1. Chancroid, primary syphilis, genital herpes, and lymphogranuloma venereum in Antananarivo, Madagascar
- Author
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Daudet Randrianasolo, Judith B. Weiss, Jocelyne Andriamiadana, Myron S. Cohen, Stephen A. Morse, Gina Dallabetta, René Randriamanga, Cheng-Yen Chen, Désiré Rasamilalao, and Behets F
- Subjects
Adult ,Male ,medicine.medical_specialty ,Primary Syphilis ,Comorbidity ,urologic and male genital diseases ,medicine.disease_cause ,Polymerase Chain Reaction ,Sensitivity and Specificity ,Chancroid ,Haemophilus ducreyi ,Syphilis Serodiagnosis ,medicine ,Madagascar ,Immunology and Allergy ,Humans ,Simplexvirus ,Syphilis ,Treponema pallidum ,Herpes Genitalis ,Ulcer ,biology ,Lymphogranuloma venereum ,bacterial infections and mycoses ,biology.organism_classification ,medicine.disease ,Dermatology ,Virology ,female genital diseases and pregnancy complications ,Infectious Diseases ,Socioeconomic Factors ,Lymphogranuloma Venereum ,Female ,Chlamydia trachomatis - Abstract
Ulcer material from consecutive patients attending clinics in Antananarivo, Madagascar, was tested using multiplex polymerase chain reaction (M-PCR) to detect Treponema pallidum, Haemophilus ducreyi, and herpes simplex virus. Sera were tested for syphilis and for IgG and IgM antibodies to Chlamydia trachomatis by microimmunofluorescence testing (MIF). By M-PCR, 33% of 196 patients had chancroid, 29% had syphilitic ulcers, and 10% had genital herpes; 32% of the ulcer specimens were M-PCR negative. Compared with M-PCR, syphilis serology was 72% sensitive and 83% specific. The sensitivity of clinical diagnosis of syphilis, chancroid, and genital herpes was 93%, 53%, and 0% and specificity was 20%, 52%, and 99%, respectively. Less schooling was associated with increased prevalence of syphilitic ulcers (P=.001). Sixteen patients (8%) were clinically diagnosed with lymphogranuloma venereum (LGV); 1 plausible case of LGV was found by MIF. In Madagascar, primary care of genital ulcers should include syndromic treatment for syphilis and chancroid.
- Published
- 1999