Prevalence of sexually transmitted infections among pregnant women attending antenatal clinics in West Coast Region of The Gambia

BackgroundSexually Transmitted Infections (STI) are the second most common cause of healthy life years lost by women in the 15 – 44 years age group in Africa.Aim/ObjectiveTo determine the prevalence of STIs among pregnant women attending antenatal care (ANC) clinics in the West Coast Region of The Gambia.Materials and MethodsBlood, urine, and high vaginal swabs samples from 280 pregnant women attending ANC in Brikama District Hospital, Brikama, and Bandung Maternity and Child Health Hospital, Bandung were examined. Serum samples were tested for HIV using western blot technique and for syphilis using the Venereal Disease Research Laboratory (VDRL) test, and rapid plasma regimen. Candida albicans, Group B Streptococcus and Neisseria gonorrhoea were identified using Analytical Profile Index (API). Direct urine microscopy was used to identify C. albicans and Trichomonas vaginalis while Chlamydia trachomatis was identified using Direct Fluorescent Antibody (DFA) test.ResultsThe overall prevalence of STIs was 53.6%. The pathogenic agents isolated were Candida albicans (31.8%), Streptococcus agalactiae (15.0%), Treponema pallidum (6.8%), HIV (5.7%), Trichomonas vaginalis (3.9%), Neisseria gonorrhoea (1.8%) and Chlamydia trachomatis (0.7%). STIs were more prevalent among women in the younger age group of 15 – 24 years (54.7%), unemployed (54.0%), Primipara (62.3%), and in the third trimester of pregnancy (72.7%).ConclusionA high prevalence of STIs was found among pregnant women attending ANC in the West Coast region of The Gambia. Public health intervention programmes should be strengthened to promote the sexual and reproductive health of pregnant women in The Gambia.     

Concomitant diagnosis of sexually transmitted infections and human monkeypox in patients attending a sexual health clinic in Milan,Italy

In 2022, many monkeypox (MPX) outbreaks have been documented in countries where MPX was not endemic. It spread all around the world, especially in European Union and United States. While MPX is classically considered to be transmitted through close contact with lesions, the hypothesis of sexual transmission has been proposed. This study considered a total of 49 patients suspected for MPX that were also tested for other sexually transmitted infections (STIs), including Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, and Trichomonas vaginalis. The data from coinfected patients suggested that MPXV and STIs might share the same route of inoculum, corroborating the hypothesis of possible sexual transmission for the emerging poxvirus. And like any other STI, MPX should be considered without stigmatization.     

Prevalence of human papillomavirus,human immunodeficiency virus and other sexually transmitted infections among female sex workers in Togo: a national cross-sectional survey

ObjectivesSub-Saharan Africa is a region with high incidence of both human immunodeficiency virus (HIV) and cervical cancer. We conducted the first national study in Togo to assess prevalence of human papillomavirus (HPV), HIV and other sexually transmitted infections (STIs) among female sex workers (FSW).MethodsA multicentric cross-sectional study was conducted among FSW recruited in hot spots (clubs, streets) in four Togolese cities. HPV and STIs were tested from cervical and anal swabs. HIV and syphilis were screened with rapid tests.ResultsIn all, 310 FSW were recruited; HIV and cervical high-risk HPV (hrHPV) prevalence were 10.6% (33/310) and 32.9% (102/310), respectively. The most frequent hrHPV types were HPV58 (13.6%, 19/140), HPV35 (12.9%, 18/140), HPV31 (12.1%, 17/140) and HPV16 (10.7%, 15/140). Prevalence of hrHPV and multiple hrHPV infections showed higher rates in HIV-positive than in HIV-negative FSW (48.5% versus 31.0%, p 0.04 and 21.2% versus 9.0%, p 0.03; respectively). Prevalence of hrHPV was higher in cervical than anal swabs (34.1% versus 20.7%, p 0.0004). High-risk HPV anal infections were more frequent among HIV-positive than HIV-negative FSW (51.9% versus 17.3%, p 2 × 10⁻⁵). Concomitant anal and cervical hrHPV infections were present in 43.2% (41/95) of hrHPV-positive FSW. Overall prevalence in the cervix of Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma genitalium and Trichomonas vaginalis were 4.2%, 6.1%, 5.5% and 6.5%, respectively.ConclusionsThis first African study on paired cervical and anal samples showed a high prevalence of genital HPV infections with a rather high rate of concomitant HPV infections but low type concordance. We report an unusual distribution of hrHPV types. These findings highlight the critical need for implementation of a national HPV vaccination strategy.     

