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David A Lewis - One of the best experts on this subject based on the ideXlab platform.
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demographic and behavioral risk factors associated with reduced susceptibility of neisseria gonorrhoeae to first line antimicrobials in south african men with gonococcal Urethral Discharge
Antimicrobial Agents and Chemotherapy, 2021Co-Authors: Ranmini Kularatne, Tendesayi Kufa, Lindy Gumede, Dumisile V Maseko, David A LewisAbstract:Neisseria gonorrhoeae is the predominant cause of male Urethral Discharge in South Africa, and escalating prevalence of gonococcal antimicrobial resistance (AMR) is a major health concern both in-country and globally. We analyzed the demographic, behavioral, and clinical characteristics of 685 men presenting with gonococcal Urethral Discharge to sentinel surveillance clinics over a 3-year period (2017 to 2019) to determine the burden of factors that are known to be associated with N. gonorrhoeae AMR to first-line therapy (defined as group 1 isolates exhibiting resistance or reduced susceptibility to extended-spectrum cephalosporins or azithromycin). Among 685 men with gonococcal Urethral Discharge, median age was 28 years (interquartile range [IQR], 24 to 32). Only two men (2/632; 0.3%) self-identified as homosexual; however, on further enquiry, another 16 (2%) confirmed that they had sex with men only. Almost 30% practiced oral sex and were at risk for pharyngeal gonococcal infection. In univariate analysis, male circumcision (odds ratio [OR], 0.69; 95% confidence interval [CI], 0.49 to 0.99) and recent sex outside the country (OR, 1.83; 95% CI, 1.21 to 2.76) were significantly associated with having a category 1 N. gonorrhoeae isolate. In a multivariable model, only sex outside South Africa increased the odds of being infected with a decreased susceptible/resistant N. gonorrhoeae isolate (adjusted odds ratio [aOR], 1.64; 95% CI, 1.05 to 2.55). These findings warrant the intensification of N. gonorrhoeae AMR surveillance among recently arrived migrant and overseas traveler populations, as well as the inclusion of extragenital specimens for N. gonorrhoeae AMR surveillance purposes.
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HIV infection in patients with sexually transmitted infections in Zimbabwe – Results from the Zimbabwe STI etiology study
2018Co-Authors: Peter H Kilmarx, Anna Machiha, Elizabeth Gonese, David A Lewis, Mike Z. Chirenje, Beth Tippett A. Barr, Ahmed S. Latif, Lovemore Gwanzura, Hunter H. Handsfield, Owen MugurungiAbstract:BackgroundHIV and other sexually transmitted infections (STI) frequently co-occur. We conducted HIV diagnostic testing in an assessment of the etiologies of major STI syndromes in Zimbabwe.MethodsA total of 600 patients were enrolled at six geographically diverse, high-volume STI clinics in Zimbabwe in 2014–15: 200 men with Urethral Discharge, 200 women with vaginal Discharge, and 100 men and 100 women each with genital ulcer disease (GUD). Patients completed a questionnaire, underwent a genital examination, and had specimens taken for etiologic testing. Patients were offered, but not required to accept, HIV testing using a standard HIV algorithm in which two rapid tests defined a positive result.ResultsA total of 489 participants (81.5%) accepted HIV testing; 201 (41.1%) tested HIV-1-positive, including 16 (11.9%) of 134 participants who reported an HIV-negative status at study enrollment, and 58 (28.2%) of 206 participants who reported their HIV status as unknown. Of 147 who self-reported being HIV-positive at study enrollment, 21 (14.3%) tested HIV negative. HIV infection prevalence was higher in women (47.3%) than in men (34.8%, p
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HIV infection in patients with sexually transmitted infections in Zimbabwe - Results from the Zimbabwe STI etiology study.
