ArticlePloS one2018
Trends in the relative prevalence of genital ulcer disease pathogens and association with HIV infection in Johannesburg, South Africa, 2007-2015.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 31 citations in OpenAlex.
- Factors associated with vaccination completion and retention among HIV negative female sex workers enrolled in a simulated vaccine efficacy trial in Kampala, Uganda.BMC infectious diseases · 2019Trial
- Clinical characteristics ofResearch square · 2026Article
- Sexually transmitted infection prevalence and Neisseria gonorrhoeae antimicrobial resistance patterns in men who have sex with men with or without urethral discharge syndrome in Johannesburg, South Africa, 2024.PLOS global public health · 2026Article
- Epidemiological Patterns of Genital Ulcer Disease and Human Immunodeficiency Virus Among Public Clinic Attendees in Mthatha, Eastern Cape, South Africa.Diseases (Basel, Switzerland) · 2025Article
- Infections caused byClinical microbiology reviews · 2024Review
- High prevalence of sexually transmitted infections and risk factors among HIV-positive individuals in Yunnan, China.European journal of medical research · 2022Article
- Aetiology of genital ulcer disease and associated factors among Mthatha public clinic attendees.Southern African journal of infectious diseases · 2022Article
- Treponema pallidum Macrolide Resistance and Molecular Epidemiology in Southern Africa, 2008 to 2018.Journal of clinical microbiology · 2021Article
- Use of a Multiplex PCR Assay To Assess the Presence of Treponema pallidum in Mucocutaneous Ulcerations in Patients with Suspected Syphilis.Journal of clinical microbiology · 2021Article
- Article
- Spectrum of HIV-associated infectious diseases: A case series through the eyes of the histopathologist.Southern African journal of HIV medicine · 2020Article
- The global and regional burden of genital ulcer disease due to herpes simplex virus: a natural history modelling study.BMJ global health · 2020Article
- Association between Knowledge of Sexually Transmitted Infections and Sources of the Previous Point of Care among Nigerians: Findings from Three National HIV and AIDS Reproductive Health Surveys.International journal of reproductive medicine · 2020Article
- Etiological profile of male urethritis and genital ulcer disease and antimicrobial susceptibility of Neisseria gonorrhoeae in Southeastern Brazil.The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious DiseasesArticle
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn South Africa, treatment of genital ulcer disease (GUD) occurs in the context of syndromic management. GUD aetiological studies have been conducted in Johannesburg since 2007. We report on GUD pathogen prevalence, sero-prevalence of STI co-infections and aetiological trends among GUD patients presenting to a community-based primary healthcare facility in Johannesburg over a 9-year period. METHODS AND
findingsGUD surveys were conducted from January to April each year. Consecutive genital ulcers were sampled from consenting adults. Swab-extracted DNA was tested by multiplex real-time PCR assays for herpes simplex virus (HSV), Treponema pallidum (TP), Haemophilus ducreyi (HD) and Chlamydia trachomatis (CT). HSV-positive DNA extracts were further subtyped into HSV-1 and HSV-2 using a commercial PCR assay; CT-positive extracts were tested with an in-house PCR assay specific for serovars L1-L3 (lymphogranuloma venereum). Sera were tested for HIV, HSV-2, and syphilis co-infections. Giemsa-stained ulcer smears were screened for Klebsiella granulomatis by microscopy. Data were analysed with STATATM version 14. Of 771 GUD specimens, 503 (65.2%) had a detectable pathogen: HSV 468 (60.7%); TP 30 (3.9%); CT L1-3 7 (0.9%); HD 4 (0.5%). No aetiological agents were detected in 270 (34.8%) ulcer specimens. Seroprevalence rates were as follows: HIV 61.7%; HSV-2 80.2% and syphilis 5.8%. There was a strong association between GUD pathogen detection and HIV seropositivity (p < 0.001); 68% of cases caused by HSV were co-infected with HIV. There was a significant decline in the relative prevalence of ulcer-derived HSV over time, predominantly from 2013-2015 (p-value for trend = 0.023); and a trend towards a decrease in the HIV seropositivity rate (p-value for trend = 0.209).
conclusionsHSV remains the leading cause of pathogen-detectable GUD in South Africa. The prevalence of HIV co-infection among GUD patients is high, underlining the importance of linkage to universal HIV testing and treatment in primary healthcare settings.
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