SEROEPIDEMIOLOGICAL STUDIES OF HAEMOPHILUS-DUCREYI INFECTION IN ETHIOPIAN WOMEN

Background and Objectives: To measure prevalence of anti-Haemophilus d ucreyi antibodies in sera from Ethiopian female attendees, and to dete rmine significant socioeconomic associations. Study Design: A modified ELISA immunoassay was used to test sera of 1,831 Ethiopian women atte nding gynecological, obstetric, and family planning clinics in Addis A baba. Results: Overall seropositivity was 19.4%. Prevalence rates for seropositivity for antibodies to H. ducreyi were significantly associa ted with ethnic group and religion, older age (greater than or equal t o 50 years: 28%), early age at first coitus (<13 years: 28%) and first coitus before the menarche (25%), being divorced (27%) or a prostitut e (24%), longer duration of marriage (>20 years: 27%) and sexual life (>20 years: 24%), number of lifetime sexual partners (2 to 5 partners: 27%) and self-reported history of both syphilis and gonorrhea (31%). Of these factors, the two most significant were first coitus before th e menarche (P <0.0001) and not being still married to the first husban d/sexual partner (P <0.001). Differences in seropositivity according t o ethnic group and religion may be explained by the number of women wi thin each group who had only one lifetime sexual partner. Women with s erological evidence of exposure to another sexually transmitted diseas e (STD) had a greater risk of exposure to H. ducreyi. The odds ratio f or H. ducreyi seropositivity in women with syphilis or gonorrhea was 3 .6, for women with genital chlamydial infection, 2.3, and for those wi th HBV or HSV-2, 1.4 and 1.3 respectively. Conclusions: This study ill ustrates the usefulness of the modified ELISA immunoassay for measurin g exposure to H. ducreyi, and the usefulness of H. ducreyi as a marker for cumulative sexual exposure. Further studies on the association of HIV transmission and H. ducreyi in Ethiopia are now indicated.