'Public Library of Science (PLoS)', 2018Co-Authors: Peter H Kilmarx, Anna Machiha, Elizabeth Gonese, David A Lewis, Mike Z. Chirenje, Beth Tippett A. Barr, Ahmed S. Latif, Lovemore Gwanzura, Hunter H. Handsfield, Owen MugurungiAbstract:BACKGROUND:HIV and other sexually transmitted infections (STI) frequently co-occur. We conducted HIV diagnostic testing in an assessment of the etiologies of major STI syndromes in Zimbabwe. METHODS:A total of 600 patients were enrolled at six geographically diverse, high-volume STI clinics in Zimbabwe in 2014-15: 200 men with Urethral Discharge, 200 women with vaginal Discharge, and 100 men and 100 women each with genital ulcer disease (GUD). Patients completed a questionnaire, underwent a genital examination, and had specimens taken for etiologic testing. Patients were offered, but not required to accept, HIV testing using a standard HIV algorithm in which two rapid tests defined a positive result. RESULTS:A total of 489 participants (81.5%) accepted HIV testing; 201 (41.1%) tested HIV-1-positive, including 16 (11.9%) of 134 participants who reported an HIV-negative status at study enrollment, and 58 (28.2%) of 206 participants who reported their HIV status as unknown. Of 147 who self-reported being HIV-positive at study enrollment, 21 (14.3%) tested HIV negative. HIV infection prevalence was higher in women (47.3%) than in men (34.8%, p
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etiology and antimicrobial susceptibility of pathogens responsible for Urethral Discharge among men in harare zimbabwe
Sexually Transmitted Diseases, 2014Co-Authors: Simbarashe Takuva, Anna Machiha, Owen Mugurungi, Junior Mutsvangwa, Albert C Mupambo, Venessa Maseko, Fatim Cham, Stanley Mungofa, Peter Mason, David A LewisAbstract:Background Periodic etiological surveillance of sexually transmitted infection (STI) syndromes is required to validate treatment algorithms used to control STIs. However, such surveys have not been performed in Zimbabwe over the past decade. Methods A cross-sectional study design was used to determine the prevalence of the key STI etiological agents causing male Urethral Discharge (MUD). Urethral swab specimens were collected for molecular analysis and Neisseria gonorrhoeae isolation from consenting men 18 years and older who presented with MUD to the 12 clinics in Harare, Zimbabwe, between November 2010 and May 2011. A validated in-house multiplex polymerase chain reaction assay was used to detect the presence of N. gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, and Mycoplasma genitalium. Gonococci were cultured on selective media, and antimicrobial susceptibilities were determined locally for ciprofloxacin, kanamycin, ceftriaxone, and cefixime using Etest strips, and minimum inhibitory concentrations were reported using defined breakpoints. Results Among 130 participants, N. gonorrhoeae was the most frequent pathogen detected (106; 82.8%), followed by C. trachomatis (15; 11.7%), M. genitalium (6; 4.7%), and T. vaginalis (2; 1.6%). Four (6.1%) of the 66 gonococci isolated were resistant to fluoroquinolones, whereas all viable isolates were susceptible to kanamycin, cefixime, and ceftriaxone. Conclusions Gonorrhea is the most important cause of MUD in men in Harare, and our study highlights the emergence of fluoroquinolone-resistant N. gonorrhoeae. Further STI surveys are required in other regions of Zimbabwe to obtain a nationally representative picture of gonococcal burden and antimicrobial resistance among MUD patients.
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phenotypic and genetic characterization of the first two cases of extended spectrum cephalosporin resistant neisseria gonorrhoeae infection in south africa and association with cefixime treatment failure
Journal of Antimicrobial Chemotherapy, 2013Co-Authors: Lindy Gumede, David A Lewis, Charlotte Sriruttan, Etienne E Muller, Daniel Golparian, Donald Fick, Johan De Wet, Venessa MasekoAbstract:Patients and methods: Two ESC-resistant N. gonorrhoeae isolates were cultured from the Urethral Discharge of two men who have sex with men (MSM). One man reported a persistent Urethral Discharge that had failed to respond to previous therapy with oral cefixime. Agar dilution MICs were determined for eight antibiotics. b-Lactam-associated resistance mutations were identified through PCR-based amplification and sequencing for several key genes: penA, mtrR and its promoter, porB1b (penB), ponA and pilQ. For molecular epidemiological characterization, full-length porB gene sequencing, N. gonorrhoeae multiantigen sequence typing (NG-MAST) and multilocus sequence typing (MLST) were performed. Results: Both isolates were resistant to cefixime, ciprofloxacin, penicillin and tetracycline and intermediate/ resistant to azithromycin, but susceptible to ceftriaxone, gentamicin and spectinomycin. Both isolates had the type XXXIV penA mosaic allele in addition to previously described resistance mutations in the mtrR promoter (A deletion), porB1b (penB) (G101K and A102N) and ponA1 (L421P). Both isolates had an identical NG-MAST sequence type (ST4822) and MLST sequence type (ST1901). Conclusions: Both isolates were resistant to cefixime and possessed a number of identical mutations in key genes contributing to ESC resistance in N. gonorrhoeae. The two isolates contained the type XXXIV penA mosaic allele and belonged to a successful international MSM-linked multidrug-resistant gonococcal clone (MLST ST1901) associated with several cefixime treatment failures in Europe and North America.
Eline L Korenromp - One of the best experts on this subject based on the ideXlab platform.
