Clinical Evaluation of 2 Point-of-Care Lateral Flow Tests for the Diagnosis of Syphilis.

A diagnostic performance study comparing the only Food and Drug Administration-approved, point-of-care (POC) treponemal test (Syphilis Health Check) and the World Health Organization pre-qualified SD Bioline POC treponemal test against a treponemal hemagglutination test (TPHA) and a sequential algorithm of nontreponemal rapid plasma reagin and TPHA found both POC tests had >85% sensitivity compared with the TPHA and >85% sensitivity and >95% specificity compared with the rapid plasma reagin and TPHA standards.

Genital Herpes Simplex Virus Type 2 Shedding Among Adults With and Without HIV Infection in Uganda.

Background: Despite the high prevalence of herpes simplex virus type 2 (HSV-2) in sub-Saharan Africa, the natural history of infection among Africans is not well characterized. We evaluated the frequency of genital HSV shedding in HIV-seropositive and HIV-seronegative men and women in Uganda.

Methods: Ninety-three HSV-2-seropositive Ugandan adults collected anogenital swab specimens for HSV DNA quantification by polymerase chain reaction 3 times daily for 6 weeks.

Sero-prevalence of herpes simplex type 2 virus (HSV-2) and HIV infection in Kampala, Uganda.

Background: Prevalence of herpes simplex type 2 virus (HSV-2) is high worldwide. Previous studies in Uganda were rural or in women. We estimated age and sex-specific sero-prevalence of HSV-2 in Kampala, Uganda.

Cutaneous T-cell lymphoma in sub-Saharan Africa.

The incidence and economic burden of cancer in sub-Saharan Africa is increasing, and innovative strategies are needed to improve prevention and care in this population. This article uses a case of cutaneous T-cell lymphoma in Uganda to propose guidelines for the diagnosis and treatment of this disease in resource-limited settings. These guidelines were developed from the consensus opinion of specialists at the Uganda Cancer Institute and Fred Hutchinson Cancer Research Center as part of an established collaboration.

Sensitivity and specificity of herpes simplex virus-2 serological assays among HIV-infected and uninfected urban Ugandans.

Herpes simplex virus type 2 (HSV-2) is a risk factor for HIV-1 infection. We characterized HSV-2 serology assay performance in HIV-positive and HIV-negative Africans. Serostatus for HSV-2 and HIV-1 was determined in 493 serum specimens stored from a community HSV-2 prevalence survey in Kampala, Uganda.

Human herpesvirus 8 load and progression of AIDS-related Kaposi sarcoma lesions.

Introduction: Human herpesvirus 8 (HHV8) is necessary for Kaposi sarcoma (KS) to develop, but whether peripheral blood viral load is a marker of KS burden (total number of KS lesions), KS progression (the rate of eruption of new KS lesions), or both is unclear. We investigated these relationships in persons with AIDS.

Methods: Newly diagnosed patients with AIDS-related KS attending Mulago Hospital, in Kampala, Uganda, were assessed for KS burden and progression by questionnaire and medical examination.

Determinants for having sex while symptomatic among patients with sexually transmitted infections in Uganda.

In order to identify predictors of having sex while symptomatic among patients with sexually transmitted infections (STIs), a cross-sectional study was done at Mulago STD clinic in Kampala, Uganda. Ninety eight patients with STIs who engaged in sex while symptomatic were compared with 40 patients who did not engage in sex while symptomatic on: social-demographic; STI symptoms, health seeking behavior; condom use, sexual behaviour; partner referral; and knowledge and attitudes about STIs. On univariate analysis the risk of having sex while symptomatic was increased by: being female (crude odds ratio (COR) 2.

Human papillomavirus genotypes associated with cervical cytologic abnormalities and HIV infection in Ugandan women.

Human papillomavirus (HPV) infection is associated with almost all cases of cervical cancer, and cervical cancer is a common malignancy in women living in developing countries. A cross-sectional study was conducted to determine the prevalence of HPV infection, human immunodeficiency virus (HIV) infection, and cervical cytologic abnormalities in women presenting to a sexually transmitted infections clinic in Kampala, Uganda. In June and July, 2002, 135 women underwent complete physical exams including Papanicolaou (Pap) smears.

Absence of Y-chromosome sequences in tumors from African women with AIDS-related Kaposi sarcoma.

Kaposi sarcoma (KS) occurs with relatively high frequency in immunosuppressed transplant recipients and in patients with AIDS. Recently, Italian investigators reported transplant-related KS tumors bearing donor-derived antigens, suggesting possible parenteral transmission of KS as whole cells, i.e.

Prevalence of sexually transmitted infections among adolescents in Kampala, Uganda, and theoretical models for improving syndromic management.

Purpose: To estimate the prevalence of treatable sexually transmitted infections (STI) in adolescents visiting a youth health clinic. To evaluate the algorithm for management of the abnormal vaginal discharge (AVD) syndrome recommended in Uganda's national guidelines and compare it with other theoretical flowchart models.

Methods: Sexually experienced adolescents who were visiting an urban youth health clinic in Kampala, Uganda were examined and interviewed (with their consent) about their socio-demographic background, sexual risk factors, and genital symptoms.

Etiology of pruritic papular eruption with HIV infection in Uganda.

Context: A frequent cause of human immunodeficiency virus (HIV)-related morbidity in sub-Saharan Africa is a commonly occurring, intensely pruritic skin rash. The resulting scars are disfiguring and stigmatizing. Despite the substantial prevalence of pruritic papular eruption (PPE) among HIV-infected Africans, the cause has been elusive.

Sexually transmitted disease management in Uganda's private-for-profit formal and informal sector and compliance with treatment.

Objective: The objective of this study was to investigate the management of sexually transmitted diseases (STDs) in the Ugandan private sector clinics and drug shops.

Study: Men with urethral discharge who had consulted clinics (264) or drug shops (141) for treatment in 5 districts were interviewed using a precoded questionnaire 1 to 3 weeks after initiation of treatment.

Results: Seventy-seven percent of patients sought treatment within 1 week of onset of symptoms but only 7% were properly managed (treated according to National Guidelines, told to use a condom or abstain, and to refer their partner).

Social marketing of pre-packaged treatment for men with urethral discharge (Clear Seven) in Uganda.

We implemented social marketing of pre-packaged treatment for men with urethral discharge (Clear Seven) in Uganda, and studied its feasibility, acceptability and effectiveness as a possible means to treat STDs and thereby prevent HIV. Clear Seven was distributed at private health care outlets in three rural districts and two divisions of the capital. Comparisons were made with a pre-intervention period in the same sites plus one additional rural district.

Efficacy of patient-delivered partner medication in the treatment of sexual partners in Uganda.

Background: Patient-based partner referral (PBPR), which is the main method for treating sexual partners of patients with sexually transmitted diseases (STDs), has limited effectiveness.

Goal: The authors compared the efficacy of PBPR with patient-delivered partner medication (PDPM) among patients attending the Mulago STD clinic in Kampala, Uganda.

Study Design: A total of 383 patients (187 women, 196 men) with STDs were randomized to the PBPR or PDPM group.

Factors influencing sexual partner referral for sexually transmitted diseases in Uganda.

Background And Objective: Patient-based partner referral has limited effectiveness. We studied factors associated with sexual partner referral among patients with sexually transmitted diseases (STDs) with a view of suggesting remedial action.

Goal: To examine the role of psychosocial variables vis-a-vis other variables in predicting sexual partner referral.