Asymptomatic reproductive tract infections/sexually transmitted infections among HIV positive women

This study aims to highlight the importance of screening all HIV positive women for various reproductive tract infections/sexually transmitted infections (RTIs/STIs) irrespective of symptoms and to determine its occurrence in asymptomatic HIV positive women. Relevant specimens were collected for diagnosis of various RTIs/STIs. STIs were diagnosed in nearly one-third of the HIV positive asymptomatic patients which is quite high. The national strategy for STIs/RTIs control misses out large number of asymptomatic RTIs/STIs in HIV positive women which is responsible for silently transmitting these infections in the community. So this strategy should be modified to include screening of all HIV positives women irrespective of symptoms of STIs/RTIs.     

Early detection of HIV infection and of asymptomatic sexually transmitted infections among men who have sex with men

ObjectiveTo provide data on incidence of early diagnosis of HIV infections and define prevalence and incidence of asymptomatic sexually transmitted infections (STI) in men who have sex with men (MSM).MethodsWe assessed a prospective cohort study of HIV-uninfected MSM at high risk for HIV infection. Participants were selected through a risk-assessment questionnaire, and they were screened for HIV infection (quarterly) and for other STI (yearly): syphilis, and hepatitis A, B and C (serology); Chlamydia trachomatis and Neisseria gonorrhoeae in penis and rectum; and human papillomavirus in anus and mouth (PCR).ResultsBetween November 2009 and October 2012, a total of 258 HIV-uninfected MSM at high risk for HIV infection were included and followed up for a median of 2 years (interquartile range 1.4, 2.5). Nineteen acute HIV infections were diagnosed (incidence, 3.9 per 100 person-years). Prevalence of STI at baseline was follows: syphilis 8.4% (95% confidence interval (CI) 5.4–12.7); hepatitis C virus (HCV) 2.0% (95% CI 0.7–4.8); C. trachomatis in penis 3.2% (95% CI 1.5–6.5) and in rectum 6.5% (95% CI 3.9–10.5); N. gonorrhoeae in penis 2.0% (95% CI 0.8–5.0) and in rectum 6.1% (95% CI 3.6–10.1); human papillomavirus in anal canal 75.7% (95% CI 68.8–81.5) and in mouth 3.8% (95% CI 1.8–7.7).ConclusionsThe implementation of the Check-Ear Project in a MSM community centre allowed for the identification of early HIV infections and asymptomatic STI among MSM. The high incidence of HIV infections and the high prevalence of STI strongly support the recommendation of periodic screenings among sexually active MSM.     

Remote consultations and HIV/AIDS continuing education in low-resource settings

BACKGROUND: Telemedicine is a way to support physicians working in resource-poor settings, providing remote consultations and continuing medical education on HIV/AIDS care. METHODS: A hybrid E-mail/web support telemedicine service was created in 2003 at the Institute of Tropical Medicine, Antwerp, Belgium, with a discussion forum hosting more than 170 healthcare professionals from 40 different countries, generally resource constrained. Interesting posts and recurring questions from this discussion forum have been elaborated as case studies or frequently asked questions, available on the website for consultation. Education and support are also provided through interactive quizzes, user-friendly guidelines, and policy documents with a particular focus on HIV/AIDS care in developing countries. RESULTS: From April 2003 to March 2005, 342 questions were sent from over 17 countries in Africa, Asia, and South America. The vast majority of these questions (93%) were patient-oriented, with only 7% being general questions. Of the patient-oriented questions, 49% were related to antiretroviral therapy, and 44% were related to the diagnosis and treatment of opportunistic infections. CONCLUSIONS: Telemedicine is a cheap and effective method of providing clinical support and continuing education to healthcare workers treating HIV-positive patients in resource-poor settings.     

