bluuebunny/crossref_metadata_2025_split huggingface dataset:
P1-S2.28 Sexually transmitted infections in sexually abused children and adolescents in Ibadan, Nigeria
Authors: Fayemiwo S A , Ayede I A , Olusanya O O , Akinbami O F , Bakare R A 
Published: July 2011

BackgroundSexual assault is a violent crime that affects men, women, and children of all ages. Sexually transmitted infections (STIs) may be transmitted during sexual assault. This study was aimed at finding the prevalence of sexually transmitted infections in potentially sexually abused children and adolescent in Ibadan.MethodsThis is a descriptive cross-sectional survey of Children and adolescents referred for possible evaluation of sexual abuse at Special Treatment Clinic, University College Hospital, Ibadan between January 2006 and December 2008. Urethral, Endocervical and high vaginal swabs were collected to establish diagnosis after clinical examination and informed consent.ResultsThere were 18 children and adolescents with a mean age of 9.75 years (SD=5.78; range 2–18 years). About 66.7 % (12) had various STIs. The male to female ratio was 1:8. Five (27.8%) had physical evidence of sexual assault at presentation, 4 (22.2%) of which had hyperaemic labia and one had torn hymen. 12 (66.7%) presented with vaginal discharge syndrome. The most common STI diagnosed was genital warts (22.2.0%). Other STIs diagnosed were vaginal candidiasis (16.7%), bacterial vaginosis (11.1%) and HIV (5.6%). There was no statistical significance between HIV infection and other STIs (p>0.05).ConclusionOur study revealed high prevalence of sexually transmitted infections among the sexually abused children and adolescents. Screening for infection should be mandatory in presumed sexually abused girls with vaginal discharge and ideally should be undertaken in all children presenting at STI clinics for evaluation of sexual abuse.
P1-S2.30 STI among vulnerables youth attending free targeted HIV counselling and testing services including and STI diagnosis and management in Benin, West Africa
Authors: Marguerite B N , Amour B A 
Published: July 2011

BackgroundIn collaboration with two health facilities and a mobile clinic, Counselling and Testing (CT) services was implemented in two departments of Benin (Atacora and Donga) trough a project funded by the Kreditanstalt für Wiederaufbau (KfW) Germany. These interventions targeted vulnerable youth (15–24) and included STI prevention, screening and management, using clinical screening algorithms. 28 868 clients requesting HIV counselling and testing were registered from 2007 to 2009 trough a database.ObjectivesTo assess rate and risks factors of STI among vulnerable youth attending counselling and testing facilities, including STI management.MethodsDescriptive analysis and logistic regression was performed on the database with SPSS 17. The dependent variable is “having had an STI the last 3 months”. The independents variables are—“having multiple partners in the three past months”, “consistent use of condom” and socio-demographic characteristics.ResultsIn all 5.1% of HIV counselled and tested clients approached for STI on-site screening had STI the last 3 month, while STI prevalence among this population is 1.9%. Multiple partners (OR=4.5; p=0.000), no consistent use of condom (0R=1.3; p=0.002) were significantly associate to IST infection. The level of instruction (OR=1.3; p=0.000) and sex (OR=0.6; p=0.000) were the significant socio-demographic characteristic associated with STI.ConclusionsData findings indicate that having had STI in the last 3 month may be a motivation for youth which are attending HIV counselling and testing facilities in Atacora/Donga in Benin, and “high numbers of partners” is the main risk factor for STI among them. Then, scaling up HIV counselling and testing services may be a right way for STI prevention, screening and management. Finding suggests that such intervention (counselling) focused on reducing number of partner, improved to promotion of condom use, may reduce STI incidence among vulnerable youth that need further investigation.
P1-S2.32 Do as I think, not as I do: the discordance between perception of risk for STBBIs and sexual risk behaviours among Canadian street-involved youth
Authors: Fang L , Klar S A , Friedman D , Gratrix J , Rossi M , Tawse C , Taylor D , Wright J , Wylie J , Wong T , Jayaraman G C ,   Team for the Enhanced Street Youth Surveillance
Published: July 2011

