Strengthening capacity to optimally care for vulnerable groups at risk for sexually transmitted infections in Kampala, Uganda.
Sexually transmitted infections (STIs) are among the most common infectious diseases. Syphilis infection continues to be an important global health problem in Uganda and other sub-Saharan African countries; whereas screening for STIs such as gonorrhea and chlamydia remains a concern due to challenges in the implementation of testing. This project set out to improve diagnosis and treatment of three key STIs in a sustainable manner, using innovative laboratory testing approaches.
The project had four key objectives; 1) to screen 800 pregnant women during antenatal care for syphilis using Immunochromatographic Strip (ICS) tests 2) to screen 400 asymptomatic individuals at high risk for acquisition of STIs for chlamydia and gonorrhea using GeneXpert® cartridges 3) to diagnose at least 50-100 STIs and link 20 partners to care and 4) to hold 3 Continuous Medical Education (CME).
2040 pregnant women were screened for syphilis, 82 (4%) tested positive and all were linked to care and treatment. 456 asymptomatic individuals were screened for gonorrhea and chlamydia, of which 299 (66%) females. 37 (8%) tested positive for chlamydia and 28 (6%) for gonorrhea while 6 (1%) individuals had dual infection. In total, 147 STIs were diagnosed and 65 (44%) partners were treated as well. Six trainings were conducted among health care workers.
As a direct result, IDI has established a surveillance platform for STIs that is routinely used; STIs screening is now standard of care at the clinic. Beyond the objectives of the project itself, this project has also spurred further study ideas. Antimicrobial resistance testing of N. gonorrhea isolates is one of the priority areas for further studies with this partnership.