应用FQ-PCR技术检测乌鲁木齐地区性病病原体的流行病学分析

目的掌握本地区性病病原体的现行感染水平及发展规律,为控制该疾病的传播和流行提供科学依据.方法采用实时荧光定量聚合酶链反应技术,定量测定病原体基因.结果连续4年对引起性病的5种主要病原体UU、HPV、HSV、NG及CT进行了检测,结果显示①阳性率分别为45.84%、29.68%、21.45%、9.09%和7.10%,与国内已有文献比较,本组UU感染率最高,而NG、CT却较低.②UU、NG及CT在女性中的阳性率高于男性,但HPV和HSV却低于男性,其性别差异与通常的认识既相一致(如UU、CT),也有不同(如HPV、HSV、NG).③4年间UU、HPV和NG感染逐年升高,CT感染逐年下降,流行趋势与国内外相关报道存在较大差异.结论乌鲁木齐性病病原体的感染现状显示明显的地区特点,深入研究并从流行病学角度分析该地性病病原体的发生、发展趋势,对加强性病防治工作具有重要意义.     

280例足月妊娠产妇性传播疾病调查分析

目的：调查围产期性传播疾病患病率,了解临床产妇女生殖健康状况。方法：1、用ELISA法检测产妇静脉血中艾滋病病毒（HIV）;2、悬滴法镜检阴道分泌物中霉菌和滴虫;3、革兰氏染色法镜检宫颈分泌物中淋球菌;4、肉眼观察外阴、阴道及宫戏是否性病疣。结论：HIV感染率为0;霉菌阳性率为21.78%;滴虫阳性率为0.7%;淋菌感染率为0;尖锐湿疣患病率1.78%。结论：280名产妇中感染性传播疾病以阴道炎患病率为首,达22.5%。其次为尖锐湿疣。淋病及艾滋病患病率为0。     

Point-of-care tests for diagnosing infections in the developing world

Infectious diseases continue to cause an enormous burden of death and disability in developing countries. Increasing access to appropriate treatment for infectious diseases could have a major impact on disease burden. Some common infections can be managed syndromically without the need for diagnostic tests, but this is not appropriate for many infectious diseases, in which a positive diagnostic test is needed before treatment can be given. Since many people in developing countries do not have access to laboratory services, diagnosis depends on the availability of point of care (POC) tests. Historically there has been little investment in POC tests for diseases that are common in developing countries, but that is now changing. Lack of regulation of diagnostic tests in many countries has resulted in the widespread use of sub-standard POC tests, especially for malaria, making it difficult for manufacturers of reliable POC tests to compete. In recent years increased investment, technological advances, and greater awareness about the importance of reliable diagnostic tests has resulted in rapid progress. Rapid, reliable and affordable POC tests, requiring no equipment and minimal training, are now available for HIV infection, syphilis and malaria, but POC tests for other infections are urgently needed. Many countries do not have established criteria for licensing and introducing new diagnostic tests, and many clinicians in developing countries have become disillusioned with diagnostic tests and prefer to rely on clinical judgment. Continuing advocacy and training in the use of POC tests are needed, and systems for quality control of POC tests need to be developed if they are to achieve their maximum potential.     

Diagnostic accuracy of point-of-care tests in acute community-acquired lower respiratory tract infections. A systematic review and meta-analysis

