Prevalence of herpes simplex type 2 and syphilis serology among young adults in a rural Gambian community

Abstract

Objectives:To estimate prevalence and risk factors for herpes simplex 2 (HSV2) positivity, syphilis and Chlamydia trachomatis infection among rural people aged 15-34 in the Gambia. Methods: Questionnaires and serum samples were collected from 1076 men and women aged 15-34 during a cross sectional prevalence survey in a rural area of the Gambia. Sera were screened for antibodies to herpes simplex virus type 2 (HSV2), and for syphilis using Treponema pallidum haemagglutination assay (TPHA) and rapid plasma reagin (RPR) tests. Urine was tested by polymerase chain reaction (PCR) for C trachomatis infection. Results: 28% of women and 5% of men were HSV2 ELISA positive; 10% of women and 2% of men were TPHA positive; and 7% of women and 1% of men were both RPR and TPHA positive.Out of 1030 urine sample tested only six were positive for C trachomatis. 7% of those who reported never having sex were positive for one or other of these tests. Prevalences of all STIs increased with age and were higher in women than men. Women were much less likely than men to seek treatment for STI symptoms at a health centre. Married people were at increased risk of an STI compared with single people. Jola and Fula women had a higher prevalence of HSV2 than women from other ethnic groups, and Fulas also had a higher prevalence of RPR/TPHA positivity. The limited number of sexual behaviour questions were not significantly associated with STIs after adjustment for age, marital status, and ethnic group. Conclusions: The prevalences of the ulcerative infections HSV2 and syphilis in this population are a cause for concern. In a setting where HIV1 prevalence remains low this indicates an urgent need for STI control and behaviour change programmes to prevent an HIV epidemic. Concerns about the validity of reported sexual behaviour data high light the necessity of biological markers in the evaluation of behaviour change programmes. (Sex Transm Inf 2001;77:358-365)

Detection, quantification and genotyping of Herpes Simplex Virus in cervicovaginal secretions by real-time PCR: a cross sectional survey

“…Over the past decade, HSV-2 has been identified as the most common aetiological agent of GUD [5]. Studies of HSV-2 seroprevalence have found high rates in African-Americans [6] and in African populations in Uganda, Zimbabwe, Tanzania, Central African Republic, South Africa and The Gambia [7-12]. In The Gambia, HSV-2 seropositivity among young adults from rural communities was 28% in women and 5% in men which increased with age [12].…”

“…Studies of HSV-2 seroprevalence have found high rates in African-Americans [6] and in African populations in Uganda, Zimbabwe, Tanzania, Central African Republic, South Africa and The Gambia [7-12]. In The Gambia, HSV-2 seropositivity among young adults from rural communities was 28% in women and 5% in men which increased with age [12]. HSV-2 seroprevalence increases with high risk sexual behaviour [9] and with factors related to polygynous marriage practices in rural populations [13].…”

Performance of routine syphilis serology in the Ethiopian cohort on HIV/AIDS

“…1 Figures on prevalence and incidence of syphilis in several studies from sub-Saharan Africa are based on commonly used serological screening assays. [2][3][4][5][6] However, the interpretation of non-treponemal and treponemal specific serological tests in a population where syphilis and HIV are endemic, is encountered with difficulty. [7][8][9] The rapid plasma reagin (RPR) test is a non-treponemal serological test for syphilis widely used as a screening test in antenatal clinics and other health facilities in the developing world.…”

Performance of the rapid plasma reagin and the rapid syphilis screening tests in the diagnosis of syphilis in field conditions in rural Africa

“…Testing was carried out in the Gambia, where the national prevalence of serologically active syphilis was recorded as 2.8% in a survey in 1995 (O'Donovan et al, unpublished data) but has been reported as high as 7% in 15-34 year old women in some districts. 3 We also evaluated the performance of a rapid syphilis test (RST, Quorum Diagnostics, Vancouver, BC, Canada) as a primary screen. The RST is a one step immunochromatographic strip test, utilising a 47 kDa recombinant antigen of Treponema pallidum to detect antibody, developed by Omega Diagnostics in association with the Programme for Appropriate Technology in Health (PATH) and UNAIDS, Sexually Transmitted Diseases Diagnostics Initiative.…”