Browsing by Author "Mashego, May."

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High AIDS-related mortality among young women in rural KwaZulu-Natal.
(South African Medical Association., 2007) Mashego, May.; Johnson, D.; Fröhlich, Janet Ann.; Carrara, H.; Abdool Karim, Quarraisha.
Objective. To establish mortality rates and cause of death in a rural community in KwaZulu-Natal. This study was conducted as part of a demographic and health survey to assess the impact of HIV infection in this community. Methods. A cross-sectional survey was conducted between February and July 2004. The survey made use of structured questionnaires and verbal autopsies, which yielded detailed information at household level, including the demographic profile of residents, mortality rates and cause of mortality between February 2003 and February 2004. Results. The overall mortality rate in this community was 2.9 deaths per 100 person-years (95% confidence interval (CI): 2.5 - 3.3 per 100 person-years). The highest mortality rate among women occurred in the 30 - 34-year age group, while among men it occurred in the 35 - 39 and > 60-year age groups. Of the 185 verbal autopsies reported, 77 deaths (42%) were attributable to AIDS. The survey revealed that women aged 20 - 24 and men aged 35 - 39 years were bearing a disproportionately large burden of AIDS-related mortality in this community. Conclusion. AIDS-related mortality was found to be disproportionately high in young women in this small rural community, and the majority of deaths resulted from pulmonary tuberculosis. The need to strengthen prevention and treatment efforts in this and similar settings is highlighted.
High prevalence of abnormal Pap smears among young women co-infected with HIV in rural South Africa – implications for cervical cancer screening policies in high HIV prevalence populations.
(South African Medical Association / Health & Medical Publications Group., 2006) Gaym, Asheber.; Mashego, May.; Kharsany, Ayesha Bibi Mahomed.; Walldorf, Jenny.; Fröhlich, Janet Ann.; Abdool Karim, Quarraisha.
Objective. To establish the relationship between HIV infection and cervical dysplasia in young women in rural South Africa. Methods. This cross-sectional study was conducted at a primary health care clinic in Vulindlela, KwaZulu-Natal. Standardised questionnaires were used to collect sociodemographic and clinical presentation data from women attending family planning and other reproductive health services. Pap smears were done using standard methods. Pap smear data were linked to HIV serostatus. Results. Four hundred and sixty-six women were included in the study. The median age was 24.3 years (range 15 - 55 years), and 80% were younger than 30 years. The HIV prevalence rate was 24.5% (95% confidence interval: 20.7 - 28.7%) and the prevalence of abnormal Pap smears was 16.9 - 6.4% ASCUS (atypical squamous cells of undetermined significance), 9.2% LGSIL (low-grade squamous intraepithelial lesions), and 1.3% HGSIL (high-grade squamous intraepithelial lesions). The association between HIV seropositivity and abnormal Pap results was statistically significant (p < 0.05). Conclusion. There is a need for more data on cervical changes in HIV co-infected women and for review of guidelines on selective Pap smear screening in high HIV prevalence settings such as sub-Saharan Africa and where access to antiretroviral treatment remains limited.
Opportunities for treating sexually transmitted infections and reducing HIV risk in rural South Africa.
(Wiley-Blackwell., 2007) Fröhlich, Janet Ann.; Abdool Karim, Quarraisha.; Mashego, May.; Sturm, Adriaan Willem.; Abdool Karim, Salim Safurdeen.
Title. Opportunities for treating sexually transmitted infections and reducing HIV risk in rural South Africa Aim. This paper is a report of a study to determine the aetiological distribution of sexually transmitted infections and prevalence of human immunodeficiency virus infection in selected primary health care clinic attendees. Background. South Africa has a high prevalence of human immunodeficiency virus and other sexually transmitted infections. Sexually transmitted infections are managed syndromically in the public sector as part of the essential nurse-driven primary care services provided at no cost to the client. Method. This cross-sectional study was conducted in a rural community in South Africa between September and November 2002. A total of 277 consenting women were recruited. Vulvo-vaginal swabs were collected for screening for Neisseriae gonorrheae, Chlamydia trachomatis and Trichomonas vaginalis using DNA amplification methods and Gram stain with Nugent’s score for the diagnosis of bacterial vaginosis. Seroprevalence of syphilis and human immunodeficiency virus infection were determined. Findings. The overall prevalence of human immunodeficiency virus in the study was 43.7% (95% confidence interval 37.6–50.0) with the prevalence in family planning clinic attendees 45.5% (95% confidence interval 38.9–52.3) and antenatal clinic attendees 33.3% (95% confidence interval 19.6–50.3). The prevalence of sexually transmitted infections amongst both the antenatal clinic and family planning attendees accounted for at least 70% of cases. Fifty per cent of women had one recognized sexually transmitted infection with 17.9% of the family planning and 14.5% of the antenatal clinic attendees having infections from two recognized pathogens. All infections were asymptomatic. Conclusion. Nurse-driven antenatal and family planning services provide a useful opportunity for integrating reproductive health services, human immunodeficiency virus voluntary counselling and testing and treatment of sexually transmitted infections.
Stabilizing HIV prevalence masks high HIV incidence rates amongst rural and urban women in KwaZulu-Natal, South Africa.
(Oxford University Press for the International Epidemiological Association., 2010) Abdool Karim, Quarraisha.; Kharsany, Ayesha Bibi Mahomed.; Fröhlich, Janet Ann.; Werner, Lise.; Mashego, May.; Mlotshwa, Mukelisiwe.; Madlala, Bernadette T.; Ntombela, Fanelesibonge.; Abdool Karim, Salim Safurdeen.
Objective: To determine the HIV incidence rate among rural and urban women in KwaZulu-Natal, South Africa. Methods: We conducted a prospective cohort study from March 2004 to May 2007. Volunteers were recruited from a rural family-planning clinic and an urban clinic for sexually transmitted infections. Consenting, HIV-uninfected women aged 14–30 years were enrolled. Demographic, clinical, sexual and behavioural data were collected using standardized questionnaires with HIV risk reduction counselling and HIV testing. Pelvic examinations were completed at quarterly visits. Results: The HIV prevalence at screening was 35.7% [95% confidence interval (CI) 32.7–38.8] amongst rural women and 59.3% (95% CI 56.5–62.0) amongst urban women. A total of 594/2240 (26.5%) enrolled women contributed to 602 person-years (PYs) of follow-up. The median age was 22 years [inter-quartile range 18–23 years]. HIV incidence rate was 6.5/100 PY (95% CI 4.4–9.2) amongst rural women and 6.4/100 PY (95% CI 2.6–13.2) amongst urban women. HIV incidence rate of 17.2/100 PY (95% CI 2.1–62.2) was highest amongst urban women <20 years of age and 10.2/100 PY (95% CI 4.1–20.9) amongst rural women ≥25 years of age. Conclusion: HIV incidence rates are devastatingly high in young women in rural and urban KwaZulu-Natal, despite reports of stabilized HIV prevalence observed in current surveillance data. The diffuse nature of the HIV epidemic underscores the urgent need to enhance HIV prevention and treatment modalities.