Declining Syphilis Trends in Concurrence With HIV Declines Among Pregnant Women in Zambia

Makasa, Mpundu; Fýlkesnes, Knut; Michelo, Charles; Kayeyi, Nkomba; Chirwa, Ben; Sandøy, Ingvild Fossgard

doi:10.1097/olq.0b013e31823b23a4

Cited by 25 publications

(28 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These results are in line with other studies on the association between HIV prevalence and educational attainment in sub-Saharan Africa [32], [33], including Zambia [3], [15]. In addition, a similar pattern of marked decrease in syphilis prevalence among educated women was observed in the same ANC data [34]. A likely explanation for this change is that educated people, once equipped with knowledge about HIV from prevention campaigns, have been quicker in changing their sexual behaviour [35], [36], [37], [38], [39], [40], [41].…”

Section: Discussionsupporting

confidence: 91%

Decline in HIV Prevalence among Young Women in Zambia: National-Level Estimates of Trends Mask Geographical and Socio-Demographic Differences

et al. 2012

Self Cite

View full text Add to dashboard Cite

BackgroundA decline in HIV incidence has been reported in Zambia and a number of other sub-Saharan countries. The trend of HIV prevalence among young people is a good marker of HIV incidence. In this study, different data sources are used to examine geographical and sub-population group differentials in HIV prevalence trends among men and women aged 15–24 years in Zambia.Design and MethodsWe analysed ANC data for women aged 15–24 years from 22 sentinel sites consistently covered in the period 1994–2008, and HIV data for young men and women aged 15–24 years from the ZDHS 2001/2 and 2007. In addition, we systematically reviewed peer-reviewed articles that have reported findings on HIV prevalence and incidence among young people.FindingsOverall trends of the ANC surveillance data indicated a substantial HIV prevalence decline among young women in both urban and rural areas. However, provincial declines differed substantially, i.e. between 10% and 68% among urban women, and from stability to 86% among rural women. Prevalence declines were steeper among those with the highest educational attainments than among the least educated. The ZDHS data indicated a significant reduction in prevalence between the two survey rounds among young women only. Provincial-level ZDHS changes were difficult to assess because the sample sizes were small. ANC-based trend patterns were consistent with those observed in PMTCT-based data (2002–2006), whereas population-based surveys in a selected urban community (1995–2003) suggested that the ANC-based data underestimated the prevalence declines in the general populations of both young both men and women.ConclusionThe overall HIV prevalence declined substantially among young women in Zambia and this is interpreted as indicating a decline in HIV incidence. It is noteworthy that overall national trends masked substantial differences by place and by educational attainment, demonstrating critical limitations in the current focus on overall country-level trends in epidemiological reports.

show abstract

Section: Discussionsupporting

confidence: 91%

Decline in HIV Prevalence among Young Women in Zambia: National-Level Estimates of Trends Mask Geographical and Socio-Demographic Differences

et al. 2012

Self Cite

View full text Add to dashboard Cite

show abstract

“…The burden of syphilis among this population of pregnant women in rural South China is also similar to what has been reported in studies conducted at regional blood donation centers that cover urban and rural areas throughout China (0.30–0.63%) [19]–[21]. Compared to other countries, the prevalence reported here is lower than among pregnant women in rural low-income settings in sub-Saharan Africa and Haiti [22]–[30] but higher than among women in rural areas in high-income countries like the U.S. [31] The syphilis epidemic among pregnant women in rural Guangdong province might be partially explained by female migrants or their husbands returning to their rural origins from the cities with untreated syphilis and persistently risky sexual behavior [32]. Studies have found that migrants in some Chinese cities have high-risk sexual behavior [33] and a higher prevalence of syphilis compared to local residents [16], [17], but few studies have examined the sexual risk of returning migrants.…”

