A national evaluation using standardised patient actors to assess STI services in public sector clinical sentinel surveillance facilities in South Africa

Kohler, Pamela; Marumo, Eva; Jed, Suzanne L.; Mema, Gladys Makati; Galagan, Sean R.; Tapia, Kenneth; Pillay, Erushka; DeKadt, Julia; Naidoo, Evasen; Dombrowski, Julia C.; Holmes, King K.

doi:10.1136/sextrans-2016-052930

Cited by 26 publications

(38 citation statements)

References 25 publications

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“…The Chlamydia infection rate among these women is substantially higher than reported among young sexually active women from other parts of SA, including rural KwaZulu-Natal (25%) (Kleppa et al 2015) and a different area in Cape Town (15%) (Menezes et al 2017). STI management remains problematic in developing countries where laboratory-based testing is frequently unavailable and where quality of STI care may be lacking (availability of medications, adherence to STI guidelines, condom provision and partner notification counselling [Kohler et al 2017]). According to the SA Department of Health guidelines (Department of Health 2015) women qualify for STI treatment, based on a combination of demographic characteristics, symptoms or clinical observations, where STI treatment entails a combination of metronidazole, azithromycin and ceftriaxone (Peters et al 2014).…”

Section: Discussionmentioning

confidence: 94%

High rates of bacterial vaginosis and Chlamydia in a low-income, high-population-density community in Cape Town

Lennard

Dabee

Barnabas

et al. 2017

Suid-Afrikaanse Tydskr Natuurwetenskap Tegnol

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Young South African women, from resource-poor communities, face several sexual and reproductive health challenges. Here we describe the vaginal microbiota and sexually transmitted infection (STI) prevalence of 102; 16-22-year-old, HIV-negative South African women from a low-income, highpopulation-density community in Cape Town (CPT). Vaginal microbiota were profiled using 16S rRNA amplicon sequencing; bacterial vaginosis (BV) status was established using Nugent scoring and STIs were determined by multiplex polymerase chain reaction. STIs were common, with 55% of women having at least one STI; 41% were infected with high-risk human papilloma virus (HPV) and a further 28% with low-risk HPV; 44% were infected with Chlamydia, 16% of whom had at least one additional STI. Similarly, BV rates were very high, with 55% of women classified as BV-positive (Nugent score ≥7), 7% as BV-intermediate (Nugent score 3-6) and 38% as BV-negative (Nugent 0-2). Group B Streptococcus (Streptococcus agalactiae), the leading cause of neonatal sepsis, was present in 25% of BV-positive women and 28% of BV-negative women, and was significantly more abundant among BV-negative women. Both Chlamydia infection and BV may adversely affect reproductive health and place these women at additional risk for HIV acquisition. The high abundance of Prevotella amnii, in particular, may increase HIV risk, given its inflammatory capacity. Laboratorybased testing for STIs (Chlamydia and Gonorrhoeae in particular) appear to be warranted in this community, together with further monitoring or treatment of BV. Hoë voorkomskoers van bakteriële vaginose en Chlamydia in 'n lae-inkomste, hoë-bevolkingsdigtheid gemeenskap in Kaapstad. Jong Suid-Afrikaanse vroue uit hulpbron-arm gemeenskappe staar verskeie uitdagings in die gesig in terme van hul seksuele en reproduktiewe gesondheid. Hier beskryf ons die voorkoms van vaginale mikrobiota en seksueel oordraagbare infeksies (SOI's) onder 102; 16-22-jarige MIV-negatiewe Suid-Afrikaanse vroue uit 'n lae-inkomste, hoë-bevolkingsdigtheid gemeenskap in Kaapstad. Vaginale mikrobiota is met behulp van 16S rRNA amplikon volgorde-bepaling geprofileer; bakteriese vaginose (BV) status is met behulp van 'n Nugent-telling vasgestel; en SOI's is deur middel van 'n multipleks polimerase kettingreaksie bepaal. SOI's was algemeen, met 55% van die vroue wat ten minste een SOI gehad het; 41% wat met hoë-risiko menslike papillomavirus (MPV) besmet was, en 'n verdere 28% wat met laerisiko-MPV besmet was; 44% van die vroue was met Chlamydia besmet, waarvan 16% een of meer addisionele SOI gehad het. BV persentasies was ook baie hoog, met 55% van die vroue wat as BV-positief (Nugent-telling ≥7) geklassifiseer is, 7% as BV-intermediêr (Nugent-telling 3-6), en 38% as BVnegatief (Nugent-telling 0-2). Streptococcus (Streptococcus agalactiae), die grootste oorsaak van neonatale sepsis, was teenwoordig in 25% van die BV-positiewe vroue en 28% van die BV-negatiewe vroue, en was dus meer onder BV-negatiewe vroue. Beide Chlamydia-infeksie en BV kan re...

