PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of genitmedLink to Publisher's site
 
Genitourin Med. 1997 February; 73(1): 33–38.
PMCID: PMC1195757

STD rapid assessment in Rwandan refugee camps in Tanzania.

Abstract

OBJECTIVE: To obtain baseline information on sexually transmitted diseases (STDs) in the Rwandan refugees camps in Tanzania, prior to establishment of STD services. SETTING: The largest camps of Rwandan refugees in the Ngara District of Tanzania (estimated population 300,000). The study was carried out in 8 days in August 1994. SUBJECTS AND METHODS: A rapid assessment technique was used to measure STD prevalences among: (i) 100 antenatal clinic attenders (ANC); (ii) 239 men from outpatient clinics (OPD); and (iii) 289 men from the community. Interviews (by questionnaire) and genital examination were performed for all participants; sampling for females included genital swabs for the the diagnosis of Neisseria gonorrhoeae (NG), Candida albicans (CA), Trichomonas vaginalis (TV), bacterial vaginosis (BV) and a blood sample for syphilis serology. Men provided urine samples which were screened for leucocytes using the leucocyte esterase (LE) dipstick; urethral swabs for Gram stain were taken from men with a reactive LE test and from those with symptoms or signs of urethritis. OPD males provided a blood sample for syphilis serology. RESULTS: All groups reported frequent experience with STDs and engaging in risky sexual behaviour prior to the survey. During the establishment of the camps, sexual activity was reportedly low. Over 50% of ANC attenders were infected with agents causing vaginitis (TV/BV/CA) and 3% were infected with NG. The prevalence of active syphilis was 4%. In the male outpatients, the prevalence of urethritis was 2.6% and of serological syphilis was 6.1%. Among males in the community, the prevalence of urethritis was 2.9% (the majority being asymptomatic infections). We noted frequent over-reporting of STD symptoms, unconfirmed clinically or biologically. CONCLUSIONS: STD case detection and management should be improved by training health workers in using the WHO syndromic approach, and through IEC campaigns encouraging attendance at clinics. Rapid epidemiological methods provide quick and useful information at low cost in refugee camps.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.2M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Piot P, Laga M. Genital ulcers, other sexually transmitted diseases, and the sexual transmission of HIV. BMJ. 1989 Mar 11;298(6674):623–624. [PMC free article] [PubMed]
  • Pepin J, Plummer FA, Brunham RC, Piot P, Cameron DW, Ronald AR. The interaction of HIV infection and other sexually transmitted diseases: an opportunity for intervention. AIDS. 1989 Jan;3(1):3–9. [PubMed]
  • Mertens TE, Hayes RJ, Smith PG. Epidemiological methods to study the interaction between HIV infection and other sexually transmitted diseases. AIDS. 1990 Jan;4(1):57–65. [PubMed]
  • Killewo JZ, Sandstrom A, Bredberg Raden U, Mhalu FS, Biberfeld G, Wall S. Incidence of HIV-1 infection among adults in the Kagera region of Tanzania. Int J Epidemiol. 1993 Jun;22(3):528–536. [PubMed]
  • Grosskurth H, Mosha F, Todd J, Mwijarubi E, Klokke A, Senkoro K, Mayaud P, Changalucha J, Nicoll A, ka-Gina G, et al. Impact of improved treatment of sexually transmitted diseases on HIV infection in rural Tanzania: randomised controlled trial. Lancet. 1995 Aug 26;346(8974):530–536. [PubMed]
  • Spiegel CA. Bacterial vaginosis. Clin Microbiol Rev. 1991 Oct;4(4):485–502. [PMC free article] [PubMed]
  • Mayaud P, Grosskurth H, Changalucha J, Todd J, West B, Gabone R, Senkoro K, Rusizoka M, Laga M, Hayes R, et al. Risk assessment and other screening options for gonorrhoea and chlamydial infections in women attending rural Tanzanian antenatal clinics. Bull World Health Organ. 1995;73(5):621–630. [PubMed]
  • Mayaud P, Changalucha J, Grosskurth H, Ka-Gina G, Rugemalila J, Nduba J, Newell J, Hayes R, Mabey D. The value of urine specimens in screening for male urethritis and its microbial aetiologies in Tanzania. Genitourin Med. 1992 Dec;68(6):361–365. [PMC free article] [PubMed]
  • McNagny SE, Parker RM, Zenilman JM, Lewis JS. Urinary leukocyte esterase test: a screening method for the detection of asymptomatic chlamydial and gonococcal infections in men. J Infect Dis. 1992 Mar;165(3):573–576. [PubMed]
  • Mosha F, Nicoll A, Barongo L, Borgdorff M, Newell J, Senkoro K, Grosskurth H, Changalucha J, Klokke A, Killewo J, et al. A population-based study of syphilis and sexually transmitted disease syndromes in north-western Tanzania. 1. Prevalence and incidence. Genitourin Med. 1993 Dec;69(6):415–420. [PMC free article] [PubMed]
  • Arya OP, Nsanzumuhire H, Taber SR. Clinical, cultural, and demographic aspects of gonorrhoea in a rural community in Uganda. Bull World Health Organ. 1973;49(6):587–595. [PubMed]
  • Vuylsteke B, Laga M, Alary M, Gerniers MM, Lebughe JP, Nzila N, Behets F, Van Dyck E, Piot P. Clinical algorithms for the screening of women for gonococcal and chlamydial infection: evaluation of pregnant women and prostitutes in Zaire. Clin Infect Dis. 1993 Jul;17(1):82–88. [PubMed]
  • Hira SK, Bhat GJ, Chikamata DM, Nkowane B, Tembo G, Perine PL, Meheus A. Syphilis intervention in pregnancy: Zambian demonstration project. Genitourin Med. 1990 Jun;66(3):159–164. [PMC free article] [PubMed]

Articles from Genitourinary Medicine are provided here courtesy of BMJ Group