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Syphilis screening in the antenatal care: a cross-sectional study from Botswana
Maria Romoren, Mafizur Rahman
BMC International Health and Human Rights , 2006, DOI: 10.1186/1472-698x-6-8
Abstract: In a cross-sectional study, 703 antenatal care attendees at 13 health facilities in Gaborone, Botswana were interviewed and examined. Venous blood samples were collected for the identification of syphilis infection. The antenatal records were used to obtain information on any screening, diagnosis and treatment of syphilis that had been done earlier in the current pregnancy.Active syphilis was found in 32 (5%) of the attendees. Among 546 women coming for a repeat antenatal care visit, 71 (13%) had not been screened for syphilis. Uptake late in pregnancy, delayed treatment and a high rate of seroconversion after testing were other identified obstacles to the effective prevention of congenital syphilis.Syphilis prevalence among pregnant women in Botswana remains high, and there is still much to be gained by improving the effectiveness of the syphilis screening and treatment programme. Earlier antenatal care attendance, rapid on-site testing, improved partner treatment and a repeat test late in pregnancy to manage incident cases are important goals for patients, health care workers and health authorities.Maternal syphilis has a severe impact on pregnancy outcome. Although antenatal syphilis screening has proven to be cheap and effective, syphilis during pregnancy continues to be a substantial problem in resource-poor settings [1]. Published information from developing countries reveals that there is reason to improve both the coverage and the quality of the syphilis screening programme in antenatal care [2-4].In Botswana, universal screening and treatment of syphilis in pregnancy is integrated in antenatal care. Blood is collected from all attendees at the first antenatal visit and analyzed with a non-treponemal syphilis test (the rapid plasma reagin [RPR] test or the venereal disease research laboratory [VDRL] test) at a centralized laboratory. According to the guidelines, high risk women should be retested at 34–36 weeks of gestation. All RPR/VDRL positive cases shoul
Oral manifestations of syphilis
Le?o, Jair Carneiro;Gueiros, Luiz Alcino;Porter, Stephen R.;
Clinics , 2006, DOI: 10.1590/S1807-59322006000200012
Abstract: the past decade has shown a significant rise in the prevalence of infective syphilis in the developed world, and striking increases in its frequency have occurred in eastern europe, particularly the uk, and in the us. although oral manifestations of syphilis are most likely to be observed during secondary disease, all stages of the disease can give rise to oral lesions. significant oral lesions such as gumma-associated bony destruction and a possible predisposition to oral squamous cell carcinoma are associated with tertiary disease. since the prevalence of infective syphilis in heterosexuals has been increasing, there has now been a gradual rise in the number of children born with congenital syphilis. consequently, the congenital disease gives rise to dental anomalies as well as bone, skin, and neurological anomalies of the face. the aim of this report is to review syphilis-related oral lesions, as well as to summarize the relations between human immunodeficiency virus (hiv) and syphilis.
Geographic Information System-based Screening for TB, HIV, and Syphilis (GIS-THIS): A Cross-Sectional Study  [PDF]
Neela D. Goswami, Emily J. Hecker, Carter Vickery, Marshall A. Ahearn, Gary M. Cox, David P. Holland, Susanna Naggie, Carla Piedrahita, Ann Mosher, Yvonne Torres, Brianna L. Norton, Sujit Suchindran, Paul H. Park, Debbie Turner, Jason E. Stout
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0046029
Abstract: Objective To determine the feasibility and case detection rate of a geographic information systems (GIS)-based integrated community screening strategy for tuberculosis, syphilis, and human immunodeficiency virus (HIV). Design Prospective cross-sectional study of all participants presenting to geographic hot spot screenings in Wake County, North Carolina. Methods The residences of tuberculosis, HIV, and syphilis cases incident between 1/1/05–12/31/07 were mapped. Areas with high densities of all 3 diseases were designated “hot spots.” Combined screening for tuberculosis, HIV, and syphilis were conducted at the hot spots; participants with positive tests were referred to the health department. Results and Conclusions Participants (N = 247) reported high-risk characteristics: 67% previously incarcerated, 40% had lived in a homeless shelter, and 29% had a history of crack cocaine use. However, 34% reported never having been tested for HIV, and 41% did not recall prior tuberculin skin testing. Screening identified 3% (8/240) of participants with HIV infection, 1% (3/239) with untreated syphilis, and 15% (36/234) with latent tuberculosis infection. Of the eight persons with HIV, one was newly diagnosed and co-infected with latent tuberculosis; he was treated for latent TB and linked to an HIV provider. Two other HIV-positive persons had fallen out of care, and as a result of the study were linked back into HIV clinics. Of 27 persons with latent tuberculosis offered therapy, nine initiated and three completed treatment. GIS-based screening can effectively penetrate populations with high disease burden and poor healthcare access. Linkage to care remains challenging and will require creative interventions to impact morbidity.