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trends in adult chlamydia and gonorrhoea prevalence incidence and Urethral Discharge case reporting in mongolia from 1995 to 2016 estimates using the spectrum sti model
Western Pacific Surveillance and Response, 2017Co-Authors: Jugderjav Badrakh, Guy Mahiane, Jane Rowley, Setsen Zayasaikhan, Davaalkham Jagdagsuren, Erdenetungalag Enkhbat, Narantuya Jadambaa, Sergelen Munkhbaatar, Melanie Taylor, Eline L KorenrompAbstract:Objective: To estimate Mongolia’s prevalence and incidence trends of gonorrhea and chlamydia in women and men 15-49 years-old, to inform control of STIs and HIV, a national health sector priority. Methods: We applied the Spectrum-STI estimation model, fitting data from two national population surveys (2001 and 2008) and from routine gonorrhea screening of pregnant women in antenatal care (1997-2016), adjusted for diagnostic test performance, male/female differences and missing high-risk populations. Prevalence and incidence estimates were then used to assess completeness of national case reporting. Results: Gonorrhea prevalence was estimated at 3.3% (95% confidence interval, 1.6-3.9%) in women and 2.9% (1.3-3.4%) in men in 2016; chlamydia prevalences were 19.5% (17.3-21.9%) and 15.6% (13.8-17.5%). Corresponding new incident cases in women and men in 2016 totaled 60,334 (36,147-121,933) and 76,893 (40,428-267,884) for gonorrhea, and 131,306 (84,232-254,316) and 148,162 (72,145-444,110) for chlamydia. Gonorrhea and chlamydia prevalence declined by an estimated 33% and 11%, respectively, over 2001-2016. Comparing numbers of symptomatic and treated cases estimated by Spectrum with gonorrhea case reports suggests that 15% of symptomatic treated gonorrhea cases were reported in 2016; only a minority of chlamydia episodes were reported as Urethral Discharge cases. Discussion: Gonorrhea and chlamydia prevalence are estimated to have declined in Mongolia during the early 2000s, possibly associated with syndromic management in primary care facilities and improving treatment coverage since 2001, and scale-up of (Global Fund-supported) HIV/STI prevention interventions since 2003. However, prevalence remain high, with most gonorrhea and chlamydia cases not treated or recorded in the public health system.
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p3 61 trends in adult chlamydia and gonorrhoea prevalence incidence and Urethral Discharge case reporting in morocco over 1995 2015 estimates using the spectrum sti model
Sexually Transmitted Infections, 2017Co-Authors: Eline L Korenromp, Amina Elkettani, Guy Mahiane, Aziza Bennani, Laith J Aburaddad, Alex Smolak, Jane Rowley, Nico Nagelkerke, Houssine Elrhilani, Kamal AlamiAbstract:Introduction Evolving health priorities and resource constraints mean that countries require data on trends in sexually transmitted infections (STI) burden, to inform program planning and resource allocation. Methods The Spectrum modelling tool estimated prevalence and incidence of gonorrhoea and chlamydia in Morocco’s 15–49 year-old population, based on prevalence data adjusted for diagnostic test performance, urban/rural and male/female differences, and missing high-risk populations, and weighted by coverage and representativeness. Results Gonorrhoea prevalence was estimated at 0.37% (95% confidence interval, 0.14%–1.0%) in women and 0.32% (0.12%–0.87%) in men in 2015; chlamydia prevalences were 3.8% (2.1%–6.4%) and 3.0% (1.7%–5.1%). Corresponding numbers of new cases in 15–49 year-old women and men in 2015 were 79,598 (23,918–256,206) and 112,013 (28,700–307,433) for gonorrhoea, and 291,908 (161,064–524,270) and 314,032 (186,076–559,133) for chlamydia. Gonorrhoea and chlamydia prevalence had declined by 41% and 27%, respectively, over 1995–2015. Prevalence declines probably related to improved STI treatment coverage, and decreasing risk behaviours. Reporting completeness among treated Urethral Discharge (UD) cases was estimated at 46%–77% in 2015. Clinically reported UD cases corresponded to 13% of all (symptomatic and asymptomatic) gonorrhoea and chlamydia cases. Conclusion STI declines and improvements in treatment coverage are consistent with Morocco’s introduction of syndromic management in 2000, scale-up of prevention interventions, and declining HIV incidence after 2003. While gonorrhoea is four-fold more common as cause of clinical UD cases than chlamydia, Morocco continues to suffer a large, untreated burden of chlamydia. Reliable monitoring of both STIs requires new periodic surveys and/or novel forms of affordable surveillance beyond high-risk populations.
Jane Rowley - One of the best experts on this subject based on the ideXlab platform.
