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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Prevalence and risk factors associated with HIV and syphilis co-infection in the African Cohort Study: a cross-sectional study
BMC Infectious Diseases, Volume 21, No. 1, Article 1123, Year 2021
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Description
Background: Each year, 5.6 million new syphilis cases are diagnosed globally. Guidelines for people living with HIV (PLWH) in low-income countries (LIC) recommend STI testing for symptomatic persons and those newly diagnosed with HIV; routine STI testing is less clear. Here we provide updated syphilis prevalence and identify co-infection risk factors in PLWH in the African Cohort Study (AFRICOS) to understand these rates as they relate to syndromic treatment. Methods: AFRICOS is a study enrolling PLWH and HIV-uninfected individuals in four African countries. Participant study enrollment information was used to determine syphilis prevalence and co-infection risk factors. Inclusion criteria consisted of adults 18 years or older receiving care at a participating clinic as a long-term resident who consented to data and specimen collection. Exclusion criteria consisted of pregnancy and/or imprisonment. Screen-positive syphilis was defined as a reactive rapid plasma regain (RPR) upon study enrollment whereas confirmed syphilis included a reactive RPR followed by reactive treponemal test. Multivariate analyses was performed to determine HIV and syphilis co-infection risk factors. Results: Between 2013 and March 1, 2020, 2939 PLWH enrolled and 2818 were included for analysis. Screen-positive and confirmed syphilis prevalence were 5.3% (151/2818) and 3.1% (87/2818), respectively. When the analysis was restricted to PLWH with an RPR titer of greater than, or equal to, 1:8, 11/87 (12.6%) participants were included. No PLWH and confirmed syphilis had documented genital ulcers. In the multivariate model, participants with confirmed syphilis co-infection were more likely to have none or some primary education [aOR 3.29 (1.60, 6.74)] and consume alcohol [aOR 1.87 (1.16, 3.03)] compared to those without syphilis. Antiretroviral therapy (ART) with suppressed viral load (VL) was protective in the unadjusted model but not adjusted multivariate model. Conclusions: Our findings show that syphilis rates in sub-Saharan Africa remain elevated where diagnosis remains challenging, and that both lower education level and alcohol consumption are significantly associated with HIV/syphilis co-infection in AFRICOS. Based on our analysis, current STI guidelines targeting testing for African individuals with either new HIV diagnosis or syndromic symptoms may be inadequate, highlighting the need for increased testing and treatment strategies in resource-limited settings. © 2021, The Author(s).
Authors & Co-Authors
Gilbert, Laura J.
United States, Silver Spring
Walter Reed Army Institute of Research
Dear, Nicole F.
United States, Silver Spring
Walter Reed Army Institute of Research
United States, Rockville
Hjf
Esber, Allahna L.
United States, Silver Spring
Walter Reed Army Institute of Research
United States, Rockville
Hjf
Iroezindu, Michael Onyebuchi
United States, Silver Spring
Walter Reed Army Institute of Research
Nigeria, Abuja
Hjf Medical Research International
Bahemana, Emmanuel
United States, Silver Spring
Walter Reed Army Institute of Research
Tanzania, Mbeya
Hjf Medical Research International
Kibuuka, Hannah N.
Uganda, Kampala
Makerere University
Owuoth, John Kevin
United States, Silver Spring
Walter Reed Army Institute of Research
Kenya, Kisumu
U.s. Army Medical Research Directorate - Africa
Kenya, Kisumu
Hjf Medical Research International
Maswai, Jonah K.
United States, Silver Spring
Walter Reed Army Institute of Research
Kenya, Kisumu
Hjf Medical Research International
Kenya, Kericho
Hjf Medical Research International
Crowell, Trevor A.
United States, Silver Spring
Walter Reed Army Institute of Research
United States, Rockville
Hjf
Polyak, Christina S.
United States, Silver Spring
Walter Reed Army Institute of Research
United States, Rockville
Hjf
Ake, Julie A.
United States, Silver Spring
Walter Reed Army Institute of Research
Bartolanzo, Danielle
Unknown Affiliation
Reynolds, Alexus
Unknown Affiliation
Song, Katherine X.
Unknown Affiliation
Milazzo, Mark J.
Unknown Affiliation
Francisco, Leilani V.
Unknown Affiliation
Mankiewicz, Shauna
Unknown Affiliation
Schech, Steven
Unknown Affiliation
Golway, Alexandra
Unknown Affiliation
Omar, Badryah
Unknown Affiliation
Mebrahtu, Tsedal
Unknown Affiliation
Lee, Elizabeth H.
Unknown Affiliation
Bohince, Kimberly
Unknown Affiliation
Parikh, Ajay P.
