International STD Research & Reviews

Introduction: Mother-to-child transmission of HIV remains a leading cause of morbidity and mortality among under-five children in Nigeria.

Aim: This study explored the perception and experience of HIV positive mothers who had accessed services for preventing mother-to-child transmission of HIV (PMTCT) in Benin City, Edo State, Nigeria.

Methodology: This was a qualitative study. HIV positive mothers accessing services for preventing mother-to-child transmission of HIV were recruited from seven health facilities across Benin City. Data collected through focus group discussions and in-depth interviews sessions.

Results: The mothers study were happy that antiretroviral medications were provided free of charge at the clinics. They commended the friendly attitude of most health workers and were particularly delighted that they could now breastfeed their babies following the availability of antiretroviral medications for mothers and babies. The mothers however complained about the discriminatory attitude of some health workers at the sites.

Conclusion: The mothers’ were generally positive in their perceptions of the programme for preventing mother-to-child transmission of HIV. However, some mothers reported negative experiences during their interactions with health workers at some of the health facilities providing comprehensive services for preventing mother-to-child transmission of HIV.

Aims: This study aims to determine the prevalence of symptomatic vulvo-vaginal candidiasis and trichomoniasis and risk factors among women presenting at the outpatient departments of two tertiary health institutions in the Niger Delta region of Nigeria.

Study Design:  A prospective cross-sectional study.

Place and Duration of Study: The study was carried out at the Niger Delta University Teaching Hospital (NDUTH), Okolobiri and the Federal Medical Centre (FMC), Yenagoa, both in Bayelsa State, Nigeria between February 2012 and May 2013.

Methodology: 1240 patients presenting with vaginal symptoms: discharge, itching, soreness or burning sensation were consecutively recruited for the study. High vaginal and endocervical swabs were taken from the women and examined microscopically for motile trichomonads and yeasts, and cultured on appropriate media. Gram staining and Germ tube test were used to identify the organisms. A structured questionnaire was used to obtain patient information relevant to the study. IBM SPSS 21 for Windows® was used for statistical analysis. Variables were compared using the Student’s t-test and Fisher’s Exact test. P values less than 0.05 were considered significant.

Results: The prevalence of VVC was 25.7% (319 subjects), and only Candida albicans genus was isolated from the samples. Bacterial culture was positive in 34.3% of the subjects and Trichomonas vaginalis identified in 6.5% of the samples. Prevalence of co-infection with C. albicans and T. vaginalis was 2.6%.  Most of the subjects with VVC and T. vaginalis infection were in the 21 years to 30 years age group. Diabetes mellitus (p<0.01), being a student (p<0.01) and being single (p<0.01) were significantly associated with C. albicans infection and T. vaginalis infection. Pregnancy was significantly associated with C. albicans infection (p=0.04).  The use of low-oestrogen oral contraceptives had no significant association with C. albicans or T. vaginalis infection.

Conclusion: Symptomatic VVC and T. vaginalis infection were found to be common in the Niger Delta region of Nigeria. Risk factors include diabetes mellitus, pregnancy, being single and being a student. Clearly defined clinical guidelines for symptomatic vulvovaginitis management are needed.

Aims: Young people especially in sub-Saharan Africa are at great risk of contracting HIV. Studies have shown that young people aged 15–24 account for an estimated 45% of new HIV infections worldwide while less than half could demonstrate accurate and comprehensive knowledge about HIV/AIDS. Similarly they lack access to appropriate reproductive health information and treatment.

This study aimed to identify the beliefs, values and attitudes of the youths and gatekeepers in the community to STIs including HIV/AIDS and socio-economic factors promoting their spread.

Place and Duration of Study: This study was carried out in Bayelsa State between January and April 2007.

Methodology: Four focus group discussions among youths and five in-depth interviews among opinion leaders were conducted in a rural and urban area of Bayelsa state. The participants were homogenous groups in terms of age and sex and comprised of an average of ten youths per group Opinion leaders were made up of media practitioners, youth leaders and religious leaders of both sexes.