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trends in adult chlamydia and gonorrhoea prevalence incidence and Urethral Discharge case reporting in mongolia from 1995 to 2016 estimates using the spectrum sti model
Western Pacific Surveillance and Response, 2017Co-Authors: Jugderjav Badrakh, Guy Mahiane, Jane Rowley, Setsen Zayasaikhan, Davaalkham Jagdagsuren, Erdenetungalag Enkhbat, Narantuya Jadambaa, Sergelen Munkhbaatar, Melanie Taylor, Eline L KorenrompAbstract:Objective: To estimate Mongolia’s prevalence and incidence trends of gonorrhea and chlamydia in women and men 15-49 years-old, to inform control of STIs and HIV, a national health sector priority. Methods: We applied the Spectrum-STI estimation model, fitting data from two national population surveys (2001 and 2008) and from routine gonorrhea screening of pregnant women in antenatal care (1997-2016), adjusted for diagnostic test performance, male/female differences and missing high-risk populations. Prevalence and incidence estimates were then used to assess completeness of national case reporting. Results: Gonorrhea prevalence was estimated at 3.3% (95% confidence interval, 1.6-3.9%) in women and 2.9% (1.3-3.4%) in men in 2016; chlamydia prevalences were 19.5% (17.3-21.9%) and 15.6% (13.8-17.5%). Corresponding new incident cases in women and men in 2016 totaled 60,334 (36,147-121,933) and 76,893 (40,428-267,884) for gonorrhea, and 131,306 (84,232-254,316) and 148,162 (72,145-444,110) for chlamydia. Gonorrhea and chlamydia prevalence declined by an estimated 33% and 11%, respectively, over 2001-2016. Comparing numbers of symptomatic and treated cases estimated by Spectrum with gonorrhea case reports suggests that 15% of symptomatic treated gonorrhea cases were reported in 2016; only a minority of chlamydia episodes were reported as Urethral Discharge cases. Discussion: Gonorrhea and chlamydia prevalence are estimated to have declined in Mongolia during the early 2000s, possibly associated with syndromic management in primary care facilities and improving treatment coverage since 2001, and scale-up of (Global Fund-supported) HIV/STI prevention interventions since 2003. However, prevalence remain high, with most gonorrhea and chlamydia cases not treated or recorded in the public health system.
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trends in adult chlamydia and gonorrhea prevalence incidence and Urethral Discharge case reporting in morocco over 1995 2015 estimates using the spectrum sexually transmitted infection model
Sexually Transmitted Diseases, 2017Co-Authors: Amina Elkettani, Guy Mahiane, Aziza Bennani, Laith J Aburaddad, Alex Smolak, Jane Rowley, Nico Nagelkerke, Houssine Elrhilani, Kamal Alami, Amina HancaliAbstract:BACKGROUND: Evolving health priorities and resource constraints mean that countries require data on sexually transmitted infections (STI) trends to inform program planning and resource allocation. METHODS: The Spectrum modeling tool estimated prevalence and incidence of gonorrhea and chlamydia in Morocco's 15- to 49-year-old population, based on prevalence surveys. Incident cases, broken down between symptomatic and asymptomatic, and treated versus untreated, were compared with Urethral Discharge (UD) case reports, to estimate reporting completeness among treated UD cases. RESULTS: Gonorrhea prevalence was estimated at 0.37% (95% confidence interval [CI], 0.14-1.0%) in women and 0.32% (0.12-0.87%) in men in 2015; chlamydia prevalences were 3.8% (95% CI, 2.1-6.4%) and 3.0% (95% CI, 1.7-5.1%). Corresponding estimated numbers of new cases in women and men in 2015 were 79,598 (95% CI, 23,918-256,206) and 112,013 (95% CI, 28,700-307,433) for gonorrhea, and 291,908 (95% CI, 161,064-524,270) and 314,032 (95% CI, 186,076-559,133) for chlamydia. Gonorrhea and chlamydia prevalence had declined by an estimated 41% and 27%, respectively, over 1995 to 2015. Prevalence declines probably related to improved STI treatment coverage, and decreasing risk behaviors. Reporting completeness among treated UD cases was estimated at 46% to 77% in 2015. Reported UD cases corresponded to 13% of all estimated (symptomatic and asymptomatic) gonorrhea and chlamydia cases. CONCLUSIONS: STI declines and improvements in treatment coverage are consistent with Morocco's introduction of syndromic management in 2000, scale-up of prevention, and declining human immunodeficiency virus incidence. While gonorrhea is four-fold more common as cause of clinical UD cases than chlamydia, Morocco continues to suffer a large, untreated burden of chlamydia. Reliable monitoring of both STIs requires new periodic surveys and/or novel forms of affordable surveillance beyond high-risk populations.