BackgroundCanadian street-involved youth are perceived to be at greater risk for sexually transmitted and bloodborne infections (STBBI) and may be more vulnerable to these infections because of their age, socioeconomic status, life course factors, and engagement in high risk behaviours. However, perception of their own risks and the behaviours that influence this perception are less understood and will be described using the Enhanced Surveillance of Canadian Street Youth (E-SYS) data.MethodsE-SYS is a repeated cross-sectional surveillance study of street-involved youth (15–24 years). Preliminary data from Cycle 6 (2009-present) (n=705) were used to determine how these youth perceive their risk for STBBI and factors that contribute to perception. Participants completed an interviewer-administered questionnaire and provided sera and urine samples for STBBI testing. Chi-square tests and unadjusted ORs were performed to assess these relationships (α=0.05, 2-sided).ResultsAmong interviewed street-involved youth, 65.8% reported that they felt they were at no or low risk of being infected with an STBBI. Age and gender did not influence perception of risk for STBBI. Factors that were significantly associated with medium or high perception of risk for STBBI included being bisexual (OR 1.6, 95% CI 1.1 to 2.3), having sex while under the influence of drugs or alcohol (OR 2.5, 95% CI 1.5 to 4.1), and not being aware of where to access health services (OR 1.7, 95% CI 1.1 to 2.6). Although engaging in anal sex affected their perception of risk for STBBI (p<0.05), having vaginal sex did not (p=0.75). Those who did not use a contraceptive barrier (eg, condom) when they last had vaginal sex felt they were at greater risk for an STBBI (OR 1.7, 95% CI 1.2 to 2.3), but barrier use during anal sex did not affect their perception of risk (p=0.3).ConclusionsAlthough many street-involved youth acknowledge that certain behaviours may put them at greater risk for STBBI, they continue to engage in these behaviours. These youth may not be fully knowledgeable about the extent to which certain risks enhance STBBI transmission or options for altering behaviours may be limited. Of concern is our finding that some youth, who perceive themselves as being at medium or high risk for an STBBI, may not know where to access services for STBBI counselling, testing, and treatment. Concerted efforts continue to be needed to engage this population and to translate knowledge into action.
P1-S2.41 Sentinel survillance for pharyngeal chlamydia and gonorrhoea among men who have sex with men - San Francisco, 2010
Authors: Park J , Marcus J , Bernstein K , Pandori M , Snell A , Philip S 
Published: July 2011

BackgroundAlthough a potentially important route for transmission, limited data exist on the burden of pharyngeal chlamydia (CT) and gonorrhoea (GC) among men who have sex with men (MSM). The San Francisco Department of Public Health has recommended nucleic acid amplification test (NAAT)-based pharyngeal screening for MSM since 2005. We examined pharyngeal CT and GC among MSM participating in the STD screening program in 2010.MethodsMSM seeking services at a variety of clinical sites provided clinician-collected pharyngeal specimens for APTIMA Combo 2 testing. The prevalence of pharyngeal CT and GC was estimated at five sentinel sites—the municipal STD clinic, a gay men's health clinic, an HIV care clinic, an HIV testing site, and primary care clinics supported by the San Francisco Department of Public Health. Positivity for each infection was calculated as the number of positive tests divided by the number of testers with corresponding CIs. Additionally, we calculated positivity and OR to determine whether the prevalence of pharyngeal CT and GC differed by HIV status among patients tested at the municipal STD clinic.ResultsIn 2010, over 12 000 pharyngeal specimens were tested for an overall CT positivity of 1.69% (95% CI 1.47 to 1.93) and GC positivity of 5.76% (95% CI 5.36 to 6.19). At the five sentinel sites, pharyngeal CT positivity ranged from 1.10% (HIV testing site) to 2.28% (STD clinic); pharyngeal GC positivity ranged from 3.4% (HIV testing site) to 7.01% (STD clinic). For tests conducted at the STD clinic among HIV-uninfected testers, pharyngeal CT positivity was 1.57% (95% CI 1.11 to 2.15) and pharyngeal GC positivity was 7.02% (95% CI 6.03 to 8.11). Among HIV-infected testers, the pharyngeal CT and GC positivity were 4.06% (95% CI 2.92 to 5.49) and 6.99% (95% CI 5.48 to 8.76), respectively. HIV-infected testers were more likely to have a positive pharyngeal CT test compared with HIV-uninfected testers (OR 2.65, 95% CI 1.65 to 4.27); there were no differences in pharyngeal GC positivity between HIV-infected and HIV-uninfected testers at the STD clinic.ConclusionSentinel surveillance data indicates that there is a substantial burden of pharyngeal CT and GC infections among MSM in San Francisco. Identification and treatment of pharyngeal infections could prevent ongoing transmission of these bacteria. Increasing access to NAAT-based pharyngeal screening should be a public health priority.
O1-S02.04 Evidence of HPV vaccine effectiveness in reducing genital warts: an analysis of California Public Family Planning Administrative Claims Data, 2007–2009
Authors: Bauer H , Wright G , Chow J 
Published: July 2011

