Sexually Transmitted Diseases at Monkey Bay Community Hospital in Mangochi, Malawi; an Analysis of Characteristics of Common Sexually Transmitted Diseases

Chung, David S.; Koh, Min Jung; Chough, Sung Hwan; Moon, Seog In; Lee, Gene K.; Kim, Ivy; Kim, Yujin; Kim, Jae Hee; Kim, Lorie; Kim, Hyun‐Jin; Kang, Eunice; Manase, Fatsani; Nyirenda, Thomas

doi:10.4236/aid.2020.105022

Cited by 1 publication

(4 citation statements)

References 17 publications

(11 reference statements)

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“…In national case reports, facility diagnosis rates were highest for vaginal discharge and urethral discharge syndromes and substantially lower for genital ulcer. This diagnostic distribution aligns with previous research among STI clients attending an urban and rural hospital in Malawi 12,13 . Furthermore, surveys indicated a higher proportion of symptomatic women treated for genital ulcer than men.…”

Section: Discussionsupporting

confidence: 88%

“…This diagnostic distribution aligns with previous research among STI clients attending an urban and rural hospital in Malawi. 12,13 Furthermore, surveys indicated a higher proportion of symptomatic women treated for genital ulcer than men. The absence of sex-stratified case report diagnoses precluded direct comparison, but prior research identified the opposite sex trend among STI clients.…”

Section: Discussionmentioning

confidence: 99%

“…The absence of sex-stratified case report diagnoses precluded direct comparison, but prior research identified the opposite sex trend among STI clients. 12,13 It is unlikely that the 90% lower GUD rate recorded in health facility data from 2014 to 2021, compared with survey data from 2000 to 2015, is explained by the decreasing prevalence of ulcerative STIs (herpesvirus [HSV]-2, syphilis, and chancroid) over time in SSA. [14][15][16] Sexually transmitted infection care seeking outside predominantly public sector facilities reporting to the national health information system may partly account for differences in the magnitude and distribution of symptoms across data sources.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, surveys indicated a higher proportion of symptomatic women treated for genital ulcer than men. The absence of sex-stratified case report diagnoses precluded direct comparison, but prior research identified the opposite sex trend among STI clients 12,13 . It is unlikely that the 90% lower GUD rate recorded in health facility data from 2014 to 2021, compared with survey data from 2000 to 2015, is explained by the decreasing prevalence of ulcerative STIs (herpesvirus [HSV]-2, syphilis, and chancroid) over time in SSA 14–16 …”

Section: Discussionmentioning

confidence: 99%

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Burden and Trends of Symptomatic Sexually Transmitted Infections in Malawi From 2000 to 2021: Comparative Analysis of Survey and Case Report Data

Michalow,

Jahn,

Cori

et al. 2024

Sexual Trans Dis

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Background In settings without etiologic testing for sexually transmitted infections (STIs), programs rely on STI symptom data to inform priorities. To evaluate whether self-reported STI symptoms in household surveys consistently represent the STI burden, we compared symptomatic infection rates between survey self-reporting and health facility case reporting in Malawi. Methods We analyzed self-reported symptoms and treatment seeking in the past year among sexually active adults from 4 Malawi Demographic and Health Surveys between 2000 and 2015. Bayesian mixed-effects models were used to estimate temporal trends, spatial variation, and sociodemographic determinants. Survey reporting was compared with health facility syndromic diagnoses between 2014 and 2021. Results In surveys, 11.0% (95% confidence interval, 10.7%–11.4%) of adults reported STI or STI-related symptoms in the last year, of whom 54.2% (52.8%–55.7%) sought treatment. In facilities, the mean annual symptomatic case diagnosis rate was 3.3%. Survey-reported treatment in the last year was 3.8% (95% credible interval, 2.3%–6.1%) for genital ulcer, 3.8% (2.0%–6.7%) for vaginal discharge, and 2.6% (1.2%–4.7%) for urethral discharge. Mean annual diagnosis rates at facilities were 0.5% for genital ulcer, 2.2% for vaginal discharge, and 2.0% for urethral discharge. Both data sources indicated a higher burden of symptoms among women, individuals older than 25 years, and those in Southern Malawi. Conclusions Survey and facility case reports indicated similar spatial and demographic patterns of STI symptom burden and care seeking, but implied large differences in the magnitude and relative burden of symptoms, particularly genital ulcer, which could affect program priorities. Targeted etiologic surveillance would improve interpretation of these data to enable more comprehensive STI surveillance.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%