Publications

Sexually transmitted diseases (STDs) are major health problems in many parts of the world, especially in developing countries, as illustrated by high prevalence rates and a high rate of complications and sequelae. STDs are medically, socially and economically important, mainly because of their sequelae, which hit women and neonates in the first place. Ectopic pregnancy, spontaneous abortion and stillbirth, prematurity and low birth weight, congenital and perinatal infections, and puerperal maternal infections represent outcomes of pregnancy in which STDs play important aetiological roles.

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The normal range of activities of 6 lysosomal enzymes was determined in extracts of chorionic villi samples obtained by a rigid forceps in the first trimester of pregnancy. These activities were compared to those in villi obtained after abortion and in cultured amniotic fluid cells and fibroblasts. For five of the six enzymes tested, the data suggest that first trimester prenatal diagnosis should be possible and reliable.

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The role of gonorrhoea and other sexually transmitted diseases as risk factors for adverse pregnancy outcome defined as low birth weight, stillbirth and postpartum endometriosis, was examined in a case control study in Nairobi, Kenya. Maternal gonococcal infection was associated with very low birth weight babies (< 1500g; 17.1 versus 5.8 per cent: P<0.01; odds ratio 3.2) and with postpartum endometriosis (18.2 versus 5.6 per cent; P = < 0.001; odds ratio 4.1). The isolation rate of Neisseria gonorrhoeae increased with declining birth weight (P < 0.05).

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The role of the human immunodeficiency virus (HIV) and other sexually transmitted diseases (STDs) as risk factor for spontaneous abortion was investigated in a case-control study in Nairobi, Kenya. Cases (n = 195) were women admitted with clinical signs and symptoms of spontaneous abortion, before 20 weeks of gestation. Patients with induced or clinically septic abortion were excluded. Controls were unselected pregnant women in their second or third trimester (n = 195).

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OBJECTIVE: To determine the prevalence of HIV-1 and syphilis antibodies in a population of pregnant women in Nairobi, Kenya, between 1989 and 1991. METHODS: As part of an ongoing prospective study on the effect of HIV-1 infection and sexually transmitted diseases, 4883 pregnant women were screened for HIV-1 and syphilis antibodies in one health-centre in Nairobi. RESULTS: HIV-1 seroprevalence increased from 6.5 to 13.0% (P < 0.001) and syphilis seroreactivity from 2.9 to 5.3% (P = 0.002), while there was no change in gonococcal infection rates.

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