BackgroundThe quadrivalent HPV vaccine, available in the US since 2006, is recommended for females age 9–26. This vaccine prevents HPV types 6 and 11, which cause 90% of genital warts (GW). Because of the rapid development of GW after infection, monitoring GW trends may provide early evidence of population level vaccine effectiveness.MethodsTrends in GW diagnoses were assessed using clinical encounter claims data from the California Family Planning Access Care and Treatment program which serves low-income females and males. Following implementation of diagnostic coding requirements, reliable data on International Classification of Diseases (ICD-9) codes were available 2007 through 2009. GW cases were defined as unduplicated clients with either an ICD-9 diagnostic code for viral warts (078.10) or condyloma (078.11) or a National Drug Code (NDC) for pharmacy-dispensed imiquimod or podofilox. Inclusion of procedure codes for destruction of genital lesions was unnecessary because these claims closely correlated (>95%) with appropriate ICD-9 codes. Denominators included unduplicated clients served. The proportions of clients with GW were stratified by age (<21, 21–25, 26–30, 31+), gender, and year. No data on vaccination status were available. Statistical significance of gender- and age-specific trends was assessed using the Cochran-Armitage test for linear trend.ResultsBetween 2007 and 2009, an average of over 1 735 000 female and 248 000 male clients were served annually. Total clients served increased each year for both females and males across all age groups, with the greatest increases seen among older age groups. Overall, 0.7% of females and 3.4% of males were diagnosed with GW. Between 2007 and 2009, GW diagnoses declined 19.4% among females less than age 21 (p trend <0.0001), whereas GW diagnoses were stable or increasing among females in older age groups see Abstract O1-S02.04 table 1. No statistically significant declines in GW diagnoses were observed among males of any age group; however, significant increases were observed among older males.Abstract O1-S02.04 Table 1Per cent change between 2007 and 2009 in GW diagnoses by gender and age groupFemalesMalesAge group% Changeptrend% Changeptrend<21−19.4<0.0001−3.30.32821–25−2.80.137−4.10.06126–30+8.80.006+12.60.000431++10.90.002+11.40.004ConclusionsThis analysis provides preliminary evidence that the HPV vaccine may be preventing GW among young women. Although using existing administrative claims data to assess trends in HPV-related diseases was inexpensive and expeditious, trends are ecological and may be explained by factors other than vaccination.
O3-S1.02 Deciphering the code ofTreponema pallidumin the UK: implications for treatment and prevention
Authors: Tipple C , Taylor G 
Published: July 2011

