Syphilis, human immunodeficiency virus, herpes genital and hepatitis B in a women's prison in Cochabamba, Bolivia: prevalence and risk factors.

OBJECTIVE: To determine the prevalence and factors associated with syphilis, human immunodeficiency virus (HIV), hepatitis B (HBV) and herpes type 2 (HSV2) among women in the prison of San Sebastian in Cochabamba (Bolivia). MATERIAL AND METHODS: We carried out a cross-sectional study including a standardized questionnaire to assess socio-demographics characteristics and risk factors (sexual practices and exposure to blood); and serological tests for syphilis, HSV2, VIH, and HBV. We performed bivariate and multivariate analyses to test the associations between variables of interest and infections. RESULTS: A total of 219 out of 220 prisoners (99.5%) participated in the study. For syphilis, 12.8% of participants had both reactive tests (RPR+/TPPA+). The prevalence of HSV2 and VIH was 62.6% and 1.4%, respectively. Anti-HBc, indicating a resolved or chronic HBV, was positive in 11.9% of participants and 0.5% had active HBV (HBsAg positive). A low level of education was associated with syphilis, HSV2 and HBV. Having occasional sexual partners was associated with syphilis and HSV2. Being over 36 years old and having more than 3 children were associated with HBV. The number of sexual partners, history of prostitution and rape, having sexual intercourses in prison and detention time were not associated with any of these infections. DISCUSSION: The prevalence of syphilis, HIV, HSV2 and HBV was higher in this vulnerable female population than in the general population in Bolivia. Control measures in detention are needed to limit the spread of these infections both in prisons and in the community.

Rapid diagnostic testing to improve access to screening for syphilis in prison.

OBJECTIVES: To assess the accuracy of on-site rapid treponemal test for syphilis diagnosis in women deprived of liberty in Bolivia. MATERIAL AND METHODS: Serological tests for syphilis were performed on 219 women deprived of liberty from the San Sebastián prison in Cochabamba, Bolivia. Syphilis was diagnosed using RPR (bioMérieux) and TPPA (Fujirebio) serological tests, and the results were compared to on-site rapid treponemal test (Alere DetermineTM Syphilis TP) in whole blood. Diagnostic performance of two FTA tests were also compared (bioMérieux and Biocientífica). RESULTS: All participants (28) with RPR+/TPPA+ had the rapid syphilis test positive (sensitivity 100%). Eleven participants had rapid syphilis test positive without RPR and TPPA both positive; nevertheless 7 of them had RPR or TPPA positive. Of 33 participants with FTA-bioMérieux positive, 22 (66.6%) had FTA-Biocientífica positive. DISCUSSION: The rapid syphilis test Determine shows excellent performance as a screening tool among women deprived of liberty affected by high prevalence of syphilis. This test is particularly indicated when there are barriers for access to conventional serological tests. It is inexpensive, easy to use and does not require electricity and laboratory infrastructure. The FTA test performed with reagents from Biocientífica had a suboptimal sensitivity.

Sífilis, virus de la inmunodeficiencia humana, herpes tipo 2 y hepatitis B en una prisión de mujeres en Cochabamba, Bolivia: prevalencia y factores de riesgo / Syphilis, human immunodeficiency virus, herpes genital and hepatitis B in a women's prison in Cochabamba, Bolivia: prevalence and risk factors

