Prevalence of herpes simplex type 1 and 2 virus (HSV-1 and 2) infection is high worldwide and is highest in developing countries like Uganda. International and local health organizations have called for studies to characterize genital herpes epidemiology in sub-Saharan Africa. Population estimates are needed for policy, for planning interventions, for valid measures of the effect of interventions and for research on new therapies and potential vaccines. The overall goal of this study is to determine the burden of infection and assess the modifiable risk factors associated with Herpes simplex types 1 and 2 infection in Kampala, Uganda with an aim of prevention of spread and relief of those who suffer with genital herpes. The proposed study will aim i) To estimate the age and sex specific prevalence of Herpes simplex type 1 and 2. ii). To estimate the incidence of Herpes simplex type 1 and 2 in an inception cohort of HSV-2 negative persons in an urban population in Uganda and iii) to identify modifiable risk factors associated with Herpes simplex types 1 and 2 prevalence and incidence in this population. The proposed study will be a two-stage stratified random population sample survey of female and male participants 15 to 65 years old in Kawempe division of Kampala District. To estimate prevalence of HSV-1 and 2, a cross-sectional serological survey at baseline will be done using type specific ELISA tests for herpes simplex type 1 and 2. Incidence will be assessed in an inception cohort of HSV-2 negative persons by 6 monthly testing for HSV-2. Risk factors for genital herpes will be assessed using a standardized questionnaire to collect information on age, sociodemographic characteristics, sexual behavior, sexual partner characteristics such as age differentials, and HIV infection status. Incidence densities and relative risks will be calculated from new HSV-2 infection and risk factors that predispose to HSV-2 incidence such as age, sex, (gender), sexual behavior, and HIV infection analyzed in a Cox proportional hazards model. By conducting a population study in an urban area in a country where rural studies show high prevalence we will describe the epidemiology genital herpes, gaining new knowledge about genital herpes in urban Uganda and highlighting the modifiable risk factors which can be targeted for effective interventions.

National Institute of Health (NIH)
Fogarty International Center (FIC)
Research Project (R01)
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Special Emphasis Panel (ZRG1-ICP-2 (51))
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Liu, Xingzhu
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New Mulago Hospital
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Nakku-Joloba, Edith; Kambugu, Fred; Wasubire, Julius et al. (2014) Sero-prevalence of herpes simplex type 2 virus (HSV-2) and HIV infection in Kampala, Uganda. Afr Health Sci 14:782-9
Lingappa, J; Nakku-Joloba, E; Magaret, A et al. (2010) Sensitivity and specificity of herpes simplex virus-2 serological assays among HIV-infected and uninfected urban Ugandans. Int J STD AIDS 21:611-6