BackgroundPoint-of-care tests could be essential in differentiating bacterial and viral acute community-acquired lower respiratory tract infections and driving antibiotic stewardship in the community.ObjectivesTo assess diagnostic test accuracy of point-of-care tests in community settings for acute community-acquired lower respiratory tract infections.Data sourcesMultiple databases (MEDLINE, EMBASE, Web of Science, Cochrane Library, Open Gray) from inception to 31 May 2021, without language restrictions.Study eligibility criteriaDiagnostic test accuracy studies involving patients at primary care, outpatient clinic, emergency department and long-term care facilities with a clinical suspicion of acute community-acquired lower respiratory tract infections. The comparator was any test used as a comparison to the index test. In order not to limit the study inclusion, the comparator was not defined a priori.Assessment of risk of biasFour investigators independently extracted data, rated risk of bias, and assessed the quality using QUADAS-2.Methods of data synthesisThe measures of diagnostic test accuracy were calculated with 95% CI.ResultsA total of 421 studies addressed at least one point-of-care test. The diagnostic performance of molecular tests was higher compared with that of rapid diagnostic tests for all the pathogens studied. The accuracy of stand-alone signs and symptoms or biomarkers was poor. Lung ultrasound showed high sensitivity and specificity (90% for both) for the diagnosis of bacterial pneumonia. Rapid antigen-based diagnostic tests for influenza, respiratory syncytial virus, human metapneumovirus, and Streptococcus pneumoniae had sub-optimal sensitivity (range 49%–84%) but high specificity (>80%).DiscussionPhysical examination and host biomarkers are not sufficiently reliable as stand-alone tests to differentiate between bacterial and viral pneumonia. Lung ultrasound shows higher accuracy than chest X-ray for bacterial pneumonia at emergency department. Rapid antigen-based diagnostic tests cannot be considered fully reliable because of high false-negative rates. Overall, molecular tests for all the pathogens considered were found to be the most accurate.     

Performance of two commercial multiplex polymerase chain reaction assays for the etiological diagnosis of sexually transmitted infections among men who have sex with men

Background and purposeThis study aimed to investigate the etiologies of sexually transmitted infections (STIs) among men who have sex with men (MSM) in Taiwan.MethodsTwo commercial assays, the BD MAX Chlamydia trachomatis (CT), Neisseria gonorrhoeae (GC), and Trichomonas vaginalis (TV) panel and the Allplex? STI Essential assay (CT, GC, Mycoplasma genitalium [MG], Mycoplasma hominis [MH], Ureaplasma urealyticum [UU], Ureaplasma parvum [UP], and TV) were evaluated. During the first stage, urine and rectal swab samples from 168 patients were evaluated using the BD MAX assay, and the multiplex RT-PCR Allplex? STI Essential assay was applied only to the patients with positive results on the BD MAX asay (n = 49). During the second stage, urine and rectal swab samples from 90 patients were evaluated using the BD MAX assay and the Allplex? qPCR.ResultsThe Allplex qPCR identified all CT, missed one and additionally one TV from the positive samples (n = 49) by the BD MAX assay in the first stage. At the second stage, both commercial assays showed similar detection rate of CT, NG or CT/NG coinfection (11.1%, 1.1% and 4.4% by the BD MAX assay; 10.0%, 1.1% and 2.2% by the Allplex qPCR). The positivity rates of MG, MH, and UU by the Allplex qPCR were 4.4%, 2.2%, and 12.2%, respectively, for urine samples and 10%, 13.3%, and 22.2%, respectively, for anal swab samples.ConclusionsHigh rates of STI-associated etiologies were observed in MSM. The positive rates were higher in rectal swabs than in urine samples.     

实时荧光定量PCR检测常见性传播疾病病原体基因

目的;用实时荧光定量聚合酶链反应(FQ-PCR)技术准确定量检测常见性病病原体基因,为临床治疗提供依据.方法采用实时FQ-PCR技术,检测了临床送检标本3641份.结果淋球菌(NGH)1416份、沙眼衣原体(CT)1165份、解脲支原体(UU)765份,人乳头瘤病毒(HPV6.11)214份、梅毒螺旋体(TP)81份,阳性率分别为26%(368/1416)、27%(315/1165)、36.5%(279/765)、77%(165/214)、21%(17/81).阳性率差异有高度显著性(P＜0.001).NGH、CT、UU、HPV6.11、TP阳性标本DNA平均拷贝数2.3×106、8.5×105、2.4×104、5.6×107、3.8×105.146例治疗后复查,其转阴率为NGH63.9%(39)、CT70%(33)、UU44.7%(17).治疗后复查转阴率差异有显著性(P＜0.05),其DNA拷贝平均数有明显下降.结论实时FQ-PCR技术检测常见性病病原体基因,具有简便、快捷、特异性高、定量准确等优点,对其诊断和治疗有指导意义.     

