Risk assessment and other screening options for gonorrhoea and chlamydial infections in women attending rural Tanzanian antenatal clinics.

Sexually transmitted diseases (STDs) are a major cause of morbidity and mortality in developing countries and may play a key role in enhancing the heterosexual transmission of human immunodeficiency virus (HIV). Treatment of STDs is one of the most cost-effective of all health interventions in developing countries; however, STDs among women in rural populations have received little attention. In this study, we report that prevalences of STDs among 964 women attending antenatal clinics in a rural area of the United Republic of Tanzania. A total of 378 (39%) of these women were infected with at least one STD pathogen, 97 (10%) had syphilis, and 81 (8%) has Neisseria gonorrhoeae (NG) and/or Chlamydia trachomatis (CT) infection. The recommended syndromic approach to screening for NG/CT infection, based on reported genital symptoms, had a low sensitivity (43%) and failed to discriminate between infected and uninfected women. A risk score approach that we developed, based on sociodemographic and other factors associated with NG/CT infection, had a higher sensitivity and lower cost per true case treated than other approaches, although its positive predictive value was only about 20%.     

男男性行为者艾滋病病毒及梅毒感染状况调查

目的 了解江苏省常州市男男性行为者(MSM)的人口学和行为学特征、艾滋病病毒(HIV)和梅毒感染情况及其影响因素.方法 通过问卷调查收集人口学、相关健康服务及行为学等信息,并采集血液和尿样标本分别进行HIV和梅毒抗体、及淋球菌和生殖道沙眼衣原体检测.结果 共有效调查593名MSM,HIV和梅毒感染率分别为13.7%(81/593)和31.2%(185/593),同时感染HIV和梅毒者占7.1%(42/593);5.7%(34/592)曾经发生过性虐待;在近6个月,63.9%(379/592)与男性发生过肛交行为,76.0%(288/379)在最近1次肛交中使用安全套,47.2%(280/592)与女性发生过性行为,53.2%(149/280)在最近1次与女性发生性行为时使用安全套;非条件多元logistic回归分析结果显示,感染HIV的危险因素为年龄偏大、学生、有过性虐待、梅毒抗体阳性;梅毒感染的危险因素为HIV抗体阳性、有过性虐待出血.结论 常州市MSM人群普遍存在高危性行为,其HIV和梅毒感染率已达较高水平;应采取HIV和性传播感染(STI)筛查及性病规范诊疗等综合防治措施.     

广州市区早孕妇女梅毒与HIV感染的流行病学调查

目的:调查广州市中心区早期妊娠妇女梅毒和HIV感染情况,对筛查阳性的孕妇进行早期治疗和干预。方法:对妊娠12周以内的早孕妇女进行梅毒血清学检查和HIV抗体初筛检查,对确诊为妊娠梅毒的孕妇,按卫生部疾病控制司2000年颁发的《性病诊断标准与处理原则》中的妊娠梅毒治疗方案给予规范治疗;对HIV感染者,给予适当的行为干预,随访并追踪孕妇的妊娠结局。结果:筛查2177例妊娠12周以内的早孕妇女,其中梅毒感染13例,感染率为5.97‰,HIV感染2例,感染率为0.92‰。结论:在妊娠早期进行梅毒和HIV感染的筛查和干预更有利于控制母婴垂直传播及避免其不良妊娠结局。     

2009-2010年凭祥市孕产妇HIV、梅毒和HCV监测

目的了解凭祥市HIV、梅毒和HCV在孕产妇人群中的感染情况。方法在2009-2010年监测期内,对首次到市妇幼保健院和市人民医院建卡或进行围产期保健的800名孕产妇血清进行HIV、梅毒和HCV抗体检测。结果 800名孕产妇中,检出HIV抗体阳性2例,阳性率为0.25%,梅毒16例,感染率为2.00%,HCV3例,感染率为0.38%。2年HIV、梅毒感染率类似;查出的HIV、梅毒、HCV感染者均为高中/中专以下文化;3类感染者年龄主要分布在25～35岁,1例HIV感染者、87.5%梅毒感染者、全部HCV感染者均为在婚孕产妇。结论该市孕产妇性传播疾病感染者主要为在婚妇女,已由高危人群向一般人群传播。     

