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Syphilis tests were done using the RPR card test (Becton Dickinson, Maryland, USA) and positive samples were confirmed with Treponema pallidum haemagglutination test (TPHA, Randox Laboratories, UK). Serum HIV-1 antibodies were detected by enzyme-linked immunosorbent assay (ELISA) (Biochem immuno systems kit, Montreal, Canada) and positive samples were confirmed using double ELISA test (Biotech, Cambridge, Ireland). Data analysis was done using SPSS version 7.5. Pearson's Chi-square with Yates' correction was used to compare proportions and the t-test to compare means. ORs and their 95% CIs were used to measure strength of association. The study was approved by the Ethical Committee of the University of Nairobi. Results From April 1997 to April 1998, an unselected group of 12,414 women who gave birth in the Pumwani Maternity Hospital (PMH) were screened for syphilis. Of them, 377 (3%) were RPR reactive. Of those 377 women, 117 (31%) had already been identified RPR positive earlier on during pregnancy while 155 (41%) had been RPR negative and 105 (28%) had not been tested during pregnancy. Postpartum, partner notification information was provided to 357 of the 377 RPR-positive women and 127 (36%) of their partners came for treatment. Forty-two (33%) of those partners had already been treated during pregnancy and of them 12 (29%) were still RPR positive at the time of delivery. Twenty-two men (17%) declined to be tested for syphilis. Of the 105 men tested, 33 (31%) were RPR positive. Fourteen men had a positive RPR test but negative TPHA test, suggesting a new early infection or a false positive RPR test. Table 1 shows the characteristics of women whose partners came for treatment and those who did not turn up. There was no difference in education, history of alcohol use, parity, bad obstetrical history, HIV status or number of sex partners in the past year. Women whose partners did not come for treatment however were younger (P=0.01), more likely to be unmarried (P
Table 1: Characteristics of women whose partners came and whose partners did not come for treatment. Characteristic Women whose partners did not come for treatment n=230 % Women whose partners came for treatment n=127 % P- value Age in years (mean + SD) 23 + 4.7 24 + 4.5 0.02 < 20 yrs old 87/230 (38) 30/123 (24) 0.01 Single 57/228 (25) 6/123 (5) 0.000 RPR + during pregnancy 67/161 (42) 49/100 (49) 0.2 Sex in exchange for money 32/230 (14) 5/123 (4) 0.004 Sex with person with STD 16/227 (7) 8/120 (7) 0.9 Ever had STD 25/230 (11) 22/123 (18) 0.06 Unfaithful spouse 61/169 (36) 25/101 (25) 0.05 History of abortion 39/230 (17) 21/124 (17) 1.0 History of LBW 13/100 (13) 3/59 (5) 0.2 Nullipari 102/230 (44) 50/124 (40) 0.5 Primigravida 85/230 (37) 43/124 (30) 0.7 Inadequate antenatal care 101/229 (44) 37/123 (30) 0.01 HIV + at delivery. 62/229 (27) 24/127 (19) 0.07 < 8 yrs of education. 161/229 (70) 77/123 (63) 0.1 Adverse obstetrical outcome 54/228 (24) 13/122 (11) 0.004 >1 sex partner in past year 92/230 (40) 40/123 (36) 0.2 Antenatal care in intervention clinic 90/230 (39) 58/123 (47) 0.1 Alcohol use 32/229 (14) 9/123 (7) 0.06 Treated for syphilis during pregnancy 63/67 (94) 49/49 (100) 0.08 Table 2 compares behavior Table 2: Characteristics of women and their partners who came for treatment. characteristics of women and their partners who came for Characteristic Women n=127 (%) Partners n=127 (%) P treatment. Men were more likely Age years (mean + SD) 24.1 + 4.5 30 + 6 to have had sex with commercial Single 6/123 (5) 6/127 (5) 1.0 Sex in exchange for money 5/123 (4) 19/127 (15) 0.003 sex workers (P=0.003), to have Sex with person with STD 8/120 (7) 29/127 (23) 0.000 had sex with a person with an Ever had STD 22/123 (18) 78/126 (62) 0.000 STD (P
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GHENT UNIVERSITY STI PREVENTION AND
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AIDS Acquired Immune Deficiency Syn
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1.1. Sexually Transmitted Infection
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countries, the rate of reporting co
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district of Uganda randomized villa
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By identifying where significant
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4.5%, 3.9%, 67.7% and 30.1% while t
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female primary health care or anten
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The research data have been publish
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2.1. OBJECTIVES 2.1.1. General obje
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2.2.3. Laboratory procedures The mi
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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,
Page 69 and 70: C HAPTER 6 PREVENTION OF SEXUALLY T
Page 71 and 72: Table 1: Syphilis Rapid Plasma Reag
Page 73 and 74: One should keep these problems in m
Page 75: The use of mailed reminders did not
Page 79 and 80: studies, indicating that couples ar
Page 81 and 82: 6.3. A Randomized, Placebo-controll
Page 83 and 84: esistance patterns in bystander flo
Page 85 and 86: In univariate analysis, the odds ra
Page 87 and 88: Widows, divorcees and separated wom
Page 89 and 90: They did not report much condom use
Page 91 and 92: The low prevalence of the other STD
Page 93 and 94: There is some evidence that frequen
Page 95 and 96: Table 1. Characteristics of HIV- po
Page 97 and 98: A significantly higher prevalence o
Page 99 and 100: There is now considerable evidence
Page 101 and 102: patients. The analysis revealed hig
Page 103 and 104: contributory factor may be that mal
Page 105 and 106: use in Kenya. In a supplement of Se
Page 107 and 108: with intensive behavioral change in
Page 109 and 110: C HAPTER 8 FINAL REMARKS STIs illus
Page 111 and 112: to protect themselves and be empowe
Page 113 and 114: Bell G, Ward H, Day S et al. Partne
Page 115 and 116: Fleming D and Wasserheit J. From ep
Page 117 and 118: Jackson DJ, Rakwar JP, Chohan B et
Page 119 and 120: Manning B, Moodley J, Ross SM. Syph
Page 121 and 122: Oberlander L, Elverdam B. Malaria i
Page 123 and 124: Serwadda D, Gray R, Wawer M et al.
Page 125 and 126: 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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