Genital ulcers in Kenya. Clinical and laboratory study

Area of Science:

• Microbiology
• Infectious Diseases
• Dermatology

Background:

• Genital ulcers are a significant public health concern, particularly in resource-limited settings.
• Identifying the causative agents of genital ulcers is crucial for effective treatment and control.
• Previous studies have indicated a diverse range of pathogens responsible for genital ulcer disease.

Purpose of the Study:

• To determine the aetiological agents responsible for genital ulcers in patients attending a special treatment clinic in Nairobi, Kenya.
• To evaluate the efficacy of different antimicrobial agents in treating genital ulcer disease.

Main Methods:

• A prospective study was conducted on 97 patients presenting with genital ulcers.
• Microbiological investigations included bacterial culture (using enriched chocolate agar with vancomycin and serum for H. ducreyi isolation), viral detection, and darkfield microscopy for syphilis.
• Patients were treated with various agents, and treatment outcomes were assessed.

Main Results:

• Haemophilus ducreyi was identified as the most frequent pathogen, found in 60 patients.
• Neisseria gonorrhoeae and Herpes Simplex Virus were identified in 5 and 4 patients, respectively.
• Syphilis was serologically suggested in 11 patients, with one confirmed case.
• Sulfadimidine demonstrated high efficacy (nearly 80%) in treating ulcers, whereas tetracycline showed limited effectiveness.

Conclusions:

• Haemophilus ducreyi is a predominant cause of genital ulcers in this Nairobi cohort.
• Sulfadimidine is a recommended treatment option for H. ducreyi-associated genital ulcers.
• Further research is needed to identify the aetiology in remaining cases and optimize treatment strategies.