Interpreting neonatal HIV seroprevalence data in Great Britain: the importance of differential fertility

In order to derive more accurate estimates of HIV infection among the general population in Great Britain from unlinked anonymous neonatal seroprevalence data, the differential HIV and fertility patterns amongst groups of women were explored. The HIV risk in women was estimated using neonatal seroprevalence data and reports of diagnoses of HIV infection in pregnant women. Live birth rates were estimated using population data and these were supplemented using data from a prospective European cohort of HIV-infected pregnant women. HIV prevalence was higher in women born in sub-Saharan Africa (SSA) and injecting drug users (IDUs) (2.50% and 0.29% respectively in London) compared to other women (0.068%). Fertility was also higher in women born in SSA (OR 1.33 using population data), whilst IDUs were more likely to have had a previous termination (OR 1.48 using the European cohort of HIV-infected pregnant women data). We conclude that when unlinked anonymous neonatal seroprevalence data is used to estimate general population prevalence, adjustments need to be made for fertility differentials in population subgroups at varying risk of HIV.     

Screening for syphilis,HIV and HBV at delivery

Qolohe and colleagues conducted a study at a hospital in Natal, South Africa to assess the prevalence of syphilis, human immunodeficiency virus (HIV) infection, and hepatitis B virus (HBV) infection in umbilical cord blood samples at the time of delivery, and to determine the seroconversion rates of syphilis and HIV infections from initial visit to delivery. 418 women were enrolled; 39 (9.3%) had reactive syphilis serology (RPR positive, TPHA positive) at delivery. 9 of the 329 booked women who were initially seronegative for syphilis seroconverted at delivery (a seroconversion rate of 2.7%). The seroprevalence rate was significantly higher for the unbooked group of women (18.2%) than for the booked group of women (8.4%). 18 women with reactive sera at the initial visit became nonreactive after 4-17 weeks. Another 50 patients showed evidence of past treponemal infection (RPR negative, TPHA positive). Overall, 32 (7.2% of 418) women were positive for HIV at delivery. 4 of the 178 (2.2%) in the booked group seroconverted. Hepatitis B surface antigen was detected in 2 women. In view of these findings, the authors recommend screening for syphilis and HIV at the time of delivery in the Natal-Kwazulu region where these diseases are endemic. Since congenital syphilis is preventable with treatment, and knowledge of HIV status affects counseling about safe sex practices, pregnancy termination, follow-up care of the infant, and breast feeding, this author recommends screening for syphilis and HIV during pregnancy and at delivery in areas of high prevalence of these two diseases.     

Prevalence of hepatitis B,hepatitis C and syphilis in female sex workers in Venezuela

OBJECTIVE: In Venezuela, female sex workers are submitted to a preventive control of syphilis and human immunodeficiency virus (HIV). However, other very important sexually transmitted infections are not evaluated. A study was carried out to identify the sociocultural background of a group of sex workers and its association with the seroprevalence of hepatitis B and C markers, in addition to routine evaluation. METHOD: A total of 212 female sex workers who attended the control center of sexually transmitted infections (STI) in the city of Los Teques, Venezuela, were evaluated. Women were asked their age, educational background, use of contraceptive methods and condoms. Blood was drawn to determine the prevalence of syphilis, hepatitis B surface antigen (HBsAg), antibodies to hepatitis B core (anti-HBc), hepatitis C (anti-HCV) and HIV. RESULTS: The prevalence of syphilis was 2.4%, seroprevalence of anti-HCV was 0.5%, HBsAg 3.8% and anti-HBc 13.8%. No cases of HIV were observed. Higher prevalence of hepatitis B markers was associated with a lower level of education (p<0.05) and higher age (p<0.05). It was found that 38.5% of participant women never used condoms and 25.6% did not use any contraceptive method. CONCLUSION: It could be necessary to implement preventive programs to immunize sex workers against hepatitis B virus as well as education programs on condom use for their protection against sexually transmitted infections.     

