ABSTRACT
Background: Knowledge of the Sociodemoraphic factors associated with HSV-2 seroprevalence and identification of the associated patient-recognizable clinical features will enable informed preventive public health interventions. There’s yet no documented data on the clinical and sociodemographic factors associated with HSV 2 Seroprevalence among pregnant women in Nigeria. Objectives: To identify sociodemographic and clinical correlates of HSV-2 seroprevalence among pregnant women attending ante-natal clinics in Benin, Nigeria. Study Location, Design and Duration: All the participants were prospectively recruited from the two major hospitals in Benin: University of Benin Teaching Hospital and Central Hospital, Benin. The cross-sectional study took place between November 2011 and June 2012. Methodology: Participants were recruited on booking. Data on their sociodemographic profiles, clinical history and obstetric characteristics were obtained by the use of structured questionnaires and hospital case records. Their blood samples were also promptly collected on recruition. Each participant’s serum was analyzed for HSV-2 IgG antibodies by gG-based type-specific ELISA. Counselling and testing for HIV were also carried out. Data analysis was done using SPSS version 16. Results: The average age of the 674 enrolled participants was 30.6±5.2 years and most of them were married and had complete secondary education. Seroprevalence of HSV-2 was 46.3%. Factors that was significantly associated with HSV-2 seropositivity included age, level of education, parity, HIV seropositivity and positive history of sexually transmitted infections. The HSV-2-infected were also significantly more likely to recall episodes of genital rashes (occurrence of rashes of any type in the external genitalia), vaginal discharge and urethral discharge. Conclusion: Risk factors for HSV-2 infection among pregnant women could include increasing age, higher parity, education below secondary level, HIV-positive status, and positive history of sexually transmitted infections. History of genital rashes, vaginal discharge and urethral discharge syndromes were associated with HSV-2 infection.
ABSTRACT
Background: Human Herpes Virus 2 (HSV-2) infection has been shown to be significantly associated with several obstetric complications, especially if the infection occurred during the pregnancy. Advocacy for policy formulation and the design of interventions requires local data on the risk factors for incident HSV-2 infection. The aim of this study is to assess HSV-2 sero-incidence among pregnant women in Benin and the effect of socio-demographic factors, HIV status, and HSV-1 status. Study Location, Design and Duration: Pregnant women attending ante-natal clinic in University of Benin Teaching Hospital and Central Hospital, Benin were prospectively recruited. A cross-sectional study was done and baseline data, obtained. The HSV-2 seronegative participants were followed up till the last clinic appointments [the closest appointment to their expected delivery dates (EDD)]. The study took place between November 2011 and December 2012. Methods: On recruitment a structured self-administered questionnaire was used to capture their socio-demographic data. Obstetric data was obtained from the patients’ case notes. Their HSV-1 and HSV-2 serostatuses were determined using an HSV glycoprotein G-based type-specific ELISA technique. Their HIV statuses were also determined. All those who were seronegative for HSV-2 were retested for HSV-2 six months later and/or on their last clinic appointment before the EDD. Incidence rates were calculated per person-years. Data analysis utilized SPSS version 16 software. Results: Out of the 674 participants, 315(46.8%) were HSV-2 seropositive while 359 (53.2%) were seronegative. 15.9% (57) of the HSV-2 sero-negative ones were lost to follow-up, giving a response rate of 84.1%. Seroincidence rate was found to be 17.9 per 100 person-years. There was significant association of seroincidence with younger reproductive age groups, unmarried status, and education below secondary level. Relative Risk (RR) and Incidence rate ratio (IRR) of HSV-2 infection among the HIV-infected cohort were 55.15 [95%CI:17.0-179.1] and 72.37 [95% CI:71.11-73.63] respectively. The RR and IRR among the HSV-1-seronegative cohort were 1.43 [95%CI:0.64-3.17] and 11.62 [95%CI:9.60-13.64] respectively. Conclusion: Seroincidence rate of HSV-2 infection among pregnant women in Benin was found to be 17.9 per 100 person-years. Positive HIV status, young age, unmarried status, and low education level were indicators of increased risk of incident HSV-2 infection.
ABSTRACT
Background/Aims: Gastric aspirate specimen is accepted as an alternative specimen of choice to sputum in the diagnosis of childhood pulmonary tuberculosis (TB); and specimen microscopy is usually the only available bacteriologic confirmatory test for streaming cases into the National TB Control Programme treatment protocol. Doubts expressed about the continued relevance of this test among the HIV-infected are based on observations that the bacteriologic yield of acid-fast smears of gastric aspirate specimens from these patients is markedly reduced. This study is aimed at determining the validity of acid-fast smear of gastric aspirates among the HIV-infected and compare with those of the HIV-uninfected. Design, Place and Duration of Study: Diagnostic study. Suspected tuberculosis patients registered in the paediatrics department of University of Benin Teaching Hospital were prospectively recruited from January 2010 to March, 2011. Methodology: A total of 263 children were recruited. Voluntary counseling and testing for HIV was done for each child. Two to three gastric aspirate specimens were also collected from each child using standard gastric aspirate (GA) collection protocols. On each specimen, Zeihl-Neelsen (ZN) staining and culture on Ogawa medium were done. After two or more weeks of incubation, typical acid-fast bacilli isolates on Ogawa medium, which failed to grow on para-nitrobenzoic acid-Ogawa (PNB-Ogawa) media were taken as positive culture for Mycobacterium tuberculosis complex (MTBC). MTBC Culture was taken as the “Reference test” for calculations of sensitivity and specificity. Results: Of the 263 children surveyed 116 (44.0%) were HIV-infected while 147 (56.0%) of them were HIV-uninfected. Among HIV-infected patients, the sensitivity was 38.3% [95%CI:24.4 – 52.2] while the specificity was 95.7% [95% CI:90.9 – 100.0]. Among the HIV-uninfected patients, the sensitivity was 22.0%[95%CI:10.5 – 33.5] while the specificity was 99.0%[95% CI:96.9 -100.0]. The sensitivity of the acid-fast smear in the HIV-infected group of patients was significantly higher than that of the HIV-uninfected group (p = 0.0401).The difference in specificity between the two groups was not statistically significant (p=0.496). There was also no significant difference in their respective positive-predictive values (85.7 vs 91.7)(p = 0.60). Conclusion: The sensitivity of GA acid-fast smear was significantly higher among the HIV infected group.