Interpretation of the Mwanza and Rakai STI trials.

摘要: Editor--In addition to discussing sexual behaviour aspects of the Mwanza and Rakai trials interventions against sexually transmitted infection (STIs), Christopher Hudson also raises a number points relating STI control in developing countries that warrant further discussion. states low prevalences with HIV herpes simplex virus (HSV), as Mwanza, may mark early stages an epidemic, high these two viruses indicate mature epidemic (1). However, data from study population show prevalence HSV-2 antibodies, adjusted for age sex, is very similar epidemics Masaka referred by (2). Also there was no association between HSV earlier Durban whereas, fact, identified significant risk factor on particularly young women (3). suggests trial should some way be termed gold standard. are still about remain uncertain. Firstly, must doubt whether or not subjects actually took mass treatment. Antibiotic levels were tested either blood urine. Although medication administered through direct observation, question remains tablets could have been "pocketed" used later if they became symptomatic sold source revenue. The cost 1 g azithromycin alone at time would region US$ 10, more than weekly wage majority participants. Many those stable monogamous relationships see little point taking unnecessary risking possible side-effects. Secondly, Michel Alary out accompanying commentary (4), mobile high-risk individuals missed Rakai. Coverage less 80%, one reminded 80/20 rule 20% contributes least 80% net transmission potential infectious agents (5). If did include core group transmitters it surprising had effect STIs HIV. Furthermore, treatments month per cluster complete which allowed plenty new infections reinfection untreated contact. basic studies done looking efficacy single dose ciprofloxacin curing chronic gonorrhoea. Differentiation gonorrhoea into acute usually recognized current textbooks WHO treatment algorithms. …