Declining Trend of Serological Syphilis Among Genitourinary Medicine Patients in the Gambia, West Africa

Analysis of factors associated with failure to return for an HIV-test result in The Gambia

Knowing one's HIV status is fundamental to the prevention and treatment of HIV and AIDS. However, HIV prevention is defeated if individuals who opt to be tested fail to return for their test result. Despite the burden of HIV and AIDS in sub-Saharan Africa, regional studies on failure to return (FTR) for an HIV-test result are lacking. We investigated the factors associated with FTR in The Gambia, West Africa. FTR was analysed for 1 755 persons who attended an outpatient clinic during 2000 to 2009. Overall, the proportion of FTR was 30%. Logistic regression showed that FTR was significantly higher among males, individuals whose nationality was not Gambian, individuals with a history of condom use, and individuals who resided in an urban area. Persons who were younger than age 18 years and persons who had received some formal education were more likely to not return for the HIV-test result than were persons aged 40 years or older and persons without formal schooling. The results provide evidence for the need for appropriate strategies to increase the receipt of HIV-test results among people in the general population and among certain group profiles.

Declining prevalence rates of syphilis among police officers in Guinea-Bissau, West Africa, 1990-2010

We analyzed prevalence rates of syphilis (positive Treponema pallidum hemagglutinin antigen/T. pallidum particle antigen and venereal disease research laboratory test) among police officers in Guinea-Bissau from 1990 to 2010 and found a significant decline from 4.5% to 0.4% (P = 0.0065). Our results are in line with other recent reports from West Africa. More research is needed to identify the reasons for this decline.

High prevalence of HIV-1, HIV-2 and other sexually transmitted infections among women attending two sexual health clinics in Bissau, Guinea-Bissau, West Africa

The objective was to examine the prevalence of HIV-1, HIV-2 and 10 other sexually transmitted infections (STIs), and to explore the relationship between HIV and those STIs in women attending two sexual health clinics in Bissau, Guinea-Bissau. In all, 711 women with urogenital problems were included. Clinical examination was performed and HIV-1, HIV-2, human T-cell lymphotropic virus (HTLV)-1, HTLV-2 and syphilis were diagnosed by serology. Trichomonas vaginalis was examined using wet mount microscopy. Cervical samples (and swabs from visible ulcers, if present) were used for polymerase chain reaction (PCR) diagnosis of Chlamydia trachomatis, Mycoplasma genitalium, Haemophilus ducreyi, herpes simplex virus (HSV)-1 and HSV-2, and culture diagnosis of Neisseria gonorrhoeae. The prevalence of HIV-1, HIV-2, and HIV-1 and HIV-2 (dual infection) was 9.5%, 1.8% and 1.1%, respectively. The prevalence of HTLV-1 was 2.8%, HTLV-2 0%, HSV-1 1.4%, HSV-2 7.7%, T. vaginalis 20.4%, syphilis 1.0%, N. gonorrhoeae 1.3%, H. ducreyi 2.7%, M. genitalium 7.7% and C. trachomatis 12.6%. HIV-1 and/or HIV-2 infection was significantly associated with active HSV-2 and HIV-1 was significantly associated with M. genitalium infection. In conclusion, HIV-1 and HIV-2 prevalence was higher compared with previous studies of pregnant women in Guinea-Bissau. The prevalence of co-infection of HIV and other STIs is high. National evidence-based guidelines for the management of STIs in Guinea-Bissau are essential.