High Syphilis and Low but Rising HIV Seroprevalence Rates in Madagascar

XI International Conference on AIDS
July 7-12, 1996

Rasamindrakotroka A., Andriamahenina R.
Laboratoire National de Reference MST/SIDA
Antananarivo, Madagascar

Behets F.
University of North Carolina at Chapel Hill, USA

May J., Andriamiadana J.
The Futures Group International, Washington, DC, USA

Ravaorarimalala C.
Ministry of Health, Madagascar

 


Mo.C.1488

 

High Syphilis and Low but Rising
HIV Seroprevalence Rates in Madagascar

Objectives

To assess HIV and syphilis seroprevalence among pregnant women, STD patients, and prostitutes in the capital Antananarivo, and in the cities of Toamasina, and Toliary.

 

Methods

Women consecutively attending antenatal clinics, individuals successively seeking care for STDs, and commercial sex workers were interviewed. Blood was collected to determine HIV-1&2 antibodies using ELISA, reactive sera were confirmed using Western blot. Sera were screened using rapid plasma reagin (RPR), reactive sera were tested using Treponema pallidum hemagglutination (TPHA).

 

Results

Results N HIV+ RPR & TPHA+
Pregnant women 1,587 1 (.1%) 192 (12.1%)
STD patients 1,575 5 (.3%) 244 (15.5%)
Prostitutes 969 2 (.2%) 296 (30.5%)

Estimates of HIV prevalence per 100,000 adult Malagasy rose from 20 in 1989, to 30 in 1992, to 70 in 1995. Overall, 536/4115 (13%) individuals reported genital ulcers and 1981/4113 (48.2%) reported genital discharge in the preceding 6 months. Syphilis seroreactivity inversely correlated with years of schooling: individuals lacking any schooling: 72/250 (28.8%); six years of schooling: 272/1162 (23.4%); 10 years: 286/1593 (17.9%); 14 years: 78/827 (9.4%); university: 18/255 (7.1%). Syphilis seroreactivity was significantly associated with history of genital ulcers, with prostitution, with number of partners in the last month, and a new partner in the last three months.

 

Conclusions

Compared to the African continent, HIV prevalence is still low but rising in Madagascar. Complacency should thus be avoided. Actions should be undertaken urgently to control the unacceptable high syphilis prevalence rates. Earnest endeavors to control curable STDs in Madagscar will improve associated morbidity and mortality and prevent further spread of HIV.

 

Prof. Rasamindrakotroka A.
LNR SIDA/MST
Service d'Immunologie CHU Hopital
Joseph Ravoahangy Andrianavalona
B.P. 4150 Anatananarivo 101, Madagascar
Tel: 261-2-231-49; 261-2-279-79 Ext. 4159

 

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