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p3 61 trends in adult chlamydia and gonorrhoea prevalence incidence and Urethral Discharge case reporting in morocco over 1995 2015 estimates using the spectrum sti model
Sexually Transmitted Infections, 2017Co-Authors: Eline L Korenromp, Amina Elkettani, Guy Mahiane, Aziza Bennani, Laith J Aburaddad, Alex Smolak, Jane Rowley, Nico Nagelkerke, Houssine Elrhilani, Kamal AlamiAbstract:Introduction Evolving health priorities and resource constraints mean that countries require data on trends in sexually transmitted infections (STI) burden, to inform program planning and resource allocation. Methods The Spectrum modelling tool estimated prevalence and incidence of gonorrhoea and chlamydia in Morocco’s 15–49 year-old population, based on prevalence data adjusted for diagnostic test performance, urban/rural and male/female differences, and missing high-risk populations, and weighted by coverage and representativeness. Results Gonorrhoea prevalence was estimated at 0.37% (95% confidence interval, 0.14%–1.0%) in women and 0.32% (0.12%–0.87%) in men in 2015; chlamydia prevalences were 3.8% (2.1%–6.4%) and 3.0% (1.7%–5.1%). Corresponding numbers of new cases in 15–49 year-old women and men in 2015 were 79,598 (23,918–256,206) and 112,013 (28,700–307,433) for gonorrhoea, and 291,908 (161,064–524,270) and 314,032 (186,076–559,133) for chlamydia. Gonorrhoea and chlamydia prevalence had declined by 41% and 27%, respectively, over 1995–2015. Prevalence declines probably related to improved STI treatment coverage, and decreasing risk behaviours. Reporting completeness among treated Urethral Discharge (UD) cases was estimated at 46%–77% in 2015. Clinically reported UD cases corresponded to 13% of all (symptomatic and asymptomatic) gonorrhoea and chlamydia cases. Conclusion STI declines and improvements in treatment coverage are consistent with Morocco’s introduction of syndromic management in 2000, scale-up of prevention interventions, and declining HIV incidence after 2003. While gonorrhoea is four-fold more common as cause of clinical UD cases than chlamydia, Morocco continues to suffer a large, untreated burden of chlamydia. Reliable monitoring of both STIs requires new periodic surveys and/or novel forms of affordable surveillance beyond high-risk populations.
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Trends in adult chlamydia and gonorrhoea prevalence, incidence and Urethral Discharge case reporting in Mongolia from 1995 to 2016 – estimates using the Spectrum-STI model
World Health Organization, 2017Co-Authors: Jugderjav Badrakh, Guy Mahiane, Jane Rowley, Setsen Zayasaikhan, Davaalkham Jagdagsuren, Erdenetungalag Enkhbat, Narantuya Jadambaa, Sergelen Munkhbaatar, Melanie Taylor, Eline KorenrompAbstract:Objective: To estimate Mongolia’s prevalence and incidence trends of gonorrhoea and chlamydia in women and men 15–49 years old to inform control of STIs and HIV, a national health sector priority. Methods: We applied the Spectrum-STI estimation model, fitting data from two national population surveys (2001 and 2008) and from routine gonorrhoea screening of pregnant women in antenatal care (1997 to 2016) adjusted for diagnostic test performance, male/female differences and missing high-risk populations. Prevalence and incidence estimates were then used to assess completeness of national case reporting. Results: Gonorrhoea prevalence was estimated at 3.3% (95% confidence interval, 1.6–3.9%) in women and 2.9% (1.6–4.1%) in men in 2016; chlamydia prevalence levels were 19.5% (17.3–21.9%) and 15.6% (10.0–21.2%), respectively. Corresponding new incident cases in women and men in 2016 totalled 60 334 (36 147 to 121 933) and 76 893 (35 639 to 254 913) for gonorrhoea and 131 306 (84 232 to 254 316) and 148 162 (71 885 to 462 588) for chlamydia. Gonorrhoea and chlamydia prevalence declined by an estimated 33% and 11%, respectively from 2001 to 2016. Comparing numbers of symptomatic and treated cases estimated by Spectrum with gonorrhoea case reports suggests that 15% of symptomatic treated gonorrhoea cases were reported in 2016; only a minority of chlamydia episodes were reported as male Urethral Discharge cases. Discussion: Gonorrhoea and chlamydia prevalence are estimated to have declined in Mongolia during the early 2000s, possibly associated with syndromic management in primary care facilities and improving treatment coverage since 2001 and scale up of HIV/STI prevention interventions since 2003. However, prevalence remains high with most gonorrhoea and chlamydia cases not treated or recorded in the public health system
Guy Mahiane - One of the best experts on this subject based on the ideXlab platform.