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Section: Discussionmentioning

confidence: 94%

High rates of bacterial vaginosis and Chlamydia in a low-income, high-population-density community in Cape Town

Lennard

Dabee

Barnabas

et al. 2017

Suid-Afrikaanse Tydskr Natuurwetenskap Tegnol

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“…The barriers to successful implementation of patient-initiated PN using referral slips were mentioned earlier in the manuscript. The concern is that South Africa has a high burden of STIs but it still relies on this strategy since the implementation of the syndromic management of STI in 2009 [27, 28].…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, two-thirds had more than one sexual partners and almost half (45.6%) were in casual sexual relationships. Inaccurate information and beliefs about STIs, having multiple sexual partners and risky sexual behavior were common in male STI patients as compared to female STI patients [12, 28, 29]. This argument also has implications for reviewing the content of health education and health promotion programs in order to close the knowledge gap among the high-risk groups.…”

Section: Discussionmentioning

confidence: 99%

Intentions to use patient-initiated partner notification and acceptability of provider-initiated partner notification for Sexually Transmitted Infections – A cross-sectional survey among minibus taxi drivers in Gauteng Province, South Africa

Mokgatle

Madiba

2018

Preprint

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29Background: In South Africa, utilization of patient-initiated partner-notification (PN) using referral-slip in 30 the management of sexually transmitted infections (STIs) is limited and only a limited number of sexual 31 partners are ever notified. The study assessed the use of patient-initiated PN method using notification and 32 referral slips and measured the level of acceptability of provider-initiated PN using short-message-service 33 (SMS) to personal mobile phones of sexual partners. 34Methods: A quantitative survey using anonymous structured self-administered and researcher 35 assisted questionnaires was conducted among minibus taxi drivers in the nine major taxi ranks in 36Gauteng province, South Africa. 37 Results: The sample consisted of 722 minibus taxi drivers with a mean age of 37.2 years old, 284 (59.5%) 38 had multiple sexual partners, 368 (52.2%) did not use a condom during last sexual act, 286 (42.8%) 39 reported inconsistent use of condoms, and 459 (65%) tested for HIV in the past 12 months. Majority 40 (n=709, 98.2%) understood the importance of PN once diagnosed with STI, but would prefer delivering PN 41 referral slip (n=670, 93.2%) over telling a partner face to face if they themselves were diagnosed with STI. 42 Acceptability of provider-initiated PN using SMS was 452 (62.7%) and associated with history of HIV 43 testing in the past year (OR=1.72, p=0.002, CI: 1.21-2.45). The perceived use of PN referral-slip from 44 sexual partner to seek treatment was 91.8% (n=659). About a third (n=234, 32.5%) were not in favor of 45 provider-initiated PN by SMS and preferred telling partners face to face. 46 Conclusion: There were contrasting findings on the acceptability and utilization of existing patient-initiated 47 PN and the proposed PN using SMS from health providers. The preference of delivering PN referral slip to 48 sexual partner over face-to-face PN renders communicating about STIs the responsibility of health 49 providers. Therefore, they have an opportunity to provide patients with options to choose a PN method that 50 is best suited to their relationships and circumstances and modify PN messages to encourage partners to use 51 the different PN to prevent STIs. 3 52 53 Keywords: partner notification, sexually transmitted infections, patient initiated, STI prevention 54 and control, taxi industry, key populations, risky sexual behavior, short-message-service. 55 4 56 Introduction 57 South Africa's burden of disease due to sexually transmitted infections (STIs) is currently one of 58 the largest in the world and this is true for all STIs, including HIV and human papilloma virus [1]. 59 The significantly high prevalence of sexually transmitted infections (STIs) in Sub-Saharan Africa 60 poses a threat because of the increased risk of HIV transmission [2]. In the African region, among 61 the population group of 15 -49 year of age, STI prevalence and incidence for four curable STIs 62 (chlamydia, gonorrhea, syphilis and trichomonas) was 19.4% and 24.1% [3-5]. The prevalence of 63 syphilis amo...

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“…Die Chlamydia-infeksiesyfer onder hierdie vroue is aansienlik hoër as wat onder jong seksueel aktiewe vroue uit ander dele van SA gerapporteer is, insluitend die landelike streke van KwaZulu-Natal (25%) (Kleppa et al 2015) en 'n ander gebied in Kaapstad (15%) (Menezes et al 2017). Die bestuur van SOI's bly problematies in ontwikkelende lande waar laboratoriumgebaseerde toetse dikwels nie beskikbaar is nie en waar die kwaliteit van SOI-versorging tekortskiet (in terme van beskikbaarheid van medisyne, nakoming van SOI-riglyne, kondoomvoorsiening en MIV-berading [Kohler et al 2017]). Volgens die SA Departement van Gesondheid se riglyne (Department of Health 2015), kwalifiseer vroue vir SOIbehandeling gebaseer op 'n kombinasie van demografiese eienskappe, simptome en/of kliniese waarnemings, waar SOI-behandeling 'n kombinasie metronidazole, azithromycin en ceftriaxone behels (Peters et al 2014).…”

