Epidemiology of syphilis in Kenya: results from a nationally representative serological survey

Otieno-Nyunya, Boaz; Bennett, Eddas; Bunnell, Rebecca; Dadabhai, Sufia; A, A. Gichangi; Mugo, Nelly; Wanyungu, John; Baya, I.; Kaiser, Reinhard

doi:10.1136/sextrans-2011-050026

Cited by 27 publications

(30 citation statements)

References 15 publications

(11 reference statements)

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“…However, it is used for treatment of Neisseria gonorrhea and Chlamydia trachomatis infections (29). A reduction in the doxycycline IC 50 could also be explained by declining usage of the drug due to reduced prevalence of gonorrhea, which decreased from 3.2% to 2.7% between 2002 and 2010 (30).…”

Section: Discussionmentioning

confidence: 99%

Reduced In Vitro Doxycycline Susceptibility in Plasmodium falciparum Field Isolates from Kenya Is Associated with PfTetQ KYNNNN Sequence Polymorphism

Achieng

Ingasia

Juma

et al. 2014

Antimicrob Agents Chemother

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Doxycycline is widely used for malaria prophylaxis by international travelers. However, there is limited information on doxycycline efficacy in Kenya, and genetic polymorphisms associated with reduced efficacy are not well defined. In vitro doxycycline susceptibility profiles for 96 Plasmodium falciparum field isolates from Kenya were determined. Genetic polymorphisms were assessed in P. falciparum metabolite drug transporter (Pfmdt) and P. falciparum GTPase tetQ (PftetQ) genes. Copy number variation of the gene and the number of KYNNNN amino acid motif repeats within the protein encoded by PftetQ were determined. Reduced in vitro susceptibility to doxycycline was defined by 50% inhibitory concentrations (IC 50 s) of >35,000 nM. The odds ratio (OR) of having 2 PfTetQ KYNNNN amino acid repeats in isolates with IC 50 s of >35,000 nM relative to those with IC 50 s of <35,000 nM is 15 (95% confidence interval [CI], 3.0 to 74.3; P value of <0.0002). Isolates with 1 copy of the Pfmdt gene had a median IC 50 of 6,971 nM, whereas those with a Pfmdt copy number of >1 had a median IC 50 of 9,912 nM (P ‫؍‬ 0.0245). Isolates with 1 copy of PftetQ had a median IC 50 of 6,370 nM, whereas isolates with a PftetQ copy number of >1 had a median IC 50 of 3,422 nM (P < 0.0007). Isolates with 2 PfTetQ KYNNNN motif repeats had a median IC 50 of 26,165 nM, whereas isolates with 3 PfTetQ KYNNNN repeats had a median IC 50 of 3,352 nM (P ‫؍‬ 0.0023). PfTetQ sequence polymorphism is associated with a reduced doxycycline susceptibility phenotype in Kenyan isolates and is a potential marker for susceptibility testing.

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Section: Discussionmentioning

confidence: 99%

Reduced In Vitro Doxycycline Susceptibility in Plasmodium falciparum Field Isolates from Kenya Is Associated with PfTetQ KYNNNN Sequence Polymorphism

Achieng

Ingasia

Juma

et al. 2014

Antimicrob Agents Chemother

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“…If International Journal of Infectious Diseases 29 (2014) [54][55][56][57][58][59][60][61] improved STI treatment and behaviour change had the greatest impact, then recent suggestions are plausible that syphilis prevalence should remain low in future years and that syphilis is a reasonable candidate for elimination in the region. 6 However, if AIDS mortality played a key role in reducing the population prevalence of syphilis, then the comparatively recent and widespread implementation of ART in the region may lead to a concomitant resurgence of syphilis. Since HIV has become a chronic disease that is manageable by ART in high-income countries, syphilis incidence has increased sharply, particularly among men who have sex with men.…”

Section: Introductionmentioning

confidence: 98%

What underpins the decline in syphilis in Southern and Eastern Africa? An exploratory ecological analysis

Kenyon

Osbak

Chico

2014

International Journal of Infectious Diseases

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“…Among the 25 previously diagnosed HIV-positive male partners, testing acceptance was 50% (3 of 6) among men in the intervention arm and 100% (19 of 19) among men in the control arm. Given the higher prevalence of syphilis among HIV-positive men (6.4%) and women (3.2%) in Kenya, 26 prioritizing syphilis testing among HIV-positive individuals and their partners before and during pregnancy could be a cost-effective approach to preventing antenatal syphilis transmission and adverse pregnancy outcomes and support overall PMTCT program success. 27 Although the prevalence of syphilis in this study was low, it is notable that all 3 men and 4 women testing positive for syphilis were in a syphilis-discordant couple, indicating a high yield for preventing maternal-to-child transmission of syphilis with successful treatment and repeat testing of both partners.…”

Section: Discussionmentioning

confidence: 99%

Uptake of Home-Based Syphilis and Human Immunodeficiency Virus Testing Among Male Partners of Pregnant Women in Western Kenya

et al. 2017

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Background Few men are tested for syphilis or HIV during their partner’s pregnancy, a high-risk period for HIV and syphilis transmission. Offering home-based rapid testing of syphilis to couples during pregnancy can support prevention efforts to reduce transmission of sexually transmitted diseases and adverse pregnancy outcomes. Methods We assessed men’s uptake of paired (separate tests, single blood draw) point-of-care syphilis and HIV tests within a randomized controlled trial of pregnant women who received clinic or home partner HIV testing. We evaluated acceptance of paired HIV-syphilis testing during pregnancy or at 6 months postpartum, and evaluated whether addition of syphilis testing affected the uptake of HIV testing among men. Results Out of 601 women, we were unable to meet 101 male partners, and 180 tested before syphilis tests were available. Paired syphilis and HIV testing was offered at home to 80 men during pregnancy and to 230 men postpartum. For syphilis, 93% of men agreed to test during pregnancy and 98% agreed postpartum. For paired syphilis and HIV testing, 91% of men tested for both during pregnancy and 96% tested postpartum. Before syphilis test introduction, 96% of men accepted HIV testing, compared to 95% of men who accepted HIV testing when paired testing was offered. Conclusions Uptake of syphilis and HIV testing was high among male partners offered couple testing at home. Introducing syphilis testing did not adversely affect HIV testing among men. Point-of-care diagnostics outside facilities can increase testing of male partners who rarely accompany women to antenatal clinics.

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Epidemiology of syphilis in Kenya: results from a nationally representative serological survey

Cited by 27 publications

References 15 publications

Reduced In Vitro Doxycycline Susceptibility in Plasmodium falciparum Field Isolates from Kenya Is Associated with PfTetQ KYNNNN Sequence Polymorphism

Reduced In Vitro Doxycycline Susceptibility in Plasmodium falciparum Field Isolates from Kenya Is Associated with PfTetQ KYNNNN Sequence Polymorphism

What underpins the decline in syphilis in Southern and Eastern Africa? An exploratory ecological analysis

Uptake of Home-Based Syphilis and Human Immunodeficiency Virus Testing Among Male Partners of Pregnant Women in Western Kenya

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