International STD Research & Reviews

Background: Syphilis continues to be a persistent public health challenge and gaining renewed attention against the back drop of HIV pandemic especially in the less developed high HIV stricken countries like Uganda. This study enrolled 150 HIV infected individuals. The objective was to determine the syphilis sero-prevalence and factors associated with syphilis infection among HIV positive individuals attending immune suppressed syndrome (ISS) clinic at International Hospital Kampala -Touch Namuwongo Project (TNP).

Methods/Design: This was a cross sectional study that recruited participants between January and May, 2014. Rapid Plasma Reagin test (RPR; BD Diagnostics) was used to screen for syphilis and if positive was confirmed by the Treponema pallidum Haemagglutination Assay (TPHA; Biotec Laboratories Limited Ipswich Suffolk, UK).

Results: We found 10% (n=15) seroprevalence of syphilis in the HIV positive individuals. Further; gender, age, occupation, marital status, polygamous relationship and education level attained did not show statistically significance association with syphilis infection (p>0.05). This prevalence was slightly higher in males (10.9%) than females (9.6%). The age groups 15-30 and 31-63 years had the highest (73%) and lowest (27%) seroprevalence of syphilis respectively. 

Conclusion: Syphilis appears to be common amongst HIV infected individuals studied. We recommend an urgent need to sensitize, screen and treat reproductively and sexually critical age group.

Vaginal microbiocinosis in 47 women with infertility and parasite invasion and 35 women with infertility without parasite invasion was investigated. In women with primary infertility, ascariasis was found in 48% of examined patients, Mycoplasma hominis was often revealed together with worm invasion, persistence of Ureaplasma species and urealyticum infection in lower parts of sexual system did not depend on presence or absence of parasites. The occurence of Esherichia colli, Klebsiella and Enterococcus faecalis was significantly higher in vaginal content under conditions of worm invasion. Dysbiotic changes in vagina were accompanied by intestinal dysbiosis in 48% cases, whereas in patients with intestinal dysbacteriosis changes of vaginal microflora content were revealed in 90% cases.

Objectives: To evaluate the sensitivity and specificity of Immunochromatographic device in comparison with Enzyme Linked Immuno-Sorbrent Assay.

Materials and Methods: It was a descriptive comparative study certified by Ethical Review Board of Allama Iqbal Medical College Lahore. Study was conducted at the Department of Pathology, Allama Iqbal Medical College Lahore. A total of 106 study subjects were included by using convenient sampling method within the duration of 4 months. Samples were processed in ELISA section, Department of Pathology, Allama Iqbal Medical College. Data was entered and analysed by using SPSS 22.0. A p-value of ≤ 0.05 was considered as statistically significant.

Results: Out of 106 patients 28 samples had been reported as positive with HIV–ELISA whereas, HIV ICT devices reported 21 cases as positive. On the other hand 78 samples stood negative with HIV-ELISA and 85 samples remained negative with HIV-ICT device. For HIV ICT device, the calculated sensitivity was 71.4% and the Specificity was 98.7%. The Positive Predictive Value (PPV) was 95.2% whereas the Negative Predictive Value (NPV) was 90.6%.

Conclusion: The ICT device is a rapid, reliable and valid device with shortest turn-around time and can be used in emergency settings and in low resource settings. Although, the device showed high sensitivity and specificity, but it cannot be taken as an ultimate diagnostic tool for HIV screening. Final diagnosis should be based on anti HIV 1/2 ELISA, Western Blot and PCR findings (Gold standard diagnostic assay).

Sexually transmitted infections are responsible for a variety of health problems, and can have serious consequences on reproductive health of the adolescents and young adults. Thus this study was designed retrospectively to explore the pattern and management of sexually transmitted infections (STIs) among undergraduates attending University health care centre within the period of six years between January 2007 and December, 2012. It was a descriptive cross sectional research study and data collection was done with the aid of a self developed checklist. Data obtained were analysed using Statistical Package for Social Sciences (SPSS-20.0). The results showed that 11770 undergraduates visited the health care centre within the study period, of which 342 (2.91%) presented with STIs. Trichomoniasis accounted for 155(45.3%) of the 342 STIs cases seen. The other STIs identified were gonorrhoea, 112(32.7%), candidiasis, 23(6.7%), chlamydiasis, 6(1.8%) and syphilis, 4(1.2%). It was also observed that 37(10.8) of the identified STIs were co-infections, and co-infection of Candida albicans (candidiasis) with Trichomonas vaginalis (trichomoniasis) 14(1.2%) as the most prevalent. Furthermore, the study showed the highest record of STIs was reported among 100 level students with 192(56.1%) cases while the least was recorded among the 500 level students with 2(0.6%). The study concluded that STIs with 2.91% prevalence must be regarded as significant notorious and real health burden on undergraduates, especially among the year one undergraduate students. It was recommended that enlightenment programmes on the prevention of sexually transmitted infections should be performed during the orientation of newly admitted students and routinely for old students.

Aims: To explore attitudes towards HIV testing in the United Kingdom (UK) from the public and healthcare practitioners (HCP) to more fully understand the barriers and motivators towards testing.

Methodology: Electronic databases Pubmed, Web of Science, OVID Medline and Google were searched. We included studies conducted in the UK that had explored public and HCP attitudes towards HIV testing, published in the combination antiretroviral therapy era (1996-2014). We excluded studies relating to HIV testing or screening of pregnant women.

Results: In a total of 64 studies identified, 41 and 23 were on positive and negative attitudes towards HIV testing of the public and HCP, respectively. Common barriers reported by the public were stigma, fear, denial, and low perception of risk. Common barriers reported by HCP were lack of confidence or anxiety around offering a test, privacy and confidentiality, and insufficient knowledge/training in HIV. Public motivators towards testing were: HCP offering/recommending a test, universal testing at practice registration, outreach rapid point-of-care (POC) testing offered as part of a check-up, availability of home testing/sampling, and informing patients about HIV and the benefit of receiving treatment.

Conclusions: Recommendations to overcome barriers include making HIV testing routine, easier and more accessible. Outreach POC testing, home testing and sampling offer motivators to testing such as ease of access, privacy and confidentiality. A proactive offer of an HIV test by the HCP is an important factor which could help increase testing rates. This could be facilitated by further education and training of HCP in General Practice.