2014-2018年泰州市孕产妇艾滋病哨点监测结果

目的  分析泰州市孕产妇艾滋病感染现状、艾滋病防治知识知晓情况及其影响因素,为当地防控策略制定和干预效果评估提供科学依据。 方法  采用现况调查的研究方法,于2014-2018年每年的监测期内,在两家妇幼保健院分别连续每次抽取400名调查对象人群进行问卷调查并采血。 结果  5年共监测孕产妇4 000人,29.9%去过外地打工,艾滋病防治知识总体知晓率为91.2%,历年知晓率存在统计学差异且总体呈上升趋势（均有P < 0.05）。多因素Logistic回归分析结果显示,孕产妇35岁及以上、大专以下和丈夫前往外地打工艾滋病知识知晓率低。共检出艾滋病感染者2例,HIV感染率为0~0.1%。 结论  泰州市孕产妇艾滋病感染率处于较低水平。     

辽宁省2010-2014年孕产妇人群艾滋病哨点监测结果分析

目的 了解辽宁省孕产妇人群HIV、梅毒、HCV感染状况及一般人口学特征、高危行为等变化趋势。方法 对2010-2014年连续开展监测的15个孕产妇哨点以重复横断面调查方法进行问卷调查并采血。结果 2010-2014年连续开展监测的15个孕产妇哨点中,监测对象一般人口学数据无明显变化;部分孕产妇自报有吸毒行为,但比例维持在较低水平;艾滋病知识知晓率逐年上升,从2010年的77.0%上升到2014年的92.9%,趋势检验P<0.001;5年间,只在2011年和2012年各检出1例HIV抗体阳性者;梅毒抗体阳性率逐年上升,从2010年的0.37%上升到2014年的0.52%,趋势检验P<0.05;HCV抗体阳性率无明显变化,波动在0.15%~0.42%,趋势检验P>0.05。结论 辽宁省孕产妇人群HIV抗体阳性率一直维持在低水平,但梅毒抗体阳性率有所上升。     

Seroprevalence and Associated Risk Factors of Toxoplasma gondii in Pregnant Women Attending in Northwest Ethiopia

Background

Toxoplasmosis is a major public health problem among immuno-compromised individuals. This study aimed to determine the seroprevalence and associated risk factors of Toxoplasma gondii infection among pregnant women with and out HIV infections.

Methods

This cross sectional study was conducted among consecutive 385 pregnant women attended Antenatal Clinic from May 2010 to October 2011 at the Gondar University Teaching Hospital, Northwest Ethiopia. Venous blood was collected from each pregnant woman for testing HIV-1/2 and anti- Toxoplasma antibodies using rapid test kits. Data were entered and analyzed using SPSS version 20 statistical package.

Results

The overall magnitude of T. gondii and HIV was 88.6% (341/385) and 11.2% (43/385), respectively. The seroprevalence of T. gondii was not different among HIV infected and non-infected pregnant women (88.4%, 38/ 43 vs 88.6%, 303/342). Keeping cats in house showed statistically significant association with seropositivity of toxoplasmosis (P<0.05).

Conclusion

Irrespective of HIV infection, high rate of T. gondii was detected among pregnant women. These high prevalences indicate the need for an intensified public health awareness to reduce both infections.     

宜昌市孕产妇艾滋病知识调查及HIV、HCV和梅毒监测结果

目的:了解宜昌市孕产妇艾滋病知识知晓水平以及艾滋病病毒(HIV)、丙型肝炎病毒(HCV)利梅毒的感染状况,为阻断艾滋病母婴传播提供科学依据。方法:对宜昌市400名孕产妇进行问卷调查,采集血样进行HIV、HCV和梅毒的血清学检测。结果:400名调查对象的艾滋病知识总知晓率为92.75%,高危行为少,HCV和梅毒感染率各为0.50%,未发现HIV抗体阳性。结论:HIV、HCV和梅毒在宜昌市孕产妇人群呈低流行状态,今后应继续加强艾滋病知识的宣传教育,开展产前常规HIV和梅毒检测,阻断艾滋病母婴传播途径。     