Objetivo: Determinar la prevalencia y los factores asociados a la infección por sífilis, virus de la inmunodeficiencia humana (VIH), virus de hepatitis B (VHB) y virus herpes tipo 2 (HSV2) en las mujeres privadas de libertad (MPL) en la prisión de San Sebastián en Cochabamba (Bolivia). Material y método: Se realizó un estudio transversal. Mediante un cuestionario estandarizado se registraron las características sociodemográficas, las prácticas sexuales y la existencia de exposición a la sangre. Se realizaron pruebas serológicas para sífilis, HSV2, VIH y VHB. Para conocer la asociación entre las variables de interés y las enfermedades, se llevaron a cabo análisis bi y multivariantes. Resultados: Participaron 219 de 220 MPL (99,5%). La prevalencia de sífilis (RPR+/TPPA+), HSV2, VIH y VHB crónico (ABsAg+) fue de 12,8%, 62,6%, 1,4% y 0,5%, respectivamente. La sífilis y el HSV2 se asociaron con un bajo nivel de educación y con el hecho de tener parejas sexuales ocasionales. El VHB se asoció con un bajo nivel de educación, la edad y el hecho de tener más de tres hijos. Estas infecciones no se asociaron con el número de parejas sexuales, los antecedentes de prostitución o violación, las relaciones sexuales en prisión y la duración de la pena privativa de libertad. Discusión: La prevalencia de las enfermedades investigadas (sífilis, VIH, HSV2 y VHB) es más elevada en la población penitenciaria femenina que en la población general de Bolivia. Es necesario implementar medidas de control en la prisión para limitar la propagación de estas infecciones, tanto en prisiones como en la comunidad

Objective: To determine the prevalence and factors associated with syphilis, human immunodeficiency virus (HIV), hepatitis B (HBV) and herpes type 2 (HSV2) among women in the prison of San Sebastian in Cochabamba (Bolivia). Material and methods: We carried out a cross-sectional study including a standardized questionnaire to assess socio-demographics characteristics and risk factors (sexual practices and exposure to blood); and serological tests for syphilis, HSV2, VIH, and HBV. We performed bivariate and multivariate analyses to test the associations between variables of interest and infections. Results: A total of 219 out of 220 prisoners (99.5%) participated in the study. For syphilis, 12.8% of participants had both reactive tests (RPR+/TPPA+). The prevalence of HSV2 and VIH was 62.6% and 1.4%, respectively. Anti-HBc, indicating a resolved or chronic HBV, was positive in 11.9% of participants and 0.5% had active HBV (HBsAg positive). A low level of education was associated with syphilis, HSV2 and HBV. Having occasional sexual partners was associated with syphilis and HSV2. Being over 36 years old and having more than 3 children were associated with HBV. The number of sexual partners, history of prostitution and rape, having sexual intercourses in prison and detention time were not associated with any of these infections. Discussion: The prevalence of syphilis, HIV, HSV2 and HBV was higher in this vulnerable female population than in the general population in Bolivia. Control measures in detention are needed to limit the spread of these infections both in prisons and in the community

Levantar las barreras al diagnóstico de la sífilis en las cárceles gracias a una prueba diagnóstica rápida / Rapid diagnostic testing to improve access to screening for syphilis in prison

Objetivos: Evaluar una prueba treponémica rápida in situ para el diagnóstico de la sífilis en mujeres privadas de libertad en Bolivia. Material y métodos: Se realizaron pruebas serológicas para la sífilis a 219 mujeres privadas de libertad (MPL) de la cárcel San Sebastián de Cochabamba, Bolivia. Esta enfermedad fue diagnosticada utilizando como referencia las pruebas serológicas reagina plasmática rápida (RPR, rapid plasma reagin, bioMérieux S.A.) y el ensayo de aglutinación de partículas de Treponema pallidum (TPPA, Treponema pallidum particle assay, Serodia(R) Fujirebio Inc.). Los resultados fueron comparados con la prueba rápida Alere DetermineTM Syphilis TP (PRADS) en sangre total. Se compararon también dos pruebas de anticuerpos treponémicos fluorescentes (FTA, fluorescent treponemal antibody) de marcas diferentes (bioMérieux y Biocientífica). Resultados: Las 28 mujeres privadas de libertad con RPR+/TPPA+ tenían la PRADS positiva (con una sensibilidad del 100%). Once participantes tenían la PRADS positiva sin RPR y TPPA, ambos reactivos; sin embargo, siete de ellos tenían la RPR o TPPA reactivo. De las 33 participantes con FTA-bioMérieux reactivo, 22 (el 66,6%) tenían el FTA-Biocientífica reactivo. Discusión: La PRADS muestra un excelente desempeño como prueba de despistaje en una población de mujeres privadas de libertad afectada por una alta prevalencia de sífilis. Esta herramienta está particularmente indicada cuando existen en las cárceles barreras de acceso a las pruebas serológicas convencionales. Es de bajo costo, de fácil uso y no necesita electricidad ni una infraestructura de laboratorio. La prueba treponémica FTA realizada con los reactivos Biocientífica tiene una sensibilidad subóptima