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trends in adult chlamydia and gonorrhoea prevalence incidence and Urethral Discharge case reporting in mongolia from 1995 to 2016 estimates using the spectrum sti model
Western Pacific Surveillance and Response, 2017Co-Authors: Jugderjav Badrakh, Guy Mahiane, Jane Rowley, Setsen Zayasaikhan, Davaalkham Jagdagsuren, Erdenetungalag Enkhbat, Narantuya Jadambaa, Sergelen Munkhbaatar, Melanie Taylor, Eline L KorenrompAbstract:Objective: To estimate Mongolia’s prevalence and incidence trends of gonorrhea and chlamydia in women and men 15-49 years-old, to inform control of STIs and HIV, a national health sector priority. Methods: We applied the Spectrum-STI estimation model, fitting data from two national population surveys (2001 and 2008) and from routine gonorrhea screening of pregnant women in antenatal care (1997-2016), adjusted for diagnostic test performance, male/female differences and missing high-risk populations. Prevalence and incidence estimates were then used to assess completeness of national case reporting. Results: Gonorrhea prevalence was estimated at 3.3% (95% confidence interval, 1.6-3.9%) in women and 2.9% (1.3-3.4%) in men in 2016; chlamydia prevalences were 19.5% (17.3-21.9%) and 15.6% (13.8-17.5%). Corresponding new incident cases in women and men in 2016 totaled 60,334 (36,147-121,933) and 76,893 (40,428-267,884) for gonorrhea, and 131,306 (84,232-254,316) and 148,162 (72,145-444,110) for chlamydia. Gonorrhea and chlamydia prevalence declined by an estimated 33% and 11%, respectively, over 2001-2016. Comparing numbers of symptomatic and treated cases estimated by Spectrum with gonorrhea case reports suggests that 15% of symptomatic treated gonorrhea cases were reported in 2016; only a minority of chlamydia episodes were reported as Urethral Discharge cases. Discussion: Gonorrhea and chlamydia prevalence are estimated to have declined in Mongolia during the early 2000s, possibly associated with syndromic management in primary care facilities and improving treatment coverage since 2001, and scale-up of (Global Fund-supported) HIV/STI prevention interventions since 2003. However, prevalence remain high, with most gonorrhea and chlamydia cases not treated or recorded in the public health system.
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trends in adult chlamydia and gonorrhea prevalence incidence and Urethral Discharge case reporting in morocco over 1995 2015 estimates using the spectrum sexually transmitted infection model
Sexually Transmitted Diseases, 2017Co-Authors: Amina Elkettani, Guy Mahiane, Aziza Bennani, Laith J Aburaddad, Alex Smolak, Jane Rowley, Nico Nagelkerke, Houssine Elrhilani, Kamal Alami, Amina HancaliAbstract:BACKGROUND: Evolving health priorities and resource constraints mean that countries require data on sexually transmitted infections (STI) trends to inform program planning and resource allocation. METHODS: The Spectrum modeling tool estimated prevalence and incidence of gonorrhea and chlamydia in Morocco's 15- to 49-year-old population, based on prevalence surveys. Incident cases, broken down between symptomatic and asymptomatic, and treated versus untreated, were compared with Urethral Discharge (UD) case reports, to estimate reporting completeness among treated UD cases. RESULTS: Gonorrhea prevalence was estimated at 0.37% (95% confidence interval [CI], 0.14-1.0%) in women and 0.32% (0.12-0.87%) in men in 2015; chlamydia prevalences were 3.8% (95% CI, 2.1-6.4%) and 3.0% (95% CI, 1.7-5.1%). Corresponding estimated numbers of new cases in women and men in 2015 were 79,598 (95% CI, 23,918-256,206) and 112,013 (95% CI, 28,700-307,433) for gonorrhea, and 291,908 (95% CI, 161,064-524,270) and 314,032 (95% CI, 186,076-559,133) for chlamydia. Gonorrhea and chlamydia prevalence had declined by an estimated 41% and 27%, respectively, over 1995 to 2015. Prevalence declines probably related to improved STI treatment coverage, and decreasing risk behaviors. Reporting completeness among treated UD cases was estimated at 46% to 77% in 2015. Reported UD cases corresponded to 13% of all estimated (symptomatic and asymptomatic) gonorrhea and chlamydia cases. CONCLUSIONS: STI declines and improvements in treatment coverage are consistent with Morocco's introduction of syndromic management in 2000, scale-up of prevention, and declining human immunodeficiency virus incidence. While gonorrhea is four-fold more common as cause of clinical UD cases than chlamydia, Morocco continues to suffer a large, untreated burden of chlamydia. Reliable monitoring of both STIs requires new periodic surveys and/or novel forms of affordable surveillance beyond high-risk populations.