杭州市孕妇产前血液传染性标志物的分析研究

目的:探讨孕妇产前血液检测传染性标志物的临床意义。方法:采用微粒子化学发光技术检测乙型肝炎病毒标志物;酶联免疫法(ELISA)检测丙型肝炎病毒抗体(HCV)、梅毒螺旋体抗体(TP)、人类免疫缺陷病毒抗体(HIV)。结果:6170名孕妇中HBsAg阳性总人数593例,HBsAg阳性率9.61%;梅毒感染人数39例,梅毒抗体阳性率0.63%;丙肝感染人数18例,丙肝抗体阳性率0.29%;未检测出HIV阳性者。结论:孕妇产前血液传染性标志物的检测,能为阻断和降低母婴传播,确保母婴安全健康提供保障;减少和避免医疗纠纷、预防医院感染提供可靠的实验室依据。     

Acquired immunodeficiency syndrome and human immunodeficiency virus infection in Bujumbura, Burundi

In the first seroepidemiological survey in Burundi in 1984, only 59 acquired immunodeficiency syndrome (AIDS) cases were recognized. We report here clinical surveillance of AIDS cases in the 4 hospitals in Bujumbura during a 4-month period in 1986. The project was combined with a seroprevalence study of pregnant women in the 6 dispensaries in Bujumbura. 258 AIDS patients were recorded. 16% of the 925 pregnant women were seropositive for human immunodeficiency virus (HIV). The clinical characteristics of 120 adult AIDS patients were similar to those reported in Kinshasa or Kigali. From demographic findings we presume that the major mode of HIV transmission in Bujumbura is by sexual contact. The results of this study formed the starting point of prevention activities against AIDS in Burundi.     

西藏自治区2015年暗娼等7类艾滋病重点人群HIV、梅毒和HCV横断面调查

目的 了解2015年西藏自治区暗娼等7类艾滋病重点人群HIV、梅毒和HCV的流行现状及其相关行为因素。方法 2015年6-12月对西藏自治区的拉萨市、昌都市、林芝市、日喀则市、山南市、阿里地区、那曲地区共7个市（地区）及25个县（区）的暗娼等7类艾滋病重点人群开展横断面调查。样本量分别为暗娼人群2 000人、MSM人群200人、注射吸毒者200人、男性流动人群1 200人、青年学生5 600人、医院就诊人群为2015年6-12月在综合医院就诊者、孕产妇为2015年6-12月在综合医院和妇幼保健机构首次接受孕期和围产期检查的门诊或住院孕产妇。收集人口学和行为学信息,进行HIV、梅毒和HCV血清学检测。计数资料采用率或构成比进行统计描述。结果 7类艾滋病重点人群共调查20 597人。暗娼人群HIV和梅毒抗体阳性率分别为0.05%（1/2 133）和5.81%（124/2 133）;MSM的HIV和梅毒抗体阳性率均为9.80%（10/102）;吸毒人群、男性流动人群及青年学生中未检出HIV抗体阳性,梅毒阳性率分别为4.00%（4/100）、0.33%（4/1 297）和0.08%（4/5 095）;医院就诊人群HIV和梅毒抗体阳性率分别为0.04%（2/5 565）和1.64%（91/5 565）;孕产妇中HIV和梅毒抗体阳性率分别为0.11%（7/6 305）和1.19%（75/6 305）。HCV抗体阳性率,吸毒人群为1.00%（1/100）,其他6类人群均低于0.50%。各类人群坚持使用安全套率均较低。结论 西藏自治区的HIV感染主要集中在MSM人群,梅毒感染主要集中在MSM人群和暗娼人群中,HCV感染主要集中在吸毒人群中,各人群对艾滋病和性病防治知识的知晓率、接受干预服务比例均低。     