Section: Soi-voorkomssyfers (55%)unclassified

Hoë voorkomskoers van bakteriële vaginose en Chlamydia in ’n lae-inkomste, hoë-bevolkingsdigtheid gemeenskap in Kaapstad

Lennard

Dabee

Barnabas

et al. 2017

Suid-Afrikaanse Tydskr Natuurwetenskap Tegnol

View full text Add to dashboard Cite

Jong Suid-Afrikaanse vroue uit hulpbron-arm gemeenskappe staar verskeie uitdagings in die gesig in terme van hulle seksuele en reproduktiewe gesondheid. Hier beskryf ons die voorkoms van vaginale mikrobiota en seksueel oordraagbare infeksies (SOI's) onder 102; 16-22-jarige MIVnegatiewe Suid-Afrikaanse vroue uit 'n lae-inkomste, hoë-bevolkingsdigtheid gemeenskap in Kaapstad. Vaginale mikrobiota is met behulp van 16S rRNA amplikon volgorde-bepaling geprofileer; bakteriese vaginose (BV) status is met behulp van 'n Nugent-telling vasgestel; en SOI's is deur middel van 'n multipleks polimerase kettingreaksie bepaal. SOI's was algemeen, met 55% van die vroue wat ten minste een SOI gehad het; 41% wat met hoë-risiko menslike papillomavirus (MPV) besmet was, en 'n verdere 28% wat met laerisiko-MPV besmet was; 44% van die vroue was met Chlamydia besmet waarvan 16% een of meer addisionele SOI gehad het. BV persentasies was ook baie hoog met 55% van die vroue wat as BV-positief (Nugent-telling ≥7) geklassifiseer is, 7% as BVintermediêr (Nugent-telling 3-6), en 38% as BV-negatief (Nugent-telling 0-2). Streptococcus (Streptococcus agalactiae), die grootste oorsaak van neonatale sepsis, was teenwoordig in 25% van die BV-positiewe vroue en 28% van die BV-negatiewe vroue, en was dus meer onder BV-negatiewe vroue. Chlamydia-infeksie sowel as BV kan reproduktiewe gesondheid nadelig beïnvloed en verhoog hierdie vroue se risiko vir die verkryging van MIV. Die voorkoms van veral Prevotella amnii kan die MIV-risiko verhoog as gevolg van sy inflammatoriese kapasiteit. Laboratoriumgebaseerde toetsing vir SOI's (veral Chlamydia en Gonorrhoeae) blyk in hierdie gemeenskap geregverdig te wees, tesame met verdere monitering en/of behandeling van BV. High rates of bacterial vaginosis and Chlamydia in a low-income, high-population-density community in Cape Town. Young South African women, from resource-poor communities, face several sexual and reproductive health challenges. Here we describe the vaginal microbiota and sexually transmitted infection (STI) prevalence of 102; 16-22-year-old, HIV-negative South African women from a low-income, high-population-density community in Cape Town (CPT). Vaginal microbiota were profiled using 16S rRNA amplicon sequencing; bacterial vaginosis (BV) status was established using Nugent scoring; and STIs were determined by multiplex polymerase chain reaction. STIs were common, with 55% of women having at least one STI; 41% were infected with high-risk human papilloma virus (HPV) and a further 28% with low-risk HPV; 44% were infected with Chlamydia, 16% of whom had at least one additional STI. Similarly, BV rates were very high, with 55% of women classified as BV-positive (Nugent score ≥7); 7% as BV-intermediate (Nugent score 3-6) and 38% as BV-negative (Nugent 0-2). Group B Streptococcus (Streptococcus agalactiae), the leading cause of neonatal sepsis, was present in 25% of BV-positive women and 28% of BV-negative women, and was significantly more abundant among BV-negative women. Both Chlamydia infection and ...

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A national evaluation using standardised patient actors to assess STI services in public sector clinical sentinel surveillance facilities in South Africa

Cited by 26 publications

References 25 publications

High rates of bacterial vaginosis and Chlamydia in a low-income, high-population-density community in Cape Town

High rates of bacterial vaginosis and Chlamydia in a low-income, high-population-density community in Cape Town

Intentions to use patient-initiated partner notification and acceptability of provider-initiated partner notification for Sexually Transmitted Infections – A cross-sectional survey among minibus taxi drivers in Gauteng Province, South Africa

Hoë voorkomskoers van bakteriële vaginose en Chlamydia in ’n lae-inkomste, hoë-bevolkingsdigtheid gemeenskap in Kaapstad

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