Unknown Affiliation
Hern, Jaclyn
Unknown Affiliation
Duff, Emma
Unknown Affiliation
Lombardi, Kara
Unknown Affiliation
Imbach, Michelle
Unknown Affiliation
Eller, Leigh Anne
Unknown Affiliation
Semwogerere, Michael
Unknown Affiliation
Naluyima, Prossy
Unknown Affiliation
Zziwa, Godfrey
Unknown Affiliation
Tindikahwa, Allan
Unknown Affiliation
Mutebe, Hilda
Unknown Affiliation
Kafeero, Cate
Unknown Affiliation
Baghendaghe, Enos
Unknown Affiliation
Lwebuge, William
Unknown Affiliation
Ssentogo, Freddie
Unknown Affiliation
Birungi, Hellen
Unknown Affiliation
Tegamanyi, Josephine
Unknown Affiliation
Wangiri, Paul
Unknown Affiliation
Nabanoba, Christine T.
Unknown Affiliation
Namulondo, Phiona
Unknown Affiliation
Tumusiime, Richard
Unknown Affiliation
Musingye, Ezra
Unknown Affiliation
Nanteza, Christina
Unknown Affiliation
Wandege, Joseph
Unknown Affiliation
Waiswa, Michael
Unknown Affiliation
Najjuma, Evelyn
Unknown Affiliation
Maggaga, Olive
Unknown Affiliation
Kenoly, Isaac Kato
Unknown Affiliation
Mukanza, Barbara
Unknown Affiliation
Langat, Rither C.
Unknown Affiliation
Ngeno, Aaron
Unknown Affiliation
Korir, Lucy
Unknown Affiliation
Langat, Raphael K.
Unknown Affiliation
Opiyo, Francis E.O.
Unknown Affiliation
Kasembeli, Alex N.
Unknown Affiliation
Ochieng, Christopher
Unknown Affiliation
Towett, Japhet
Unknown Affiliation
Kimetto, Jane
Unknown Affiliation
Omondi, Brighton
Unknown Affiliation
Leelgo, Mary
Unknown Affiliation
Obonyo, Michael
Unknown Affiliation
Rotich, Linner
Unknown Affiliation
Tonui, Enock
Unknown Affiliation
Chelangat, Ella
Unknown Affiliation
Kapkiai, Joan
Unknown Affiliation
Wangare, Salome
Unknown Affiliation
Kesi, Zeddy Bett
Unknown Affiliation
Ngeno, Janet
Unknown Affiliation
Langat, Edwin
Unknown Affiliation
Labosso, Kennedy
Unknown Affiliation
Rotich, Joshua
Unknown Affiliation
Cheruiyot, Leonard
Unknown Affiliation
Changwony, Enock
Unknown Affiliation
Bii, Mike
Unknown Affiliation
Chumba, Ezekiel
Unknown Affiliation
Ontango, Susan
Unknown Affiliation
Gitonga, Danson
Unknown Affiliation
Kiprotich, Samuel
Unknown Affiliation
Ngtech, Bornes
Unknown Affiliation
Engoke, Grace
Unknown Affiliation
Metet, Irene
Unknown Affiliation
Airo, Alice
Unknown Affiliation
Kiptoo, Ignatius N.
Unknown Affiliation
Sing’oei, Valentine
Unknown Affiliation
Rehema, Winne
Unknown Affiliation
Otieno, Solomon
Unknown Affiliation
Ogari, Celine
Unknown Affiliation
Modi, Elkanah
Unknown Affiliation
Adimo, Oscar
Unknown Affiliation
Okwaro, Charles
Unknown Affiliation
Lando, Christine
Unknown Affiliation
Onyango, Margaret
Unknown Affiliation
Aoko, Iddah
Unknown Affiliation
Obambo, Kennedy
Unknown Affiliation
Meyo, Joseph
Unknown Affiliation
Suja, George
Unknown Affiliation
Adamu, Yakubu
Unknown Affiliation
Azuakola, Nnamdi
Unknown Affiliation
Asuquo, Mfreke
Unknown Affiliation
Tiamiyu, Abdulwasiu Bolaji
Unknown Affiliation
Kokogho, Afoke
Unknown Affiliation
Mohammed, Samirah Sani
Unknown Affiliation
Okoye, Ifeanyi
Unknown Affiliation
Odeyemi, Sunday O.
Unknown Affiliation
Suleiman, Aminu
Unknown Affiliation
Parker, Zahra F.
Unknown Affiliation
Ochai, Inalegwu
Unknown Affiliation
Maganga, Lucas Henze
Unknown Affiliation
Khamadi, Samoel Ashimosi
Unknown Affiliation
Kisinda, Abisai
Unknown Affiliation
Mwamwaja, Jaquiline
Unknown Affiliation
Gervas, Reginald
Unknown Affiliation
Mkondoo, Dorothy
Unknown Affiliation
Somi, Nancy
Unknown Affiliation
Mwaisanga, Gwamaka
Unknown Affiliation
Olomi, Willyhelmina
Unknown Affiliation
Statistics
Citations: 12
Authors: 119
Affiliations: 8
Identifiers
Doi:
10.1186/s12879-021-06668-6
ISSN:
14712334
Research Areas
Health System And Policy
Infectious Diseases
Maternal And Child Health
Sexual And Reproductive Health
Substance Abuse
Study Design
Cross Sectional Study
Cohort Study
Study Approach
Quantitative