To examine spatial variations and clustering of syphilis prevalence among pregnant young women aged 18–35 years in Central Uganda.
Approach:
Data Analysis: Secondary data from a randomized trial was analyzed using Moran's I tests, Local Indicator of Spatial Association (LISA), and Kulldorff Spatial-Scan Poisson model to detect syphilis clustering.
Statistical Methods: Prevalence ratios for sociodemographic and bio-behavioral HIV risk factors associated with residence in high-prevalence divisions were estimated using modified Poisson regression.
Key Findings:
Of 422 women diagnosed with syphilis, 26 (6%) had HIV and syphilis.
Syphilis prevalence clustering was negatively associated with polygamous marriages, unplanned pregnancies, and HIV testing >3 months prior.
Significantly higher syphilis prevalence was found in Kasangati Town Council, Kawempe, and Nabweru; lower in Kyengera Town Council.
No significant clustering was detected among women with HIV.
Random patterns of syphilis prevalence were observed across all divisions.
Interpretation:
Syphilis prevalence was similar within neighboring divisions, with the highest rates in Kasangati Town Council and Kawempe.
Limitations:
The study relied on secondary data, which may have limitations in accuracy.
Syphilis testing methods and availability may vary outside of study conditions.
Conclusion:
Identifying high-prevalence clusters is crucial for understanding the distribution of syphilis among pregnant women.
by Rogers Nsubuga, Timothy R. Muwonge, Andrew Mujugira, Barbara Castelnuvo, Edith Nakku-Joloba, Rosalind Parkes-Ratanshi, Yukari C. Manabe, Agnes N. Kiragga