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p3 61 trends in adult chlamydia and gonorrhoea prevalence incidence and Urethral Discharge case reporting in morocco over 1995 2015 estimates using the spectrum sti model
Sexually Transmitted Infections, 2017Co-Authors: Eline L Korenromp, Amina Elkettani, Guy Mahiane, Aziza Bennani, Laith J Aburaddad, Alex Smolak, Jane Rowley, Nico Nagelkerke, Houssine Elrhilani, Kamal AlamiAbstract:Introduction Evolving health priorities and resource constraints mean that countries require data on trends in sexually transmitted infections (STI) burden, to inform program planning and resource allocation. Methods The Spectrum modelling tool estimated prevalence and incidence of gonorrhoea and chlamydia in Morocco’s 15–49 year-old population, based on prevalence data adjusted for diagnostic test performance, urban/rural and male/female differences, and missing high-risk populations, and weighted by coverage and representativeness. Results Gonorrhoea prevalence was estimated at 0.37% (95% confidence interval, 0.14%–1.0%) in women and 0.32% (0.12%–0.87%) in men in 2015; chlamydia prevalences were 3.8% (2.1%–6.4%) and 3.0% (1.7%–5.1%). Corresponding numbers of new cases in 15–49 year-old women and men in 2015 were 79,598 (23,918–256,206) and 112,013 (28,700–307,433) for gonorrhoea, and 291,908 (161,064–524,270) and 314,032 (186,076–559,133) for chlamydia. Gonorrhoea and chlamydia prevalence had declined by 41% and 27%, respectively, over 1995–2015. Prevalence declines probably related to improved STI treatment coverage, and decreasing risk behaviours. Reporting completeness among treated Urethral Discharge (UD) cases was estimated at 46%–77% in 2015. Clinically reported UD cases corresponded to 13% of all (symptomatic and asymptomatic) gonorrhoea and chlamydia cases. Conclusion STI declines and improvements in treatment coverage are consistent with Morocco’s introduction of syndromic management in 2000, scale-up of prevention interventions, and declining HIV incidence after 2003. While gonorrhoea is four-fold more common as cause of clinical UD cases than chlamydia, Morocco continues to suffer a large, untreated burden of chlamydia. Reliable monitoring of both STIs requires new periodic surveys and/or novel forms of affordable surveillance beyond high-risk populations.
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Trends in adult chlamydia and gonorrhoea prevalence, incidence and Urethral Discharge case reporting in Mongolia from 1995 to 2016 – estimates using the Spectrum-STI model
World Health Organization, 2017Co-Authors: Jugderjav Badrakh, Guy Mahiane, Jane Rowley, Setsen Zayasaikhan, Davaalkham Jagdagsuren, Erdenetungalag Enkhbat, Narantuya Jadambaa, Sergelen Munkhbaatar, Melanie Taylor, Eline KorenrompAbstract:Objective: To estimate Mongolia’s prevalence and incidence trends of gonorrhoea and chlamydia in women and men 15–49 years old to inform control of STIs and HIV, a national health sector priority. Methods: We applied the Spectrum-STI estimation model, fitting data from two national population surveys (2001 and 2008) and from routine gonorrhoea screening of pregnant women in antenatal care (1997 to 2016) adjusted for diagnostic test performance, male/female differences and missing high-risk populations. Prevalence and incidence estimates were then used to assess completeness of national case reporting. Results: Gonorrhoea prevalence was estimated at 3.3% (95% confidence interval, 1.6–3.9%) in women and 2.9% (1.6–4.1%) in men in 2016; chlamydia prevalence levels were 19.5% (17.3–21.9%) and 15.6% (10.0–21.2%), respectively. Corresponding new incident cases in women and men in 2016 totalled 60 334 (36 147 to 121 933) and 76 893 (35 639 to 254 913) for gonorrhoea and 131 306 (84 232 to 254 316) and 148 162 (71 885 to 462 588) for chlamydia. Gonorrhoea and chlamydia prevalence declined by an estimated 33% and 11%, respectively from 2001 to 2016. Comparing numbers of symptomatic and treated cases estimated by Spectrum with gonorrhoea case reports suggests that 15% of symptomatic treated gonorrhoea cases were reported in 2016; only a minority of chlamydia episodes were reported as male Urethral Discharge cases. Discussion: Gonorrhoea and chlamydia prevalence are estimated to have declined in Mongolia during the early 2000s, possibly associated with syndromic management in primary care facilities and improving treatment coverage since 2001 and scale up of HIV/STI prevention interventions since 2003. However, prevalence remains high with most gonorrhoea and chlamydia cases not treated or recorded in the public health system
Kamal Alami - One of the best experts on this subject based on the ideXlab platform.