Violence against civilians and access to health care in North Kivu, Democratic Republic of Congo: three cross-sectional surveys
Kathryn P Alberti, Emmanuel Grellety, Ya-Ching Lin, Jonathan Polonsky, Katrien Coppens, Luis Encinas, Marie-No?lle Rodrigue, Biagio Pedalino, Vital Mondonge
Conflict and Health , 2010, DOI: 10.1186/1752-1505-4-17
Abstract: In May 2009, we conducted three cross-sectional surveys among 200 000 resident and displaced people in North Kivu (Kabizo, Masisi, Kitchanga). The recall period covered an eight month period from the beginning of the most recent offensives to the survey date. Heads of households provided information on displacement, death, violence, theft, and access to fields and health care.Crude mortality rates (per 10 000 per day) were below emergency thresholds: Kabizo 0.2 (95% CI: 0.1-0.4), Masisi 0.5 (0.4-0.6), Kitchanga 0.7 (0.6-0.9). Violence was the reported cause in 39.7% (27/68) and 35.8% (33/92) of deaths in Masisi and Kitchanga, respectively. In Masisi 99.1% (897/905) and Kitchanga 50.4% (509/1020) of households reported at least one member subjected to violence. Displacement was reported by 39.0% of households (419/1075) in Kitchanga and 99.8% (903/905) in Masisi. Theft affected 87.7% (451/514) of households in Masisi and 57.4% (585/1019) in Kitchanga. Access to health care was good: 93.5% (359/384) of the sick in Kabizo, 81.7% (515/630) in Masisi, and 89.8% (651/725) in Kitchanga received care, of whom 83.0% (298/359), 87.5% (451/515), and 88.9% (579/651), respectively, did not pay.Our results show the impact of the ongoing war on these civilian populations: one third of deaths were violent in two sites, individuals are frequently subjected to violence, and displacements and theft are common. While humanitarian aid may have had a positive impact on disease mortality and access to care, the population remains exposed to extremely high levels of violence.A 5-year war that ravaged the Democratic Republic of Congo (DRC) officially ended with the endorsement of peace agreements and withdrawal of troops in 2003. The war had a devastating impact; millions of civilians died, many due to lack of access to health care[1-5]. Although a national peace process has been held and elections were conducted in 2006, the eastern regions of the country have yet to see the end of hostili
Infection status and risk factors of HIV, HBV, HCV, and syphilis among drug users in Guangdong, China - a cross-sectional study
Jie Wu, Jinying Huang, Duorong Xu, Ciyong Lu, Xueqing Deng, Xiaolan Zhou
BMC Public Health , 2010, DOI: 10.1186/1471-2458-10-657
Abstract: A cross-sectional study on drug use behaviors, sex behaviors, and presence of antibodies to HIV, HCV, Treponema pallidum, and surface antigen of HBV (HBsAg) was conducted among drug users recruited from 3 detoxification centers in Qingyuan, Guangdong, China. Risk factors for each of four infections were analyzed with logistic regression model.A total of 740 subjects were recruited, the median age was 31 years old (range 24-38). The seroprevalence rates of HIV, HBsAg, HCV and syphilis were 4.6%, 19.3%, 71.6% and 12.6%, respectively. Risk factors for HIV were intravenous drug use and co-infection with syphilis. Having a regular sexual partner who was a drug user was considered to be a risk factor for HBV. Intravenous drug use was a risk factor for HCV. However, the consistent use of condoms with commercial sex partners was protective for HCV infection. Compared to drug users living in urban area, those living in rural areas were more likely to be infected with syphilis, and there was an association between commercial sex and syphilis.The prevalence of HIV, HBV, HCV and syphilis were high among drug users in detoxification centers in Qingyuan, thus, risk reduction programs for the drug user population is urgently required.Since adopting a free market economy and an open door policy in 1978, China has witnessed a remarkable increase in sexually transmitted infections (STIs) and HIV [1]. By the end of 2007, the cumulative number of HIV positive individuals reported in China was 223,501, including 62,838 AIDS cases and 22,205 recorded deaths, 38.5% of reported HIV positive people were infected via intravenous drug use (IDU) [2]. Meanwhile, the prevalence of some blood-borne and sexually transmitted infections, including HBV, HCV and syphilis among drug users is also alarming. Several Studies in China have confirmed that the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV) and syphilis in drug user population is higher than that in the general population. For
