A serosurvey of Haemophilus ducreyi, syphilis, and herpes simplex virus type 2 and their association with human immunodeficiency virus among female sex workers in Lagos, Nigeria.

BACKGROUND AND OBJECTIVES: To determine the prevalence rates of serological reactivity of Haemophilus (H.) ducreyi, Treponema pallidum, and herpes simplex virus type 2 (HSV-2) antibodies among female sex workers (FSWs) and their association with human immunodeficiency virus (HIV) antibody status. STUDY DESIGN: Cross-sectional, standard serological assays were used for syphilis, HSV-2 and HIV; a modified enzyme-linked immunosorbent assay (ELISA) was used to detect specific anti-H. ducreyi immunoglobulin (Ig) G and IgA antibodies. RESULTS: Seroprevalence rates were 86% for anti-H. ducreyi IgG and 69% for anti-H. ducreyi IgA; 4% for rapid plasma reagin (RPR) and Treponema palladium hemagglutination assay (TPHA) confirmed syphilis; 59% for HSV-2; 12% for HIV-1 and 2% for HIV-2. Lower-class FSWs were significantly more likely than upper-class FSWs to be H. ducreyi seropositive (IgG: OR = 42.7; IgA: OR = 7.6) and have current or past syphilis infection (RPR: OR = 3.5; RPR and TPHA: OR = 4.5). The presence of syphilis increased significantly with older age (P-trend < 0.001). Non-Nigerian FSWs had significantly higher reactivity to chancroid (IgG: OR = 3.5; IgA: OR = 1.8) and borderline reactivity to syphilis (RPR: OR = 1.6; TPHA: OR = 2.0). A history of sex with non-Nigerian Africans was significantly associated with chancroid reactivity and borderline significant with syphilis serostatus. H. ducreyi seropositivity was significantly more likely in FSWs with HSV-2 (OR = 2.4) and syphilis (OR = 5.6). Chancroid and HSV-2 antibodies were also more common in HIV-infected FSWs. CONCLUSION: The prevalence of H. ducreyi antibodies is the highest rate that has been reported. Our findings underscore the importance of an effective program to control GUDs as part of the strategy to prevent the potentially explosive spread of HIV in Nigeria.

PIP: Cross-sectional standard serologic assays were used to determine the prevalence of Haemophilus ducreyi, Treponema pallidum, and herpes simplex virus type 2 (HSV-2) antibodies among 796 female commercial sex workers from Lagos, Nigeria, and their association with HIV antibody status. The seroprevalence rates were 86% for anti-H. ducreyi IgG and 69% for anti-H. ducreyi IgA, 4% for rapid plasma reagin and Treponema palladium hemagglutination assay confirmed syphilis, 59% for HSV-2, 12% for HIV-1, and 2% for HIV-2. Lower-class sex workers were significantly more likely than upper-class sex workers to be H. ducreyi-positive and to have current or past syphilis infection. The presence of syphilis increased significantly with older age. Non-Nigerian sex workers had significantly higher reactivity to chancroid and borderline reactivity to syphilis. A history of sex with non-Nigerian Africans was significantly associated with chancroid reactivity and borderline significant with syphilis serostatus. H. ducreyi seropositivity was significantly more likely in female sex workers with HSV-2 and syphilis. Chancroid and HSV-2 antibodies were also more common in HIV-infected sex workers. The high prevalence of H. ducreyi antibodies detected in this study underscores the importance of an effective program to control genital ulcerative disease as part of the strategy to prevent the spread of HIV in Nigeria.

Seroprevalence study of HIV-I, HIV-II and HTLV-I among patients at the Dermato-Venereology Clinic of the Lagos University Teaching Hospital.

BACKGROUND: Seroprevalence studies of HIV-I and HIV-II that have been reported in Nigeria were among commercial sex workers and blood donors. There are no data from STD patients and dermatologic patients. METHODS: A seroprevalence study of HIV-I, HIV-II and HTLV-I was prospectively conducted among STD clinic attendees and among patients with dermatoses which have been linked with HIV disease. The studies were done in 1992 and 1994. RESULTS: Some patients had more than one seropositive type. In 1992, the percentages of seropositive results to HIV-I, HIV-II and HTLV-I were 31, 19 and 50, respectively, and in 1994 the percentages of HIV-I and HTLV-I were 65 and 35, respectively. CONCLUSIONS: Patients should be routinely screened for HTLV-I, in addition to HIV-I and HIV-II, among blood donors and also neurology clinic attendees in Nigeria. They should also be screened for retroviral infections when they present with dermatoses clinically suggestive of papular urticaria, onchodermatitis, or papulonecrotic tuberculids.

Prevalence of trypanosomiasis in sheep and goats in a region of northern Nigeria.

The prevalence of trypanosomosis was studied during April-June 1991, in sheep and goats kept peridomestically in Alkaleri and Gombe local Government areas of Bauchi State in Northern Nigeria. A total of 615 animals. consisting of 258 sheep and 357 goats were examined for trypanosome infection. Of this total, 19 (7.4%) sheep and 18 (5.0%) goats were positive giving a total infection rate of 37 (6.0%), 22 being positive with Trypanosoma vivax, 9 with T. congolense and 6 with T. brucei. In order to elucidate the most appropriate tool for surveying trypanosomosis in small ruminants under Nigerian field conditions, the sensitivity of four techniques currently in use for the parasitological diagnosis of trypanosomosis was investigated. The concentration methods: haematocrit centrifugation and buffy coat method, were more accurate than the standard trypanosome detection methods: wet film and thin film. Due to the prevalence of the disease, sheep and goats must be treated as well as cattle in the region.

Demographic characteristics of retroviral infections (HIV-1, HIV-2, and HTLV-I) among female professional sex workers in Lagos, Nigeria.

In 1990/1991, 885 prostitutes residing in 11 of the 12 Local Government Areas (LGAs) of Lagos State, Nigeria, participated in a cross-sectional study to determine current seroprevalence of antibodies to human immunodeficiency virus type 1 (HIV-1) and type 2 (HIV-2), and human T-cell lymphotropic virus type I (HTLV-I). The overall prevalence of HIV-1 was 12.3%, of HIV-2, 2.1%, and of HTLV-I, 2.8%. HIV-1 seropositivity did not vary significantly by age, socioeconomic class, or nationality, but HIV-1 seroprevalence was significantly elevated for prostitutes resident in the Port area of Lagos which serves as a crossroads for international and national commerce (OR = 2.3; 95% CI = 1.1, 4.6). HIV-2 infection was significantly associated with low socioeconomic class (OR = 3.7; 95% CI = 1.2, 10.8) and non-Nigerian nationality (OR = 6.7; 95% CI = 2.5, 18.4). Prevalence of HTLV-I infection increased significantly with age (OR = 2.3; 95% CI = 1.0, 5.3). The high seroprevalence of HIV-1 in this survey, compared with previous surveys reported in the last several years and the correlation between high prevalence and areas of international commerce suggest that HIV-1 is spreading in this area of Nigeria. Intensified prevention campaigns are needed to address this possible emerging epidemic.