Feb 10, 2006
Kjetland EF, Ndhlovu PD, Gomo E, Mduluza T, Midzi N, Gwanzura L, Mason PR, Sandvik L, Friis H, Gundersen SG Journal title: AIDS (London, England) AIDS 2006 Feb;20(4):593-600 PMID: 16470124 Article on PubMed: http://www.ncbi.nlm.nih.gov/pubmed/16470124 Abstract OBJECTIVE: To determine the association between female genital Schistosoma haematobium infection and HIV. DESIGN AND METHODS: A cross-sectional study with a 1-year follow-up. Gynecological and laboratory investigations were performed for S. haematobium and HIV. Sexually transmitted infections, demographic and urogenital history were analysed as confounders. The participants were 527 sexually active, non-pregnant, non-menopausal women between the ages of 20 and 49 years. The setting was a rural Zimbabwean community where S. haematobium related lesions were found in 46% of the women, HIV in 29% and herpes simplex type- 2 (HSV-2) in 65%. RESULTS: In permanent residents (>3 years residency), HIV was found in 41% (29/70) of women with laboratory proven genital schistosomiasis as opposed to 26% HIV positive (96/375) in the schistosomal ova negative group [odds ratio (OR), 2.1; 95% confidence interval (CI), 1.2-3.5; P = 0.008. In multivariate analysis S. haematobium infection of the genital mucosa was significantly associated with HIV seropositivity (adjusted OR, 2.9; 95% CI, 1.11-7.5; P = 0.030). All seven women who became HIV positive during the study period (seroincidence 3.1%) had signs of S. haematobium at baseline. In accordance with other studies HIV was significantly associated with HSV-2 (OR, 3.0; 95% CI, 1.7-5.3; P < 0.001), syphilis and human papillomavirus. The highest HIV prevalence (45%) was found in the 25-29 years age group. CONCLUSION: Women with genital schistosomiasis had an almost three-fold risk of having HIV in this rural...
Jan 10, 2006
Kjetland EF, Mduluza T, Ndhlovu PD, Gomo E, Gwanzura L, Midzi N, Mason PR, Friis H, Gundersen SG Journal title: Transactions of the Royal Society of Tropical Medicine and Hygiene Trans. R. Soc. Trop. Med. Hyg. 2006 Aug;100(8):740-52 PMID: 16406034 Article on PubMed: http://www.ncbi.nlm.nih.gov/pubmed/16406034 Abstract Urinary schistosomiasis is known to be associated with lesions in the female genital organs, particularly with the presence of ‘sandy patches’ in the lower genital tract. This study sought to determine the effect of treatment with praziquantel on gynaecological schistosomiasis in residents of an area endemic for Schistosoma haematobium. A cohort study was conducted among women aged 20-49 years in rural Zimbabwe. The shape and size of lesions were mapped pre treatment and 3 and 12 months following treatment. Ova of S. haematobium were looked for in cytology smears, wet mounts, biopsies, urine and stool. Specimens were collected for detection of sexually transmitted diseases and cancer. At baseline, almost half of the 527 women included in the study had sandy patches. Although urinary ova excretion decreased following treatment (odds ratio 10.3, 95% CI 3.8-27.8,...
Mar 17, 2005
Kjetland EF, Ndhlovu PD, Mduluza T, Gomo E, Gwanzura L, Mason PR, Kurewa EN, Midzi N, Friis H, Gundersen SG Journal title: The American journal of tropical medicine and hygiene Am. J. Trop. Med. Hyg. 2005 Mar;72(3):311-9 PMID: 15772328 Article on PubMed: http://www.ncbi.nlm.nih.gov/pubmed/15772328 Abstract Up to 75% of women with urinary schistosomiasis have Schistosoma haematobium ova in the genitals. This study aimed to describe the prevalence of gynecologic S. haematobium infection and to differentiate the disease from sexually transmitted infections (STIs). Gynecologic and laboratory investigations for S. haematobium and STIs were performed in 527 women between the ages of 20 and 49 in rural Zimbabwe. Genital homogenous yellow and/or grainy sandy patches, the commonest type of genital pathology, were identified in 243 (46%) women. Grainy sandy patches were significantly associated with S. haematobium ova only. Genital S. haematobium ova was also significantly associated with homogenous yellow sandy patches, mucosal bleeding, and abnormal blood vessels. The presence of ova was not a predictor for ulcers, papillomata, leukoplakia, polyps, or cell atypia. Mucosal sandy patches seem to be pathognomonic for S. haematobium infection in the female genitals. Coexistence of ova and other lesions may not be causal....
