University of Zambia Medical Library

Epidemiology: STD/HIV Surveillance Studies (Aids in Zambia Bibliography #5-9)

(#5) "Sexually Transmitted Diseases in Zambia: A review of trends from 1983-1987"
Matondo, P., Sandala, L.M., Hira, S.K. (1989) Medical Journal of Zambia Vol 24, pp 3-5
Geographical Area: National; Keywords: Surveillance; Location: UNZA Medical Library

Morbidity returns from established sexually transmitted disease (STD) centres from 1983 to 1987 were reviewed. Despite under-diagnosis, new cases increased from 46,726 in 1983 to 109,496 in 1987. The male to female ratio of attendees remained approximately 2:1. The five common STDs were: gonorrhoea (30 per cent), chancroid (18 per cent), syphilis (15 per cent), trichomoniasis (8 per cent) and candidiasis (4 per cent). Of these, chancroid and syphilis had exponential increase in 1987 while the other three generally had uniform increase over the five year period. In view of epidemiologic similarities and bidirectional interactions between conventional STDs and HIV infection, the STDs trends elicited from this study are indicators of continued sexual transmission of HIV and are cause for concern. There is need to monitor the STD trends more closely.

"A Review of Sexually Transmitted Disease Patients Attending the University Teaching Hospital"
Kapembwa, B. (1989) unpublished
Geographical area: Lusaka; Keywords: Health-seeking behaviour; Location: UNZA Medical Library

Sexually transmitted diseases (STDs) are important enough, both economically and scientifically, to be reported and discussed, as their incidence is high in Zambia. The aim of the study is to review factors that lead people to acquiring sexually transmitted diseases and the sources for the STDs. Patients with sexually transmitted diseases were interviewed. Additional information was extracted from records at the skin clinic of the University Teaching Hospital. The results revealed that many patients got STDs as a result of having sex with strangers or as a result of having multiple sexual partners.

(#7) "A Study of the Prevalence of Sexually Transmitted Disease Among Full Time University Students at the University of Zambia"
Kabwe, C.N. (1990) unpublished
Geographical area: Lusaka; Keywords: Gonorrhoea, syphilis, students; Location: UNZA Medical library

A descriptive, retrospective review of all full time students' records who attended the STD Clinic between 1986-1987 was conducted on the basis of medical records kept at the STD Clinic at UNZA from l986 - 1989. The variables of interest in this study were gender, diagnosis and being a full time student. The purpose of the study was to describe the prevalence of sexually transmitted diseases among full time UNZA students presenting gonorrhoea and syphilis. The study revealed that STDs at UNZA have been on the increase from 1986 - l988 despite the sharp fall in l989. The trend in relation to gonorrhoea and syphilis was fluctuating. Gonorrhoea was more common than syphilis with more female patients than males.

(#8)"Epidemiology of Human Immunodeficiency Virus in Families in Lusaka,Zambia"
Hira, S.K., Nkowane, B.M. (1990) Journal of Acquired Immune Deficiency Syndrome Vol 3(1);1990; pp 83-6.
Geographical area: Lusaka; Keywords: AIDS-related complex, genital ulcers Location: UNZA Medical Library

Persons living in the same household as index patients with AIDS or ARC in Lusaka, Zambia were clinically and serologically evaluated for HIV-1 infection. In the 150 households of male index cases, 92 (61.3 per cent) of their spouses were infected, compared with 57 (73.1 per cent) of the spouses of the 78 female index cases. The more advanced the clinical stage of illness in the index cases, the greater the probability of HIV infection in the spouse (RR = 4.44), and the more likely the spouse was symptomatic. Four of the 11 spouses who seroconverted to HIV also had sexual intercourse at a time when their HIV-infected partner had genital ulcers (RR = 7.45). Of 144 children under 5 years of age, 36 (25 per cent) were infected, all had infected mothers and were the last to be born in all but one household. Three of 120 children 5 to 10 years of age were also infected, presumably through perinatal transmission. Forty-six of 52 discordantly infected couples followed for one year continued to have unprotected vaginal intercourse, and all of these seroconverted to HIV. The study suggests that there is an increasing risk of HIV heterosexual transmission as infection progresses in the infected partner, and that more effective counselling is needed to prevent it.

(#9) "HIV infection in a rural district in Zambia: prevalence and socioeconomic factors associated with seropositivity"
Buve, A., Foster, S.D., (1993) Paper presented at the IXth International Conference on AIDS, Berlin, 1993.
Geographical area: Monze, Southern Province; Key words: Surveillance; Location: UNICEF, ODA

The study was carried out in Monze District, 200 km from Lusaka along the main road and the railway. The district has a population 160,000 of whom 20,000 live in Monze town. In 1991 -1992 data were collected on HIV seroprevalence among patients attending the hospital OPD, rural health centre attenders, and blood donors who are related to patients. 24 per cent of the patients attending the OPD, 18 per cent of rural health centre attenders, and 15 per cent of blood donors were found to be HIV-positive. 91 seropositive adults who were admitted to hospital were compared with 68 seronegative patients with respective to socio-economic variables. After adjusting for age, sex, and residence (rural or urban) seropositive patients were more likely to be skilled workers or traders, and had lived at their present residence for a shorter time. Of patients with HIV disease who had moved to their present residence less than five years ago 26 per cent stated that they had moved because of illness. Our data suggest that HIV infection has reached a high level of prevalence in Monze district and is associated with high mobility and work in urban areas. Patients tend to return to rural areas when they get too sick to work, placing a burden on families and health services in rural areas.

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