Protozoal enteric infections in homosexual men

Summary The prevalence of enteric protozoal infections was examined in a group of 200 homosexual men. Entamoeba histolytica (E. histolyt.) was found in 22.8%, apathogen amoeba in 54.5% and Giardia lamblia (G. lamblia) in 9.1% of the participants. Antibodies against E. histolyt. were significantly higher in subjects carrying E. histolyt. than in the group with apathogen amoeba and in uninfected participants. Clinical symptoms were not associated with protozoal infection. The analysis of a number of variables showed that oral-anal sex and promiscuity were the two most important risk factors for protozoal infection. The clinical significance of protozoal enteric infections and their possible relation to the acquired immune deficiency syndrome (AIDS) is discussed.     

杭州地区性病门诊男性就诊者HPV感染的流行病学调查

目的 了解杭州地区性病（STD）门诊男性就诊者中人乳头瘤病毒（HPV）感染的流行情况。方法 利用HPV黏膜型通用引物MY09／11。PCR方法检测STD门诊年龄在18—70岁男性就诊者阴茎拭子中的HPV DNA，并对阳性PCR产物用限制性长度片段多态性方法和直接测序法确定病毒基因型。结果 在采集的375例阴茎拭子中，81．3％（305例）产生足够的DNA可用于PCR扩增。HPVDNA的阳性率为13．8％（42／305），其中低危型HPV的阳性率为8．5％（26／305），高危型HPV的阳性率为4．3％（13/305），混合型感染的阳性率为1．0％（3/305）。居住地在城市、受教育程度越低、性伴侣的人数越多HPV DNA的检出率越高（P〈0．05）。结论 HPV在男性高危人群的感染并不少见，HPV DNA的检出与就诊者的居住地、教育程度及性伴侣人数有相关性。对男性高危人群HPV的感染应引起重视，积极采取预防和控制措施。     

Susceptibility of middle adolescent females to sexually transmitted infections: impact of hormone contraception and sexual behaviors on vaginal immunity

PROBLEM: The resistance and/or susceptibility to infections can be influenced by patterns of immunomodulators. Based on this and the high rate of sexually transmitted infections (STIs) in adolescents, we examined the longitudinal relationship between sexual behaviors, hormonal contraceptive use, and bacterial vaginosis (BV) with vaginal-associated immunomodulators in adolescent females. METHOD OF STUDY: Over 27 months, subjects completed detailed questionnaires, and consented to vaginal swabs for STI testing, and vaginal lavages for identification of immunomodulators including T-helper, proinflammatory, and chemokines. Concentrations of immunomodulators were correlated with each parameter together with prevalence of STIs. RESULTS: Each parameter had a limited influence on vaginal immunomodulators with no evidence of any pattern(s) associated with infection. Conversely, the local presence of proinflammatory cytokines and neutrophils in those with an STI indicated some immune responsiveness. CONCLUSION: Sexual behaviors, contraceptive usage, and BV do not appear as factors in susceptibility of adolescents to STIs through the influence of local immunomodulators.     

Exotic and indigenous problem plants species used,by the Bapedi,to treat sexually transmitted infections in Limpopo Province,South Africa

Background

The ethnic usage of exotics and indigenous problem plants is a highly debated topic, as legislative requirements over-shadow their potential medicinal value, particularly to treat sexually transmitted infections (STIs). Limited information exists regarding their medicinal value among the Bapedi.

Objectives

To ascertain the importance of exotics and indigenous problem plants in the treatment of STIs, a major global primary health care challenge.

Methods

A field observation and semi-structured questionnaire focussing on species diversity, types of STIs treated and medicinal preparation as well as application was used to collect data from 34 traditional healers.