Results: The FGD revealed that youths in both the urban and rural areas had limited access to reproductive health information, contraceptive advice and treatment. This resulted in wide spread use of herbal medicine and high doses of quinine among youths as contraceptives with an early age of sexual debut. Cost of procuring an abortion varied from 17 to 25 USD.  Socio-cultural and economic factors contributing to the spread of HIV/AIDS among youths identified by opinion leaders were deterioration of traditional social discipline and norms of behavior, multiple sexual partners, poverty, non-acceptance by religious groups of all proven HIV preventive methods such as condom use among youths, and on-going harmful cultural practices such as female genital mutilation and socio-cultural events such as 'owigiri night'.

Conclusion: There is a need for health programmes and mass media interventions that will improves access to reproductive health information and services, among youths in this region so as to help check the spread of STIs.

Introduction: Gonorrhea is a worldwide public health problem. In Bhutan, the incidence of sexually transmitted infections increased from 12/10,000 in 2011 to 92/10,000 population in 2015. Disease burden and antibiotic resistance of Neisseria gonorrhoea have never been studied.

Aim: To study the burden of gonorrhea and trends in antibiotic susceptibility pattern of N. gonorrhoea in Bhutan.

Study Design: A descriptive, retrospective study.

Place of Study: The study was carried out in four large hospitals, the only hospitals with microbiology culture facilities in Bhutan; the Jigme Dorji Wangchuck National Referral Hospital (JDWNRH), Eastern Regional Referral Hospital (ERRH), Central Regional Referral Hospital (CRRH), and Phuentsholing General Hospital (PGH).

Methods: Laboratory data of patients investigated for gonococcal urethritis in the four hospitals; over four years (2012-15) were analyzed. Laboratory processes involved microscopy by Gram stain and culture.

Results: A total of 1,858 samples were processed; JDWNRH (60.2%, 1,119), PGH (17.7%, 329), CRRH (11.5%, 214) and ERRH (10.6%, 196). Only 1.2% (22) was females. The commonest age group was 20-30 years. There was an increasing trend in the number of cases in all hospitals. Microscopically, Gram-negative diplococci were seen in 80.7% (1,499) of cases and N. gonorrhoea was isolated in 78.3% (1,173). Only 13.6% (3/22) were culture positive in females. Resistance against nalidixic acid, ciprofloxacin, penicillin, and tetracycline were >70% but against ceftriaxone (currently recommended antibiotic), azithromycin, spectinomycin and cefpodoxime were <5% (critical resistance level for recommended therapy).

Conclusion: The burden of gonorrhea increased over years but there were only a few female patients indicating poor adherence to ‘seek and treat partners’ advocated in treatment guidelines. Compliance with treatment guidelines warrants reinforcement. With ceftriaxone resistance of 0.2%, Bhutan can continue to use it as recommended therapy with ongoing, multi-site, resistance surveillance as resistances continue to emerge and spread worldwide. Such surveillance would provide early warning or evidence to base future changes in therapeutic choices.

Blood transfusion service comes with its various risks which include transfusion of transmissible infections especially hepatitis B. Though Nigeria is noted as a high endemic region for hepatitis B virus (HBV) infection, yet most techniques focus on detection of only hepatitis B surface antigen marker in serum or plasma. This study aims at optimizing ‘safe blood’ practice by advancing hepatitis B virus testing in prospective blood donors (PBD) beyond single marker serologic screening and estimating HBV endemicity among blood donors based on HBV markers seroprevalence. Up to 4 ml of K3EDTA anticoagulated sample was obtained from PBD and aliquot into two separate plain containers following informed consent and ethical approval. A total of four hundred and seventy (470) of PBD were initially screened for HBV markers using NOVA HBV 5-in-1 rapid one-step enzyme immunoassay between August, 2014 and November, 2015. Results were analyzed using SPSS version 21. The results showed that the overall gender ratio and mean age of PBD screened for HBV are 1.45:1 and 26.87±7.51 respectively. Chi square revealed right knowledge of most of the routes of hepatitis B viral transmission by PBD (χ² range = 11.6 – 102.3, p < 0.05). Also, this study revealed HBsAg seroprevalence of 6.4% based on NOVA 5-in-1 rapid EIA. Cummulative HBV markers seroprevalence was 19.36% including 34 (7.23%) HBsAb⁺ and 1(0.21%) HBsAb⁺HBeAb⁺HBcAb⁺ showing evidence of vaccinated and naturally immunized donors respectively.  In conclusion, the use of more stringent serologic techniques and workable algorithm to reduce risks associated with blood transfusion and enhance both blood donors’ and recipients’ safety is no longer a luxury but a necessity.