BackgroundThe efficacy and convenience of single-dose oral azithromycin meant it became the preferred treatment for syphilis in many countries and a suitable alternative to penicillin in many more. However, two point mutations (A2058G and A2059G) in the 23srRNA gene ofTreponema pallidum(T pallidum) have separately been shown to confer high-level macrolide resistance. Furthermore, molecular analyses ofT pallidumwith an enhanced sub-typing method have revealed the existence of a number of strain types, which both persist over generations and may be associated with distinct clinical phenotypes.MethodsFollowing informed consent, whole EDTA blood and ulcer exudate absorbed onto filter paper Snostrips were collected from patients with any stage of syphilis in a London genito-urinary medicine clinic between 2006 and 2008.T pallidumDNA was extracted and strain types and macrolide resistance-associated mutations sought by: (1) PCR amplification of the 23srRNA gene and restriction fragment length polymorphism (RFLP) analysis following Mbo-II and Bsa-I digestion; (2) determination of the number of 60-base repeats within the ARP gene by PCR and agarose gel electrophoresis; (3) PCR amplification of the TPR gene family and RFLP analysis following Mse-I digestion; (4) sequence analysis of a section of the tp548 gene.ResultsForty-two of the 44 (95.5%) patients diagnosed with syphilis were male, of which 63.6% were MSM and 28/44 (63.6%) were HIV-1 infected.T pallidumDNA was present in sufficient quantity and quality for analysis in 18/44 (40.9%). 23srRNA gene analysis revealed 6/18 (33.3%) wild-type sequences, 11/18 (61.1%) A2058G mutants and 1 (5.6%) A2059G mutant. Full strain-typing was possible in 5 clinical samples (four were 14d/g and one was 14d/f), and partial typing in a further 7 (see Abstract O3-S1.02 table 1).Abstract O3-S1.02 Table 1SampleNumber of ARP gene repeatsTPR gene Mse-1 RFLP analysisTp548 gene sequence analysisFinal enhanced strain type1––G–214dG14d/g314dG14d/g414dG14d/g5––G–6––F–714dF14d/f814–F–9––G–1014dG14d/g1114–F–12––F–Positive control (Nichols)14–A14a/aConclusionsThe high frequency ofT pallidummacrolide resistance mutations described in the UK for the first time has clear implications for national treatment strategies. The majority of patients with syphilis were men, of which most were MSM and over half were HIV-1 positive. It is thought that transmission ofT pallidumwithin sexual networks has played a part in the resurgence of syphilis in the UK over the last decade and the predominance of the 14d/g subtype may reflect this. Alternative explanations are that this strain type is more virulent or has become endemic, as in the case of the Scottish data that revealed 77% of syphilis cases there to be type 14d.
O3-S1.03 Performance of reverse sequence syphilis screening in Jamaica
Authors: Hobbs M , Gordon F , Cooper C J , Eastman S , Hylton-Kong T , Watson-Grant S , Weir S , Figueroa J P 
Published: July 2011

BackgroundAlgorithms for syphilis serologic testing traditionally have relied on screening with a non-treponemal test, such as the rapid plasma reagin (RPR) test or the toluidine red unheated serum test (TRUST) followed by confirmation using a treponemal test, such as Treponema pallidum particle agglutination (TP-PA). To reduce time, material and labour costs, many laboratories, including at the Comprehensive Health Centre in Kingston, Jamaica, have reversed the sequence testing first with a rapid treponemal test followed by non-treponemal testing of reactive sera.MethodsIn a survey of STIs among men who have sex with men (MSM) in Jamaica, syphilis serologic testing is currently conducted using an initial rapid treponemal SD Bioline Syphilis 3.0 test followed by TRUST for reactive sera. Discordant sera that are Bioline-positive and TRUST-negative, or sera with TRUST titres < or =8 undergo supplemental testing by TP-PA. SD Bioline was previously validated in the field and reference laboratory in Jamaica and is 95.2% sensitive and 93.5% specific compared to TP-PA. Here we report the results from sera obtained from 135 MSM in Kingston between December 2010 and February 2011.ResultsAmong 135 sera evaluated using the reverse syphilis screening sequence, 13 (9.6%) had a positive rapid treponemal test. Among these 13 reactive sera, 6 (46.2%) were nonreactive with TRUST. All discordant sera were also reactive by TP-PA, indicating that initial rapid testing did not produce false-positives in this setting. The proportion of discordant syphilis test results was similar among HIV+ and HIV- men. The prevalence of primary syphilis detected by concordant positive treponemal and non-treponemal tests in this survey was 5.2%, compared to 5.3% in a previous survey conducted in this population during 2007–2008 using the traditional screening sequence.ConclusionsThe prevalence of primary syphilis among MSM in Kingston has not changed since the previous survey. In the current survey using the reverse screening sequence, nearly half of sera that were reactive with the treponemal test produced discordant results with the non-treponemal test. Such results are consistent with previous syphilis infection, treated or untreated, or early primary syphilis in which non-treponemal antibodies have yet to develop. Distinguishing these possibilities requires detailed history and clinical assessment in addition to serologic test results.
O3-S1.05 Quality assurance of syphilis testing in a rural health facility using dried tube specimens (DTS)
Authors: Adu-Sarkodie Y , Dompreh A , Opoku B Kofi , Dzokoto A , Mabey D , Peeling R 
Published: July 2011