深圳市已婚妊娠梅毒患者配偶的梅毒感染情况及影响因素分析

目的 了解已婚妊娠梅毒患者配偶的梅毒感染情况,并从妊娠梅毒患者及配偶自身角度分析影响配偶感染梅毒的因素。方法 对2008-2011年间在深圳市确诊感染梅毒的已婚孕产妇进行调查和配偶追踪,并对就诊的配偶进行甲苯胺红不加热血清试验（tolulized red unheated serum test,TRUST）和梅毒螺旋体颗粒凝集试验（teponema pallidum purtide assay,TPPA）检测,通过问卷收集已婚妊娠梅毒患者及其配偶的相关信息,采用多因素logistic回归模型分析配偶感染梅毒的影响因素。结果 本研究共纳入已婚妊娠梅毒患者及其配偶2 261对。接受调查的配偶中,528例TRUST和TPPA均阳性（23.35%）,129例仅TPPA阳性（5.71%）,配偶的梅毒感染率为29.06%（657/2 261）。妊娠梅毒患者血清滴度≥1：8、疾病诊断为早期梅毒和足量治疗后者其配偶感染梅毒的风险较高（均有P<0.05）。配偶文化水平在高中及以下、自身存在多性伴行为者其感染梅毒的风险较高（均有P<0.05）。结论 已婚妊娠梅毒患者的配偶具有较高的梅毒感染率,妊娠梅毒患者的梅毒血清滴度水平、疾病诊断情况以及配偶的多性伴行为等是影响配偶感染梅毒的重要因素。     

Seroepidemiological survey of hepatitis C virus among commercial sex workers and pregnant women in Kinshasa, Democratic Republic of Congo

BACKGROUND: Studies conducted mainly in industrialized countries have shown that the transmission of hepatitis C virus (HCV) is mainly parenteral, and have emphasized the role of nosocomial transmission. In Equatorial Africa, the respective contributions of parenteral and non-parenteral routes of transmission are unknown. The potential role of sexual transmission in this area of high HCV endemicity, where sexually transmitted infections (STI) are frequent, is suggested by the fact that HCV infection is rare in infants and young adolescents, but increases thereafter with age. The present study, conducted in Democratic Republic of Congo, was designed to determine the prevalence of HCV infection and associated sexual risk factors in two female populations with different sexual behaviour. METHODS: Cross-sectional studies conducted among commercial sex workers (CSW; n = 1144) and pregnant women (n = 1092) in the late 1980s in Kinshasa showed a high frequency of at-risk sexual behaviour, STI and human immunodeficiency virus (HIV) infection, particularly among CSW. We screened samples collected during these epidemiological studies for antibodies to HCV using a second-generation ELISA with confirmation by a third-generation LIA. We also assessed sociodemographic variables, medical history, STI markers and sexual behaviour, and their potential association with HCV infection. RESULTS: The overall prevalence of anti-HCV was 6.6% (95% CI : 5.2-8.2) among CSW and 4.3% (95% CI : 3.2-5.7) among pregnant women (age-adjusted OR = 1.5, 95% CI : 1.0-2.1, P = 0.05). Multivariate analysis showed that the presence of anti-HCV among CSW was independently associated with a previous history of blood transfusion (P < 0.001), age >30 years (P < 0.001) and the presence of at least one biological marker of STI (P < 0.03). No such links were found among pregnant women (although the history of blood transfusions was not investigated in this group). Anti-HCV was not associated with sociodemographic variables or sexual behaviour in either group, or with individual markers of STI. Despite the high-risk sexual behaviour and the higher prevalence of STI in CSW, the difference in HCV seroprevalence between CSW and pregnant women (6.6% versus 4.3%) was small, particularly when compared with the difference in the seroprevalence of HIV (34.1% versus 2.8%). CONCLUSION: The role of sexual transmission in the spread of HCV seems to be limited. Parenteral transmission (including blood transfusion and injections), possibly related to the treatment of STI, probably plays a major role.     

Prevalence of HIV,syphilis and genital chlamydial infection among women in north-west Ethiopia.

The prevalence of sexually transmitted diseases (STD) among women visiting antenatal (ANC) and gynaecological clinics in Gondar, north-west Ethiopia, was investigated. Between April and August 1995, 728 women consented to enter the study. Prevalence rates were 5.9% (41/693) for chlamydial antigen in cervix, 18.8% (113/600) for syphilis (Treponema pallidum haemagglutination assay [TPHA]) and 25.3% (150/593) for HIV. Active syphilis (RPR)+, TPHA+ was detected in 74% (44/597). HIV infection rate was higher among women with higher age of first marriage and low gravidity. It was significantly associated with young age, urban residence, and presence of genital ulcer (odds ratio [OR] = 6.3), and lymphadenopathy (OR = 2.8) on examination. Women seropositive for syphilis had married at an earlier age, were significantly older and had changed husbands. Low gravidity and age < 30 were independently significant risk factors for cervical chlamydial antigen positivity which was predominantly asymptomatic. Significant association was observed between HIV infection and syphilis (OR = 2.6). Active syphilis was associated with chlamydial (OR = 3.4) and HIV infection (OR = 4.1). The rate of 23.4% and 15.1% of HIV seropositivity among ANC attenders and rural women respectively is an indicator of the rapid progression of the HIV epidemic in the area.     

