genital Ulcers Among HIV-1 Seronegative, Herpes Simplex Virus Type 2 Seropositive African Women: A Randomized, Placebo-Controlled Trial

Sexually Transmitted Diseases ◽

10.1097/olq.0b013e31823b50c6 ◽

2012 ◽

Vol 39 (1) ◽

pp. 21-24 ◽

Cited By ~ 3

Author(s):

Jared M. Baeten ◽

Stewart E. Reid ◽

Sinead Delany-Moretlwe ◽

James P. Hughes ◽

Richard S. Wang ◽

...

Keyword(s):

Herpes Simplex Virus ◽

Herpes Simplex ◽

Herpes Simplex Virus Type ◽

Controlled Trial ◽

Virologic Response ◽

African Women ◽

Genital Ulcers ◽

Simplex Virus ◽

Hiv 1

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Genital ulcer disease among STD clinic attenders in Nairobi: association with HIV-1 and circumcision status

International Journal of STD & AIDS ◽

10.1258/0956462961918374 ◽

1996 ◽

Vol 7 (6) ◽

pp. 410-414 ◽

Cited By ~ 37

Author(s):

James M Nasio ◽

Nico J D Nagelkerke ◽

Anthony Mwatha ◽

Stephen Moses ◽

Jackoniah O Ndinya-Achola ◽

...

Keyword(s):

Risk Factor ◽

Transmitted Disease ◽

Genital Ulcer ◽

Ulcer Disease ◽

Sexually Transmitted ◽

Unknown Risk ◽

Increased Risk ◽

Male Patients ◽

Genital Ulcers ◽

Hiv 1

In previous studies, genital ulcers in men have been found to be associated with increased risk of HIV-1 seroconversion. To further explore this association male patients attending a sexually transmitted disease STD clinic in Nairobi for either urethritis controls, n 276 or a genital ulcer cases, n 607 were compared with respect to sexual behaviour, presence of HIV-1 antibody and circumcision status. Patients were followed to study risk factors for incident genital ulcers and HIV-1 seroconversion. At entry, being married was associated with higher prevalence of HIV-1 OR 1.76 and genital ulcers OR 1.42 . Lack of circumcision was associated with both HIV-1 infection OR 4.67 and the presence of a genital ulcer OR 2.23 . Genital ulcers were also associated with HIV-1 infection OR 1.87 independent of circumcision status. On follow-up, HIV-1 seropositivity was associated with incident genital ulcers. It is argued that the association between genital ulcers and HIV-1 infection may be more complex than ulcers simply being a risk factor for HIV-1 infection, and that HIV-1 infection may either increase the risk of acquiring a genital ulcer, or HIV-1 infection and genital ulcers may have some unknown risk factor in common.

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