BackgroundAssuring the quality of a diagnostic test is important in healthcare. For syphilis testing, this includes proficiency testing of previously well characterised serum samples by health workers blinded to the results of characterisation. As part of a study on the feasibility of using a Point of Care (POC) rapid test devise for syphilis testing in rural antenatal settings, proficiency testing material prepared in a referral laboratory using Dried Tube Specimens (DTS) was sent for testing by the nurses/midwifes in these rural settings.MethodsFive well characterised DTS (one high RPR reactive, three low RPR reactives and one RPR non-reactive) were sent for on-site testing in eight rural antenatal facilities in Eastern Ghana. Training of nurses/midwifes in reconstituting the DTS and their testing and reporting was previously carried out. An instruction leaflet was enclosed in each batch of the DTS. Four rounds of the testing were carried out at monthly intervals.ResultsSeven out of the eight facilities correctly reported results of the DTS for all the rounds. One facility however reported all specimens as negative at the first round. On-site investigation showed that the nurse running the antenatal clinic who normally wore reading glasses had lost them. On replacing her glasses and going through an on-site re-training, she obtained 100% in subsequent rounds of testing.ConclusionSyphilis proficiency testing in rural facilities carried out by non-laboratory personnel using DTS is feasible. Initial training with on-site monitoring is important to detect any testing problems.
O3-S1.06 Diagnostic accuracy of rapid point-of-care tests to detect syphilis: a meta-analyses
Authors: Jafari Y , Peeling R , Shivkumar S , Lambert G , Claessens C , Cajas J , Klein M , Joseph L , Pai N 
Published: July 2011

BackgroundThe World Health Organization estimates that in 2006, there were 12 million new cases of syphilis. In developing countries, there is a lack of proper screening due to limited laboratory services and long distances from clinics. In developed countries, there is limited access to care among hard-to-reach populations. In this context of disconnect with the health care system, point of care (POC) tests have proven to be an invaluable resource, yet their accuracy needs to be established in order to justify their use.MethodElectronic databases were searched from 1 January 1980 to 24 September 2010 for articles evaluating syphilis POC tests. Data were extracted and a second reviewer independently reviewed a subset of the articles. Subgroups were made according to the index test, the sample tested, and reference standard employed. Pooled sensitivity and specificity were calculated using Hierarchical Summary Receiver Operating Characteristic Curve. Adjustments were made to account for imperfect reference standards.Results30 (47%) from 64 full text articles assessed articles were included in the meta-analysis. The most common kits evaluated were Determine, Bioline, Syphicheck, and Visitect in whole blood and sera samples. Using a Treponema Pallidum (TP) specific reference standard, in sera, the Determine test was the most accurate with a pooled sensitivity of 98.43% (96.03, 99.94) and a specificity of 97.74% (96.38, 98.92). In whole blood, Bioline was the most accurate with a sensitivity of 87.70% (84.78, 90.58) and a specificity of 99.07% (98.50, 99.59). The sensitivity of Determine and Visitect were lower when using whole blood than when using serum. When we adjusted for imperfect reference standards, the pooled parameters of accuracy improved when compared to pooled accuracy under the assumption of a perfect reference standard.ConclusionsDetermine with high sensitivity and Bioline with high specificity appeared to perform the best of the tests studied. Higher accuracy in serum warrants the use of serum rather than whole blood wherever possible. Confirmation with non-TP specific reference standard are required to confirm whether the infection is active or treated.