Sexually transmitted diseases in the history of Uganda

Abstract

First noticed in Uganda in 1863 by a European explorer, sexually transmitted diseases (STDs) were cited as a major cause of morbidity and mortality throughout this century. In 1908 the venereal diseases campaign was launched marking the real introduction of western medicine. By the mid-1920s, the campaign was combined with the medical service but throughout the colonial period (1901-1962) venereal diseases were considered intractable. A 1991 survey revealed alarming incidence rates and in light of the importance of STDs as a co-factor in the transmission of HIV, it is of paramount importance to implement more effective control measures.

PIP: Sexually transmitted diseases (STDs) were first noticed in Uganda in 1863 and have been a major cause of morbidity and mortality throughout this century. By the mid-1920s, the venereal diseases campaign introducing Western medicine was combined with the medical service, but throughout the colonial period (1901-1962) venereal diseases were considered intractable. A 1991 survey revealed alarming incidence rates. A recent retrospective study of sexually transmitted diseases over the period 1986-1990 at 9 sentinel sites (hospitals located along the major east-west trade axis) revealed that in some hospitals they accounted for 16% of all admissions. Testing for syphilis antibody during the National Serosurvey for HIV in 1988 revealed that 17.5% of random specimens were antibody positive. The Serosurvey also discovered that in some areas of Uganda 15-30% of those infected with HIV had a history of genital ulcer disease within the past 5 years; for example, 30% of the outpatients at Mulago's sexually transmitted diseases clinic present with genital ulcers. A most disturbing discovery is the fact that well over 90% of gonorrhea in Uganda is resistant to penicillin. AIDS had first been noticed by many practitioners during 1981-1982, and by 1985 it was declared to be epidemic. Many epidemiologists believe that AIDS was perhaps introduced by 45,000 Tanzanian soldiers during their occupation of the country in 1979 and 1980. However, the long history of high incidence of other STDs combined with the fact that treatment never eliminated venereal diseases, better explain the wildfire spread of HIV. By June 1991, it was estimated that nearly 1.5 million Ugandans were infected with HIV, and that in some urban hospitals, like Mulago, about 40% of beds were occupied by patients with AIDS or AIDS-related illnesses. In light of the importance of STDs as a cofactor in the transmission of HIV, it is of paramount importance to implement more effective control measures.