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trends in adult chlamydia and gonorrhea prevalence incidence and Urethral Discharge case reporting in morocco over 1995 2015 estimates using the spectrum sexually transmitted infection model
Sexually Transmitted Diseases, 2017Co-Authors: Amina Elkettani, Guy Mahiane, Aziza Bennani, Laith J Aburaddad, Alex Smolak, Jane Rowley, Nico Nagelkerke, Houssine Elrhilani, Kamal Alami, Amina HancaliAbstract:BACKGROUND: Evolving health priorities and resource constraints mean that countries require data on sexually transmitted infections (STI) trends to inform program planning and resource allocation. METHODS: The Spectrum modeling tool estimated prevalence and incidence of gonorrhea and chlamydia in Morocco's 15- to 49-year-old population, based on prevalence surveys. Incident cases, broken down between symptomatic and asymptomatic, and treated versus untreated, were compared with Urethral Discharge (UD) case reports, to estimate reporting completeness among treated UD cases. RESULTS: Gonorrhea prevalence was estimated at 0.37% (95% confidence interval [CI], 0.14-1.0%) in women and 0.32% (0.12-0.87%) in men in 2015; chlamydia prevalences were 3.8% (95% CI, 2.1-6.4%) and 3.0% (95% CI, 1.7-5.1%). Corresponding estimated numbers of new cases in women and men in 2015 were 79,598 (95% CI, 23,918-256,206) and 112,013 (95% CI, 28,700-307,433) for gonorrhea, and 291,908 (95% CI, 161,064-524,270) and 314,032 (95% CI, 186,076-559,133) for chlamydia. Gonorrhea and chlamydia prevalence had declined by an estimated 41% and 27%, respectively, over 1995 to 2015. Prevalence declines probably related to improved STI treatment coverage, and decreasing risk behaviors. Reporting completeness among treated UD cases was estimated at 46% to 77% in 2015. Reported UD cases corresponded to 13% of all estimated (symptomatic and asymptomatic) gonorrhea and chlamydia cases. CONCLUSIONS: STI declines and improvements in treatment coverage are consistent with Morocco's introduction of syndromic management in 2000, scale-up of prevention, and declining human immunodeficiency virus incidence. While gonorrhea is four-fold more common as cause of clinical UD cases than chlamydia, Morocco continues to suffer a large, untreated burden of chlamydia. Reliable monitoring of both STIs requires new periodic surveys and/or novel forms of affordable surveillance beyond high-risk populations.
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p3 61 trends in adult chlamydia and gonorrhoea prevalence incidence and Urethral Discharge case reporting in morocco over 1995 2015 estimates using the spectrum sti model
Sexually Transmitted Infections, 2017Co-Authors: Eline L Korenromp, Amina Elkettani, Guy Mahiane, Aziza Bennani, Laith J Aburaddad, Alex Smolak, Jane Rowley, Nico Nagelkerke, Houssine Elrhilani, Kamal AlamiAbstract:Introduction Evolving health priorities and resource constraints mean that countries require data on trends in sexually transmitted infections (STI) burden, to inform program planning and resource allocation. Methods The Spectrum modelling tool estimated prevalence and incidence of gonorrhoea and chlamydia in Morocco’s 15–49 year-old population, based on prevalence data adjusted for diagnostic test performance, urban/rural and male/female differences, and missing high-risk populations, and weighted by coverage and representativeness. Results Gonorrhoea prevalence was estimated at 0.37% (95% confidence interval, 0.14%–1.0%) in women and 0.32% (0.12%–0.87%) in men in 2015; chlamydia prevalences were 3.8% (2.1%–6.4%) and 3.0% (1.7%–5.1%). Corresponding numbers of new cases in 15–49 year-old women and men in 2015 were 79,598 (23,918–256,206) and 112,013 (28,700–307,433) for gonorrhoea, and 291,908 (161,064–524,270) and 314,032 (186,076–559,133) for chlamydia. Gonorrhoea and chlamydia prevalence had declined by 41% and 27%, respectively, over 1995–2015. Prevalence declines probably related to improved STI treatment coverage, and decreasing risk behaviours. Reporting completeness among treated Urethral Discharge (UD) cases was estimated at 46%–77% in 2015. Clinically reported UD cases corresponded to 13% of all (symptomatic and asymptomatic) gonorrhoea and chlamydia cases. Conclusion STI declines and improvements in treatment coverage are consistent with Morocco’s introduction of syndromic management in 2000, scale-up of prevention interventions, and declining HIV incidence after 2003. While gonorrhoea is four-fold more common as cause of clinical UD cases than chlamydia, Morocco continues to suffer a large, untreated burden of chlamydia. Reliable monitoring of both STIs requires new periodic surveys and/or novel forms of affordable surveillance beyond high-risk populations.
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Urethral Discharge in morocco prevalence of microorganisms and susceptibility of gonococcos
Eastern Mediterranean Health Journal, 2002Co-Authors: Kamal Alami, Ait N Mbarek, M Akrim, B Bellaji, A Hansali, H Khattabi, A Sekkat, El R Aouad, J MahjourAbstract:We studied 422 patients with Urethral Discharge recruited from 4 sentinel sites in Morocco to determine sociodemographic characteristics, history of STI infection, infecting organism and antibiotic susceptibility of Neisseria gonorrhoeae. The mean age of the sample was 28 years (range 16-67 years), and most were single, had multiple sex partners without taking protective measures and came from all social backgrounds; 59.9% had a history of a previous STI. The majority (87%) of the infections were the acute form. By polymerase chain reaction of urine samples of 399 patients, 41.6% had N. gonorrhoeae infection, 6.3% Chlamidia trachomatis and 10.8% both organisms; in 41.4% no organism was identified. N. gonorrhoeae was strongly susceptible to ciprofloxacin.
