GHENT UNIVERSITY Karoline FONCK - International Centre for ...

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6. Fonck K, Claeys P, Bashir F, Bwayo J, Fransen L, Temmerman M. Syphilis control in pregnancy: effectiveness and sustainability of a decentralized program, Am J Pub Health 2001; 91:705-7. (Chapter 6) This paper provides an analysis of the existing syphilis program in Nairobi. 7. Gichangi P, Fonck K, Sekande-Kigondu C, Ndinya-Achola J, Bwayo J, Kiragu D, Claeys P, Temmerman M. Partner notification of pregnant women infected with syphilis in Nairobi, Kenya. Int J STD & AIDS 2000; 11:257-61. (Chapter 6) In this paper, we report the determinants and effect of partner notification and treatment in pregnant women. 8. Fonck K, Kaul R, Kimani J, Keli F, MacDonald KS, Ronald AR, Plummer FA, Kirui P, Ngugi EN, Moses S, Temmerman M. A randomized, placebo-controlled trial of azithromycin prophylaxis to prevent STI and HIV-1 in Kenyan sex workers: study design and baseline findings. Int J STD AIDS 2000; 11:804-11. (Chapter 6) The overall objectives of this study were to 1) evaluate the impact of regular routine azithromycin chemoprophylaxis on STI and HIV-1 incidence in this population; 2) examine potential adverse effects of monthly azithromycin administration, including effects on antibiotic resistance patterns in bystander flora. 9. Fonck K, Kaul R, Keli F, Bwayo J, Ngugi E, Moses S, Temmerman M. Sexually transmitted infections and vaginal douching in a population of female sex workers in Nairobi, Kenya. Sex Transm Inf 2001; 77:271-276. (Chapter 6) This study was undertaken to assess the association between vaginal douching and sexually transmitted infections among a group of female sex workers. INTRODUCTION 17
2.1. OBJECTIVES 2.1.1. General objectives C HAPTER 2 OBJECTIVES AND METHODS The overall aim of this work was to assess the epidemiology of STI including HIV-1 in groups at various risk for HIV/STI and to attempt to document the quality, impact and effectiveness of existing STI control interventions in Nairobi. This information in turn should help national authorities strengthen their STI prevention and control strategies. 2.1.2. Specific objectives 1. To study the prevalence rates of sexually transmitted pathogens including HIV in different populations in Nairobi, Kenya; 2. To examine the effects of some of the risk factors for STI transmission; 3. To assess the health-seeking behavior among the population in Nairobi in relation to STI; 4. To define the effectiveness of the existing treatment algorithm in use in Kenya; 5. To assess the impact and the cost effectiveness of the existing syphilis screening program for pregnant women in Nairobi; 2.2. METHODS 2.2.1. Study design The studies took place within the framework of the EC funded AIDS/STD Control Project in Nairobi and Mombasa. As part of this project, operational research aimed at improving existing prevention and control strategies, was performed. We used observational studies including prospective cohort and cross-sectional designs. Routinely collected data from clinics and labs were also used. The methods used and the population examined are described in detail in each chapter. Chapter 2 18
Page 1 and 2: GHENT UNIVERSITY STI PREVENTION AND
Page 3 and 4: AIDS Acquired Immune Deficiency Syn
Page 5 and 6: 1.1. Sexually Transmitted Infection
Page 7 and 8: countries, the rate of reporting co
Page 9 and 10: district of Uganda randomized villa
Page 11 and 12: By identifying where significant
Page 13 and 14: 4.5%, 3.9%, 67.7% and 30.1% while t
Page 15 and 16: female primary health care or anten
Page 17: The research data have been publish
Page 21 and 22: 2.2.3. Laboratory procedures The mi
Page 23 and 24: C HAPTER 3 PREVALENCE AND RISK FACT
Page 25 and 26: After registration by the clinic cl
Page 27 and 28: The majority of the women were infe
Page 29 and 30: eing single, ever having been treat
Page 31 and 32: prevalence found in a family planni
Page 33 and 34: 3.2. Declining Syphilis Prevalence
Page 35 and 36: Training Nurses at the antenatal cl
Page 37 and 38: We believe that the observed declin
Page 39 and 40: Wasserheit 1992, Laga 1993). In Nai
Page 41 and 42: Table 1: Demographic data of 471 pa
Page 43 and 44: women. Overall, significantly fewer
Page 45 and 46: Stigmatization by health staff also
Page 47 and 48: 4.2. Health-Seeking Behavior and Se
Page 49 and 50: Between September and November 1998
Page 51 and 52: Table 2: Healthcare-seeking behavio
Page 53 and 54: Thirteen women had engaged in sex w
Page 55 and 56: Men reported more extramarital affa
Page 57 and 58: C HAPTER 5 DIAGNOSIS AND MANAGEMENT
Page 59 and 60: discharge and abdominal pain-two co
Page 61 and 62: Data were entered and analyzed in S
Page 63 and 64: One of the peripheral health center
Page 65 and 66: Evaluation of Algorithms The result
Page 67 and 68: In this study of symptomatic women,
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C HAPTER 6 PREVENTION OF SEXUALLY T
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Table 1: Syphilis Rapid Plasma Reag
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One should keep these problems in m
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The use of mailed reminders did not
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Table 1: Characteristics of women w
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studies, indicating that couples ar
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6.3. A Randomized, Placebo-controll
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esistance patterns in bystander flo
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In univariate analysis, the odds ra
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Widows, divorcees and separated wom
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They did not report much condom use
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The low prevalence of the other STD
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There is some evidence that frequen
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Table 1. Characteristics of HIV- po
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A significantly higher prevalence o
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There is now considerable evidence
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patients. The analysis revealed hig
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contributory factor may be that mal
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use in Kenya. In a supplement of Se
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with intensive behavioral change in
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C HAPTER 8 FINAL REMARKS STIs illus
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to protect themselves and be empowe
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Bell G, Ward H, Day S et al. Partne
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Fleming D and Wasserheit J. From ep
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Jackson DJ, Rakwar JP, Chohan B et
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Manning B, Moodley J, Ross SM. Syph
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Oberlander L, Elverdam B. Malaria i
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Serwadda D, Gray R, Wawer M et al.
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Van Dam J, Anastasi MC. Male Circum
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WHO Collaborating Center on HIV/AID
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S UMMARY Sexually transmitted infec
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notification. Innovative and locall
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connaissance des femmes sur la sant
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Nous avons démontré que le coût
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vonden we een hoge prevalentie van
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We hebben aangetoond dat de kost va
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