Simbarashe Takuva1, Owen Mugurungi, Junior Mutsvangwa, Anna Machiha, Albert C Mupambo, Venessa Maseko, Fatim Cham, Stanley Mungofa, Peter Mason, David A Lewis. 1. From the *Centre for HIV and STI, National Institute for Communicable Diseases (NHLS), Johannesburg, South Africa; †Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; ‡STI, HIV/AIDS and TB Programmes, Ministry of Health and Child Care, Harare, Zimbabwe; §Biomedical Research and Training Institute, Harare, Zimbabwe; ¶City of Harare Health Services, Rowan Martin Building, Harare, Zimbabwe; ∥Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD; **Makerere University Walter Reed Project, Kampala, Uganda; ††Western Sydney Sexual Health Centre, Parramatta, Australia; and ‡‡Centre for Infectious Diseases and Microbiology& Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, Australia.
Abstract
BACKGROUND: Periodic etiological surveillance of sexually transmitted infection (STI) syndromes is required to validate treatment algorithms used to control STIs. However, such surveys have not been performed in Zimbabwe over the past decade. METHODS: A cross-sectional study design was used to determine the prevalence of the key STI etiological agents causing male urethral discharge (MUD). Urethral swab specimens were collected for molecular analysis and Neisseria gonorrhoeae isolation from consenting men 18 years and older who presented with MUD to the 12 clinics in Harare, Zimbabwe, between November 2010 and May 2011. A validated in-house multiplex polymerase chain reaction assay was used to detect the presence of N. gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, and Mycoplasma genitalium. Gonococci were cultured on selective media, and antimicrobial susceptibilities were determined locally for ciprofloxacin, kanamycin, ceftriaxone, and cefixime using Etest strips, and minimum inhibitory concentrations were reported using defined breakpoints. RESULTS: Among 130 participants, N. gonorrhoeae was the most frequent pathogen detected (106; 82.8%), followed by C. trachomatis (15; 11.7%), M. genitalium (6; 4.7%), and T. vaginalis (2; 1.6%). Four (6.1%) of the 66 gonococci isolated were resistant to fluoroquinolones, whereas all viable isolates were susceptible to kanamycin, cefixime, and ceftriaxone. CONCLUSIONS: Gonorrhea is the most important cause of MUD in men in Harare, and our study highlights the emergence of fluoroquinolone-resistant N. gonorrhoeae. Further STI surveys are required in other regions of Zimbabwe to obtain a nationally representative picture of gonococcal burden and antimicrobial resistance among MUD patients.
BACKGROUND: Periodic etiological surveillance of sexually transmitted infection (STI) syndromes is required to validate treatment algorithms used to control STIs. However, such surveys have not been performed in Zimbabwe over the past decade. METHODS: A cross-sectional study design was used to determine the prevalence of the key STI etiological agents causing male urethral discharge (MUD). Urethral swab specimens were collected for molecular analysis and Neisseria gonorrhoeae isolation from consenting men 18 years and older who presented with MUD to the 12 clinics in Harare, Zimbabwe, between November 2010 and May 2011. A validated in-house multiplex polymerase chain reaction assay was used to detect the presence of N. gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, and Mycoplasma genitalium. Gonococci were cultured on selective media, and antimicrobial susceptibilities were determined locally for ciprofloxacin, kanamycin, ceftriaxone, and cefixime using Etest strips, and minimum inhibitory concentrations were reported using defined breakpoints. RESULTS: Among 130 participants, N. gonorrhoeae was the most frequent pathogen detected (106; 82.8%), followed by C. trachomatis (15; 11.7%), M. genitalium (6; 4.7%), and T. vaginalis (2; 1.6%). Four (6.1%) of the 66 gonococci isolated were resistant to fluoroquinolones, whereas all viable isolates were susceptible to kanamycin, cefixime, and ceftriaxone. CONCLUSIONS: Gonorrhea is the most important cause of MUD in men in Harare, and our study highlights the emergence of fluoroquinolone-resistant N. gonorrhoeae. Further STI surveys are required in other regions of Zimbabwe to obtain a nationally representative picture of gonococcal burden and antimicrobial resistance among MUD patients.
Authors: Justin Hardick; Trevor A Crowell; Kara Lombardi; Akindiran Akintunde; Sunday Odeyemi; Andrew Ivo; George Eluwa; Jean Njab; Stefan D Baral; Rebecca G Nowak; Thomas C Quinn; Kent Barbian; Sarah Anzick; Sylvia Adebajo; Manhattan E Charurat; Julie Ake; Charlotte A Gaydos Journal: Int J STD AIDS Date: 2018-07-04 Impact factor: 1.359
Authors: Meklit Workneh; Matthew M Hamill; Francis Kakooza; Emmanuel Mande; Jessica Wagner; Olive Mbabazi; Rodney Mugasha; Henry Kajumbula; Richard Walwema; Jonathan Zenilman; Patrick Musinguzi; Peter Kyambadde; Mohammed Lamorde; Yukari C Manabe Journal: JMIR Public Health Surveill Date: 2020-06-10