Barriers to the Implementation of the Nursing Approach in Public Hospitals in Lubumbashi in the Democratic Republic of Congo: A Cross-Sectional Descriptive Study
Ndayi Kabamba Julie, Ilunga Kandolo Simon, Kabange Umba Irène, Matungulu Matungulu Charles, Abdulu Mahuridi, Mwinkeu Kasongo Narcisse, Malonga Kaj Francoise
Open Access Library Journal (OALib Journal) , 2017, DOI: 10.4236/oalib.1103721
Introduction: The nursing approach (NA) is the essence of the nursing profession. However, its implementation is almost absent in the hospitals of the Democratic Republic of Congo (DRC). Objectives: The aim of this study was to determine nurses’ knowledge, attitudes and practices in relation to the nursing approach and to identify barriers to the implementation of this approach. Methods: To achieve these objectives, we carried out a cross-sectional descriptive study among the nurses of the 11 public hospitals of Lubumbashi, from June to September 2015. Thanks to a validated questionnaire, we collected the data by interview, supported by participatory observation. Results: The results showed that 67.6% of respondents were trained on NA; However, 99.3% did not know the exact number of NA steps and 62.6% did not cite any steps; The majority (93.5%) of trainees on NA find that this process provides quality patient care; 100% of the sample wish to put it into practice; 100% of the sample need continuous training on NA including 67.6% to improve knowledge and 32.4% to learn; 89.1% of those trained reported not practicing NA, but participating direct observation gave 100% of non-practice. The barriers to implementation of the NA were inadequate nursing staff (75.6%), inadequate equipment (71.5%), lack of time (62.6%), lack of theoretical and practical knowledge (47.2%), lack of nursing records (26%) and lack of institution for nursing care within the hospital (17%). Conclusion: Therefore, capacity building of nurses through continuing education, as well as initial training on NA, would increase their knowledge, reinforce positive attitude and promote its implementation, all supported by improved working conditions and the implementation of a professional nursing quality assurance organization.
Is Congenital Syphilis Really Congenital Syphilis?  [PDF]
Yi Li,Bernard Gonik
Infectious Diseases in Obstetrics and Gynecology , 2006, DOI: 10.1155/idog/2006/81629
Abstract: Detroit has recently been distinguished as having the highest congenital syphilis rate in the United States (250.3 cases per 100 000 live births in Detroit versus 10.3 in the US). However, depending on each health department's followup and CDC reporting, these data may not accurately reflect the true congenital syphilis rate. This study examines the reported cases over a three-year time period with focus on the criteria used for diagnosis. All local health department congenital syphilis CDC collection forms (form 73.126) were reviewed for the years in question. The reported congenital syphilis cases in the year 2002–2004 in Detroit were reviewed. No cases met confirmed case criteria and few probable cases were based on neonatal evaluations. The majority of “congenital syphilis” cases were established based on incomplete maternal data such as missing followup serologic titers in the absence of complete neonatal information. In conclusion, although the reported congenital syphilis rate in Detroit is alarmingly high, the true occurrence of congenital syphilis is likely to have been overstated. A health department reporting program that includes more diligent neonatal followup would allow for a more accurate representation of this public health concern.
