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Epidemiology of syphilis in Kenya: results from a nationally representative serological survey
  1. Boaz Otieno-Nyunya1,
  2. Eddas Bennett2,
  3. Rebecca Bunnell1,
  4. Sufia Dadabhai3,
  5. Anthony Gichangi A1,
  6. Nelly Mugo4,
  7. John Wanyungu5,
  8. Isaack Baya6,
  9. Reinhard Kaiser1,
  10. for the Kenya AIDS Indicator Survey Study Team
  1. 1Center for Global Health, Division of Global HIV/AIDS, Centers for Disease Control and Prevention, Nairobi, Kenya
  2. 2Center for Global Health, Division of Global HIV/AIDS, Centers for Disease Control and Prevention, Atlanta, USA
  3. 3Department of Epidemiology and Biostatistics, University of California. San Francisco, USA
  4. 4Kenyatta National Hospital and University of Nairobi, Nairobi, Kenya
  5. 5National AIDS and STD Control Program, Kenya Ministry of Health, Nairobi, Kenya
  6. 6Kenya National Public Health Laboratory Services, Nairobi, Kenya
  1. Correspondence to Dr Reinhard Kaiser, Center for Global Health, Division of Global HIV/AIDS, Centers for Disease Control and Prevention Kenya, P.O. Box 606-00621 Village Market Nairobi, Kenya; r_kaiser{at}gmx.de

Abstract

Objectives The authors used data from the Kenya AIDS Indicator Survey (KAIS) 2007 to determine the prevalence of syphilis and associated risk factors among adults aged 15–64 years.

Methods KAIS was a nationally representative population-based sero-survey that examined demographic and behavioural indicators and serological testing for syphilis, HIV and herpes simplex virus type 2 (HSV-2) in adults aged 15–64 years. The authors analysed data from 8935 women and 6727 men with complete syphilis results. Logistic regression models stratified by sex were used to assess potential factors associated with syphilis sero-prevalence.

Results Overall, 262 adults tested positive for syphilis (1.8%, 95% CI 1.5% to 2.1%); sero-prevalence was similar among women and men (1.7%, 95% CI 1.3% to 2.0% and 1.9%, 95% CI 1.5% to 2.3%, respectively). Syphilis prevalence was the highest among men with HIV (6.4%, 95% CI 3.1% to 9.7%) and HSV-2 (4.5%, 95% CI 3.4% to 5.7%) infection. Independent risk factors for syphilis included HIV (men only, adjusted OR (AOR) 3.4, 95% CI 1.6% to 7.1%), HSV-2 (women, AOR 3.5, 95% CI 2.1% to 5.8%; men AOR 2.2, 95% CI 1.3% to 3.7%), lack of male circumcision (AOR 2.2, 95% CI 1.3% to 3.7%), poorest or poorer versus richest wealth index (women, AOR 2.0, 95% CI 1.0% to 4.2%; men AOR 2.5, 95% CI 1.4% to 4.9%) and no primary versus secondary or more education in men (AOR 4.8, 95% CI 2.0% to 11.7%).

Conclusions Syphilis prevalence in the general population in Kenya is relatively low and eradication could be possible but would require intensified syphilis prevention and control efforts, including routine screening in HIV, sexually transmitted infection and antenatal care clinics as well as in family planning and male circumcision settings.

  • Syphilis
  • genital ulcer disease
  • Kenya
  • national prevalence
  • risk factors

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Footnotes

  • Kenya AIDS Indicator Survey Study Group: Michael Arnold, Godfrey Baltazar, Isack Baya, John Bore, Rebecca Bunnell, Sufia Dadabhai, Helen Dale, Jared Ichwara, Allen Hightower, Tura Galgalo, Catherine Gichimu, Anthony Gichangi, Reinhard Kaiser, Timothy Kellogg, George Kichamu, Andrea Kim, Evelyn Kim, Samuel Kipruto, George K'opiyo, Ernest Makokha, Barbara Marston, Lawrence Marum, Margaret Mburu, Jonathan Mermin, Joy Mirjahangir, Rex Mpazanje, Ibrahim Mohamed, Patrick Muriithi, James Muttunga, Mary Mwangi, Carol Ngare, Raymond Nyoka, Linus Odawo, Samuel Ogola, Christopher Omolo, Tom Oluoch, Ray Shiraishi, John Wanyungu and Anthony Waruru.

  • Funding This work was supported by the President's Emergency Plan for AIDS Relief (PEPFAR) through the US Centers for Disease Control and Prevention (CDC) and the USA Agency for International Development and by the Joint United Nations Programme on HIV/AIDS. Several authors are CDC employees. The findings and conclusions in this manuscript are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval Kenya Medical Research Institute (KEMRI) Ethical Review Committee and the US Centers for Disease Control and Prevention (CDC) Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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