Jan 13, 2005
Kjetland EF, Gwanzura L, Ndhlovu PD, Mduluza T, Gomo E, Mason PR, Midzi N, Friis H, Gundersen SG Journal title: Archives of gynecology and obstetrics Arch. Gynecol. Obstet. 2005 Jun;272(1):67-73 PMID: 15647913 Article on PubMed: http://www.ncbi.nlm.nih.gov/pubmed/15647913 Abstract INTRODUCTION: Syndromic management of sexually transmitted infections (STIs) is one important strategy in human immunodeficiency virus (HIV) prevention in developing countries, but there is a scarcity of rural community-based data on the relative prevalences of the STIs. We sought to determine the prevalences of the STIs and their clinical correlates in rural Zimbabwean women. METHODS: A cross-sectional study was conducted among 527 sexually active, non-pregnant, non-menopausal women between the ages of 20 and 49 years. RESULTS: The seroprevalence for herpes simplex virus type 2 (HSV-2), HIV, trichomoniasis and syphilis were 64.5, 29.3, 24.7 and 6.2% respectively. HSV-2 seropositivity was significantly associated with current non-syphilitic ulcers (adjusted odds ratio [OR] 4.91, 95% confidence interval [CI] 1.08-22.34, p = 0.040). HSV-2 seroprevalence peaked at the age of 35 whereas HIV peaked at 25. The two diseases were strongly associated (OR 2.92, 95% CI 1.85-4.65, p < 0.001). CONCLUSION: There is evidence of rural epidemics of both HSV-2 and HIV, and a change in the aetiology of genital ulcers in rural Zimbabwe....
Jun 1, 2004
Baay MF, Kjetland EF, Ndhlovu PD, Deschoolmeester V, Mduluza T, Gomo E, Friis H, Midzi N, Gwanzura L, Mason PR, Vermorken JB, Gundersen SG Journal title: Journal of medical virology J. Med. Virol. 2004 Jul;73(3):481-5 PMID: 15170646 Article on PubMed: http://www.ncbi.nlm.nih.gov/pubmed/15170646 Abstract Cervical cancer is a leading cause of cancer-related deaths in developing countries, and the human papillomavirus (HPV) is linked etiologically to cervical cancer. Hence, a vaccine which prevents HPV-associated cervical cancer would have the most impact in developing countries, including the African continent. The type-specific immune response towards HPV virus-like particles, in combination with geographical variation in the prevalence of HPV, necessitates the presence of multiple HPV type antigens in a single vaccine cocktail in order to provide relevant protection. We aimed to investigate whether co-infection with HIV, which is highly prevalent in Africa, plays a role in HPV genotype distribution. After informed consent, HPV detection by GP5+/6+ PCR and HIV detection by serology was carried out on 236 women from the rural north-western part of Zimbabwe. The prevalence of HPV was higher in HIV positive women (54%) than in HIV negative women (27%). Certain HPV types (HPV types 11, 39, 43, 51, and 59, P-values ranging from 0.017 to 0.067) occurred more frequently in HIV positive women. Only high-risk HPV, and not HIV, was associated significantly with cervical intraepithelial neoplasia in multiple regression analysis. In conclusion, a high prevalence of HPV was found in a rural community, where regular Papanicolaou (Pap) smears would be a logistic and economic impossibility, but where free vaccination programmes against other infections are already established. The results suggest that HIV co-infection...
Mar 31, 2004
Midzi N, Ndhlovu PD, Nyanga L, Kjetland EF, Reimert CM, Vennervald BJ, Gomo E, Mudenge G, Friis H, Gundersen SG, Mduluza T Journal title: Parasite immunology Parasite Immunol. 2003 Nov-Dec;25(11-12):581-8 PMID: 15053779 Article on PubMed: http://www.ncbi.nlm.nih.gov/pubmed/15053779 Abstract Eosinophil cationic protein (ECP) levels were measured in vaginal lavage extracts from 518 Zimbabwean reproductive women, age range 15-49 years, to assess the potential use of ECP as a diagnostic marker for female genital schistosomiasis (FGS). One hundred and fifty women had confirmed FGS status. These included 77 (cases) women who had ova in genital tissue and 73 (controls) women who had no ova in genital tissue. Participants were examined at baseline, 3 and 15 months post-treatment with praziquantel. ECP levels were determined using the enzyme linked immunosorbent assay (ECP-ELISA). ECP levels from 18 Norwegian women were used to calculate the diagnostic values of the test. FGS was diagnosed from the study population using genital biopsy and smears. Women were also diagnosed for urinary schistosomiasis using the urine filtration technique. The prevalence of urinary schistosomiasis was 39 % at baseline and this declined to 8% and 6% at 3 and 15 month post-treatment surveys, respectively. There was a higher mean ECP level in women with FGS, 889.3 ng/mL (95% CI: 457.0-1327.5) compared to the endemic control group, 359.1 ng/mL (95%, CI: 227.3-490.9), P = 0.027. Mean ECP levels declined at 3 months following treatment of infected individuals. There was no correlation between ECP levels and tissue ova density, and urine egg intensity. The sensitivity, specificity, positive and negative predictive values for the ECP-ELISA test were 35%, 80%, 65% and 53%, respectively. Our...