Objectives: To assess the accuracy of on-site rapid treponemal test for syphilis diagnosis in women deprived of liberty in Bolivia. Material and methods: Serological tests for syphilis were performed on 219 women deprived of liberty from the San Sebastián prison in Cochabamba, Bolivia. Syphilis was diagnosed using RPR (bioMérieux) and TPPA (Fujirebio) serological tests, and the results were compared to on-site rapid treponemal test (Alere DetermineTM Syphilis TP) in whole blood. Diagnostic performance of two FTA tests were also compared (bioMérieux and Biocientífica). Results: All participants (28) with RPR+/TPPA+ had the rapid syphilis test positive (sensitivity 100%). Eleven participants had rapid syphilis test positive without RPR and TPPA both positive; nevertheless 7 of them had RPR or TPPA positive. Of 33 participants with FTA-bioMérieux positive, 22 (66.6%) had FTA-Biocientífica positive. Discussion: The rapid syphilis test Determine shows excellent performance as a screening tool among women deprived of liberty affected by high prevalence of syphilis. This test is particularly indicated when there are barriers for access to conventional serological tests. It is inexpensive, easy to use and does not require electricity and laboratory infrastructure. The FTA test performed with reagents from Biocientífica had a suboptimal sensitivity

Sífilis congénita en 2 niños de una cárcel de Bolivia / Congenital syphilis in 2 children in a Bolivian prison

En el año 2013, se realizó un estudio transversal que reveló 28 casos de sífilis activa en 219 mujeres privadas de libertad (MPL) en una cárcel de Cochabamba, Bolivia. Se buscó la sífilis congénita (SC) en los niños que convivían con las madres infectadas. Resulta importante la prevención de la transmisión vertical de la sífilis mediante un despistaje sistemático de las embarazadas y el tratamiento oportuno por profesionales entrenados, dentro del ámbito carceral que representa una población clave para el control de esta enfermedad responsable de complicaciones graves (AU)

In 2013 a cross-sectional study was carried out that revealed 28 cases of active syphilis amongst female inmates in a prison of Cochabamba, Bolivia. A search was conducted for congenital syphilis amongst the children that lived with the infected mothers. It is important to note the prevention of perinatal transmission of syphilis by systematic screening of pregnant women and appropriate treatment given by trained professionals within the prison environment, which represents a key population for controlling this disease, which is responsible for causing severe complications (AU)

[Streptococcal infection in a primary school population. Study during the academic year]. / Infección estreptocócica en una población escolar primaria. Estudio durante un curso escolar.

One hundred and seventy four children from the "República de Checoslovaquia" National School of the Centro Habana-Norte municipality were investigated during the 1976-1977 academic course months. The method of mail interview of parents was used. Every month the history of oropharyngeal infection and antibiotic administration was obtained, and bacteriology of pharyngeal exudates was performed. Antistreptolysin or AELO titers were determined at three-month intervals. Cardiovascular physical examinations were made and electrocardiograms obtained during the last month. 19,22% of exudates were positive for hemolytic streptococci. 46,56% of streptococcal strains isolated corresponded to the group A. Hemolytic streptococci isolation ranged between 10,4% in October, 1976 and 36,1% in April, 1977. The monthly distribution of the different serological groups of isolated hemolytic streptococci disclosed statistically significant differences. 78,26% of the 667 AELO reactions corresponded to titers of 200 or more Todd units. Average titers in the four stages of the serological study are between 382,42 and 463,92 Todd units. Significative differences between the results of bacteriology and serology and the physical state of oropharynx or the history of clinical manifestations were not evidenced. Manifestations of carditis or rheumatic fever were not found.