Results

Seven exotics and three indigenous problem species were identified. These species were used to treat four STIs; with Catharanthus roseus illustrating its dominance in the treatment of gonorrhoea. Some medicinal species used by Bapedi traditional healers have been validated through scientific research or through their extensive use by various cultures in South Africa and other parts of Africa. To the best of our knowledge Alternanthera pungens, Caesalpinia decapetala, Cinnamomum verum, and Citrullus lanatus are reported for the first time in the treatment of the investigated STIs.

Conclusions

Exotic and indigenous problem species constitute an important component of the STIs treatment protocol. Their utilization by Bapedi cautions against the narrow-minded approach of indiscriminate eradication, as these species can play a significant role in the primary health care needs of socio-economic vulnerable people.     

Sexually transmitted infections,their treatment and urban change in colonial Leopoldville, 1910–1960

During the colonial period sexually transmitted infections (STIs) came to be recognised as a major public health problem in African cities. Thus, STI control and urban modernisation became deeply entangled as authorities redrew spatial and social boundaries to manage populations and their cross-cultural interaction. Public health measures, urban planning and policing were part of a coordinated effort to neutralise the potential impact of rapidly growing African urban migration on the Belgian Congo’s ‘model’ capital Leopoldville. While STI control was facilitated by new drugs (arsenicals, sulfonamides and antibiotics) to treat syphilis, chancroid, gonorrhoea and chlamydia (bacterial STIs), the effects of the 1929 economic crisis and urban social change illustrated the limits of colonial authority. Redesigning urban spaces and repressive measures to curb polygyny and prostitution operated in a parallel fashion with the expansion of health coverage, new treatments and awareness campaigns. To gain a better understanding of the evolution of STI incidence among African urban populations during the colonial period between 1910 and 1960, extensive archival records and secondary literature were consulted to assess the interplay between improved screening, diagnostic and therapeutic methods with demographic and social change. They show that STI rates, probably peaked during the pre-1929 period and apart from a short period in the early 1930s associated with mass screening, declined until becoming residual in the 1950s. Reflecting upon sanitary interventions and their broader dimensions, the article analyses the evolution of treatment regimes and their impact in the changing urban organisation and environment of the colony’s capital.     

Insights into the toll‐like receptors in sexually transmitted infections

Toll‐like receptors (TLRs) are like soldiers of an innate immune system, which protects vital biological processes against invading pathogens. TLR signalling pathways help in the removal of pathogens and mediate well‐established inflammatory processes. However, these processes may also aid in the development or augmentation of an infection or an autoimmune disease. Recent studies have delineated TLR polymorphism's role in the loss of function, making hosts more resistant or vulnerable to the development of an infection. In this review, we have discussed the association of TLRs with sexually transmitted infections (STIs), especially to the pathogen‐specific ligands. We have also assessed the impact on TLR downstream signalling and the maintenance of cellular homeostasis during immune responses. Besides, we have discussed the role of TLRs single nucleotide polymorphisms in various STIs. Since TLRs are known to play a part in defence mechanisms and in aiding infections therefore, a thorough understanding of TLRs structure and molecular mechanisms is required to explain how they can influence the outcome of an STI. Such a strategy may lead to the development of novel and useful immunotherapeutic approaches to control pathogen progression and prevent transmission.     

Chlamydia trachomatis infections in heterosexuals attending sexually transmitted disease clinics in Slovenia

This study assessed the age and gender distribution of Chlamydia trachomatis infections among patients attending two clinics for sexually transmitted diseases (STDs) in Slovenia. Between January 1999 and December 2003, 1714 heterosexual male and 892 heterosexual female patients were tested for C. trachomatis. The prevalence of C. trachomatis infection was 19.5% (n = 334) for male patients and 10.7% (n = 96) for female patients, with the highest prevalence in the group aged 15-30 years. The prevalence decreased between 2000 and 2003 among female patients. The results support the implementation of routine screening for C. trachomatis genital infection among male and female patients aged < 30 years attending STD clinics in Slovenia.