The prevalence of sexually transmitted infections and their association with knowledge, attitudes, and practice in male street children in Indonesia

BACKGROUND

Street children's level of knowledge, attitudes, and practice (KAP) regarding sexually transmitted infections (STIs) and HIV-related diseases remains a challenge since it is difficult to reach all key populations. This study aims to provide an overview of the findings of STI cases and their association with the KAP of street children in Jakarta and Banten.

METHODS

We conducted a cross-sectional study on 259 male street children (aged 10 -21 years old). We collected the data through questionnaire interviews, history taking, physical examination, and specimen collection for STI and HIV testing.

RESULTS

5.8% (n = 15) STI cases were discovered, consisting of Hepatitis B (n = 6), Hepatitis C (n = 1), HIV (n = 2), Chlamydia (n = 3), Syphilis (n = 1), and Gonorrhea (n = 1). Buskers (44.4%) and other occupations like helping parents sell their wares, parking lot attendants, shoe shiners, or gathering (44.8%) dominated the sociodemographic characteristics. Condomless sex predominated risky sexual behavior, despite some subjects already having good knowledge.

CONCLUSION

Sociodemographic characteristics and the KAP of street children in Indonesia are varied. The association between the KAP level and STI cases in street children is challenging to describe. Further studies covering more areas in Indonesia are required.

Conformity of yaws clinical features to combined rapid diagnostic test in children aged 2-15 years in an endemic area

INTRODUCTION

The diagnosis of yaws is established by clinical examination and confirmed through a laboratory test. Unrecognized lesions may lead to a missed opportunity for diagnosis and complete eradication of yaws. The use of Dual Path Platform (DPP® RDT) Syphilis Screen and Confirm RDT (Chembio, Medford, New York) has been recommended by the World Health Organization (WHO) for endemic areas with limited laboratory facilities. To date, there have not been any studies assessing the conformity of clinical features based on the WHO guidelines with DPP® RDT.

METHODOLOGY

A cross-sectional study was conducted to evaluate the conformity of yaws clinical features based on the WHO guidelines to the DPP® RDT. We recruited children aged 2-15 years old in Alor, Indonesia. All subjects underwent clinical examination and were tested with DPP® RDT. Fisher's exact test was used to analyze the overall agreement between the clinical features and the DPP® RDT results.

RESULTS

A total of 197 study subjects (mean age 9 years) were enrolled. The most frequent skin lesion was a yaws scar (79.7%). Eight subjects (3%) were diagnosed with yaws based on the DPP® RDT examination. The overall agreement between clinical features and DPP® RDT was 26.9% (p = 0.202).

CONCLUSIONS

The conformity of clinical features in suspected yaws to DPP® RDT is low; thus, clinical features should not be used as a sole initial reference in establishing yaws diagnosis, even in endemic areas.