Seroprevalence of HIV infection in pregnant women in the Annaba region (Algeria)

BackgroundThe goal of the study is to assess the prevalence and the risk factors of the infection by the human immunodeficiency virus (HIV) among pregnant women in the area of Annaba (Algeria).MethodsWe performed a cross-sectional study with analytical purposes. The study included 3044 pregnant women admitted to two regional hospitals within a period of time of five months. Two Elisa tests were used to determine the prevalence of HIV infection. An analysis of medical history and serum tests for biomarkers hepatitis virus B infection, hepatitis virus C infection and syphilis to determine the possible mode of contamination, by blood or sexual transmission.ResultsHIV prevalence was 5.3/1000 (CI 95%; 3.12–8.37), HBV prevalence 24.7/1000 (CI 95%; 19.6–30.7), HCV prevalence 6.3/1000 (CI 95%; 3.8–9.5) and syphilis prevalence 2.6/1000 (CI 95%; 1.2–5). On average, pregnant women infected by HIV were 33 ± 5 years old, married, and had three children. The analysis of the markers of exposure risk investigated in our study showed that the pregnant women infected with HIV do not compose a specific risk group. Overall our results suggest that the more probable route of HIV transmission for women of the Annaba region is via heterosexual intercourse with spouse.ConclusionThe prevalence of HIV infection in Annaba remains high 5.3/1000, compared with the national average of 1/1000. In this region, pregnant women infected with HIV are not part of a group at particular risk. The HIV monitoring should be further strengthened in our country.     

2010—2011年盐城市盐都区孕产妇艾滋病哨点监测分析

目的了解盐城市盐都区孕产妇艾滋病病毒(HIV)、梅毒、丙型肝炎病毒(HCV)的感染状况及艾滋病防治相关知识水平,为预防控制工作提供依据。方法按照《全国艾滋病哨点监测实施方案》要求,2010和2011年分别对400名孕产妇进行问卷调查和血清学检测。结果 2010和2011年监测的孕产妇艾滋病防治知识知晓率分别为60.25%(241/400)和83.75(335/400),HIV和HCV抗体均未检出,梅毒抗体检出率分别为1.5%和1.0%。结论盐都区孕产妇人群艾滋病和丙肝呈低流行,但存在多种危险因素,应加强健康教育和行为干预,提高艾滋病防治知识知晓率,减少对艾滋病的恐慌和歧视,阻断母婴传播的发生。     

2016—2018年瑞安市孕产妇艾滋病哨点监测结果分析

目的 了解瑞安市2016—2018年孕产妇艾滋病知晓情况和相关性行为特征,为制定艾滋病防治策略和干预措施提供依据。 方法 对2016—2018年每年4—7月期间首次到瑞安市妇幼保健院进行孕产期保健的孕产妇进行问卷调查,并采血进行HIV抗体、梅毒抗体、HCV抗体血清学检查。 结果 2016—2018年共监测孕产妇1 200人,其艾滋病知识总体知晓率86.25%,各年度分别为82.00%、85.00%、91.75%,呈逐年上升趋势(χ²＝16.82,P＜0.001)。年龄大于25岁、文化程度越高、初次孕产及生育次数越少者知晓率越高。孕产妇本人和其丈夫去过外地打工经商的比例分别为16.08%、19.25%,吸毒的比例分别为0.25%、1.16%,丈夫患过艾滋病或性病的占0.08%。孕产妇HIV抗体、梅毒抗体和HCV抗体阳性检出率分别为0、0.17%和0.08%。 结论 瑞安市孕产妇艾滋病HIV感染率总体处于低流行水平,但部分孕产妇存在本人或丈夫吸毒、丈夫患性病等现象,存在感染艾滋病/性病的风险,应当进一步采取有效措施,控制艾滋病/性病在该人群中传播。