Section: Discussionsupporting

confidence: 86%

Syphilis Screening among 27,150 Pregnant Women in South Chinese Rural Areas Using Point-of-Care Tests

et al. 2013

View full text Add to dashboard Cite

ObjectivesTo determine the prevalence and correlates of syphilis among pregnant women in rural areas of South China.MethodsPoint-of-care syphilis testing was provided at 71 health facilities in less developed, rural areas of Guangdong Province. Positive samples were confirmed at a local referral center by toluidine red unheated serum tests (TRUST) and Treponema pallidum particle agglutination (TPPA) tests.ResultsAltogether 27,150 pregnant women in rural Guangdong were screened for syphilis. 106 (0.39%) syphilis cases were diagnosed, of which 78 (73.6%) received treatment for syphilis. Multivariate analysis revealed that older pregnant women (31–35 years old, aOR 2.7, 95% CI 0.99–7.32; older than 35 years old, aOR 5.9, 95% CI 2.13–16.34) and those with a history of adverse pregnant outcomes (aOR 3.64, 95% CI 2.30–5.76) were more likely to be infected with syphilis.ConclusionsA high prevalence of syphilis exists among pregnant women living in rural areas of South China. Enhanced integration of syphilis screening with other routine women's health services (OB GYN, family planning) may be useful for controlling China's syphilis epidemic.

show abstract

“…This does not correspond with the findings from 5 rounds of syphilis surveillance among pregnant women in Zambia between 1994–2008 which showed consistently lower risk of syphilis in higher educated women [28]. It is likely that GUD is substantially under-reported in this population-based survey, and therefore this lack of association could be explained by differential reporting bias, i.e.…”

Section: Discussioncontrasting

confidence: 74%

Risk factors, healthcare-seeking and sexual behaviour among patients with genital ulcers in Zambia

2012

Self Cite

View full text Add to dashboard Cite

BackgroundGenital ulcers (GU) are associated with an increased risk of HIV transmission. Understanding risk factors for genital ulcers and sexual behaviour patterns after onset of symptoms and health seeking behaviour among GU-patients can provide useful information to aid design effective prevention strategies for genital ulcers. We investigated risk factors of self-reported GUs and care-seeking in the general population, and assessed GU patients regarding past care-seeking, recent sexual behaviour and partner awareness of the disease.MethodsWe analysed national data on genital ulcers from the 2007 Zambia Demographic and Health Survey, and data from a cross-sectional survey of genital ulcer patients from primary health care facilities in Lusaka, Zambia.ResultsThe prevalence of GU in 2007 in the general population of Lusaka was 3.6%. Important predictors for genital ulcers were age 25–29 years, being widowed/separated/divorced and having a high number of life-time sexual partners. No differences in care-seeking were observed by residence, wealth and gender, and 60% of the respondents sought care from public health facilities. Among patients with GUs in Lusaka, 14% sought care >2 weeks after symptom onset. Forty-two percent were not aware of their HIV status, 57% reported sex after onset of symptoms and only 15% reported consistent condom use.ConclusionsLow awareness of HIV status despite high probability of being infected and low condom use after onset of genital ulcer symptoms leads to a high potential for transmission to sexual partners. This, combined with the fact that many patients with GUs delayed seeking care, shows a need for awareness campaigns about GUs and the importance of abstinence or use of condoms when experiencing such symptoms.

show abstract

Declining Syphilis Trends in Concurrence With HIV Declines Among Pregnant Women in Zambia

Cited by 25 publications

References 16 publications

Decline in HIV Prevalence among Young Women in Zambia: National-Level Estimates of Trends Mask Geographical and Socio-Demographic Differences

Decline in HIV Prevalence among Young Women in Zambia: National-Level Estimates of Trends Mask Geographical and Socio-Demographic Differences

Syphilis Screening among 27,150 Pregnant Women in South Chinese Rural Areas Using Point-of-Care Tests

Risk factors, healthcare-seeking and sexual behaviour among patients with genital ulcers in Zambia

Contact Info

Product

Resources

About