The Forgotten Sons of the State: The Social and Political Positions of Former Government Soldiers in Post-War Mozambique  [cached]
Nikkie Wiegink
Colombia Internacional , 2013, DOI: 10.7440/colombiaint77.2013.03
Abstract: This article shows that 21 years after the signing of the peace accords, the Mozambican state continues to struggle with the social and political niche of the more than 90,000 demobilized soldiers. The article departs from the observation that the memory construction of the past liberation and civil war done by the FRELIMO government was highly influential in creating and sharpening categories of veterans, determining which "type" of veteran has access to privileged resources and which is excluded. Based on ethnographic fieldwork, the problematic relationship between ex-combatants of the government army and the Mozambican government is explored. For veterans, this relationship is characterized by frustration, hope, patrimonialism and the use of the threat of violence. This plays out in negotiations involving material aspects (particularly pensions), but also symbolic aspects of being regarded as worthy veterans.
Personal networks and quality of life in Colombian individuals demobilized from the armed conflict  [PDF]
José Amar-Amar,Raimundo Abello-Llanos,Camilo Madariaga Orozco,José Hernando ávila-Toscano
Universitas Psychologica , 2011,
Abstract: The Aim of this study was to identify the existence of significant relationships between structural and functional indicators of personal networks of demobilized individuals and their levels of physical and psychological quality of life. We assessed 37 individuals living in an area of military distension in the Colombian Caribbean using the SF-36 and the ASSIS in a correlational study. The data were examined with Social Network Analysis (SNA) and statistical calculation with the Student t and Pearson correlation coefficients. There were small networks, with high levels of dissatisfaction with social support and low indices of quality of life. There were significant differences in the general perception of support networks and obtaining objective help (p = 0.000) and correlations between levels of social participation.in networks and psychological vitality of individuals.
Brzeziński Piotr
Our Dermatology Online , 2010,
Abstract: Background: Corynebacterial infection is a common condition in soldiers. Pitted keratolysis (PK), a bacterial infection confined to the plantar stratum corneum, does not severely impede patient activity but can be unpleasant and embarrassing because of its ‘‘rotten’’ odor. The incidence of PK in soldiers has been reported to be between 1,5% and 77.1%. Erythrasma is a superficial infection caused by Corynebacterium minutissimum and affects the major skin folds and the interdigital regions of the feet. It is characterized by erythematous, brown, scaly patches and maceration, and exhibits coral-red fluorescence under Wood light. Trichomycosis axillaris (TMA) is caused by the Corynebacterium tenuis. Patients affected by trichomycosis axillaris present with complaints of a disagreeable underarm odor and a history of hyperhidrosis and poor hygiene. Examination reveals the underarm hair to be coated with black, yellow-white or reddish deposits.Objective: The aim of this study was to determine the frequency corynebacterium triad in soldiers (pitted keratolysis, erythrasma, trichomycosis axillaris)Methods: The study involved 1694 men, soldiers in age about 23 years, (in period 5 months (-8-12.2008)). 103 persons, whose dermatologic symptoms/changes were analysed, were qualified for the research. Reconnaissance put on base of characteristic clinical sign and under Wood light.Results: Incidence of PK observed at 103 patients (which make up 6,08% of 1694 soldiers). EA diagnosed at 15 soldiers (14,56% of 103 patients), and TMA was diagnosed of 3 patients (2,91% of 103 patients). The coexistence are summarized as follows: erythrasma and PK; 15 of 103 patients (14,56%), TMA and PK in 3 of 103 patients (2,91%). The coexistence of rythrasma, TMA, and PK was noted in 1 patients (0,97%).Conclusions: Corynebacterial infection is a common condition in soldiers. In most cases/most often development of PK is observed. Our results demonstrate that either erythrasma or TMA can be associated with PK. We suggest that a closer, wider inspection is required to rule out the coexistence of the other. corynebacterial infections (Erythrasma, TMN) when a dermatologist encounters PK.
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