Viruela símica en un paciente con vih: reporte de caso / Monkeypox in a patient with HIV: case report

RESUMEN La viruela símica es una enfermedad zoonótica endémica en algunas zonas de África; desde mayo del 2022 se confirmaron múltiples reportes de viruela símica (VS) en países no endémicos. Se presenta el caso de un paciente con antecedente de VIH con exantemas en diversas regiones del cuerpo, con mayor concentración en la región glútea, asociado a adenopatías cervicales y proctitis infecciosa. Se procedió a la toma de la muestra de las lesiones dermatológicas para el estudio molecular de reacción en cadena de la polimerasa en tiempo real (RT-PCR), que confirmó el diagnóstico de VS. La infección por Treponema pallidum y Neisseria gonorrhoeae se identificó mediante serología y cultivo de secreción anal, respectivamente. Se aplicó tratamiento con antibióticos específicos para gonorrea y sífilis, y la VS respondió favorablemente a la terapia sintomática e inmunomoduladora.

ABSTRACT Monkeypox (Mpox) is a zoonotic disease, endemic in some areas of Africa. But since May 2022, multiple cases of Mpox have been reported in non-endemic countries. We present the case of a patient with a history of HIV, as well as rash in several areas of the body, mostly in the gluteal region, associated with cervical lymphadenopathy and infectious proctitis. Diagnosis was confirmed by real-time polymerase chain reaction (RT-PCR) of skin lesion samples. Treponema pallidum and Neisseria gonorrhoeae infection was confirmed by serology and rectal discharge culture, respectively. The patient received antibiotics specific for gonorrhea and syphilis and his condition improved due to symptomatic and immunomodulatory therapy.

Gonorrhea prevalence in adults in Brazil: Spectrum-STI trend estimation, 2000-2020

ABSTRACT Background: Gonorrhea is not a notifiable disease in Brazil, and the national health information system does not collect data on reported cases or infection prevalence. Methods: We compiled published data on gonorrhea prevalence in Brazil from cross-sectional surveys and clinical trials between 2000 and 2020. The study entry criteria included a sample size of 50 or more, and Neisseria gonorrhoeae infection detected in urine, urethral, anal, or cervicovaginal specimens using either Nucleic Acid Amplification Test or culture. Gonorrhea prevalence trends between 2000 and 2020 were generated using Spectrum-STI, a statistical trend-fitting model. Results: Forty-five studies with 59 gonorrhea prevalence data points were identified. Fifty data points were for women and represented 21,815 individuals, eight for men encompassing a total of 4,587 individuals, and one for transgender people comprising 345 individuals. The Spectrum-STI estimate for the prevalence of urogenital infection with gonorrhea in women 15-49 in 2020 was 0.63% (95% confidence interval (CI): 0.13-2.23) and was lower than the 1.05% estimated value for 2000 (95% CI: 0.36-2.79). The corresponding figures for men were 0.70% (95% CI: 0.16-2.44) and 1.14% (95% CI: 0.34-3.15). Anal prevalence estimates could not be generated because of insufficient data (three data points). Conclusions: These results suggest that the overall prevalence of genitourinary gonococcal infections in Brazil is less than 1%. Data on gonorrhea prevalence in men and in populations at increased STI vulnerability are limited.

Epidemiological features of some sexually transmitted diseases among the population of Ulaanbaatar city / Монголын Анагаах Ухаан

Introduction@#According to the World Health Organization (WHO), more than a million cases of sexually transmitted diseases (STDs) are registered in the world every day. Our country is among the countries with a concentrated spread of HIV infection among the population at risk According to the WHO classification. Although Mongolia is one of the countries with a low prevalence of HIV/AIDS, it is considered to a country with a high risk of STD caused from the location in the middle of the two countries where the HIV infection is spreading as fastest, thus it is important to study.@*Purpose@#The aim is to study the epidemiology of sexually transmitted diseases in the population of Ulaanbaatar.@*Material and Method@#The study was conducted using a single-moment descriptive research design. The following information was obtained from the statistics of the Health Development Center. Including as following: </br>• Annual indicators of the disease: Statistical data of sexually transmitted diseases between 2017- 2021 (Ulaanbaatar city) </br>• Annual indicators of the disease: 2017-2021 statistical data on the state of sexually transmitted diseases (city average and provincial average)@*Result@#Considering the prevalence rate of sexually transmitted infections per 10,000 population by age group, as of 2017-2021, the population aged 20-39 had the highest rate of infection with 9.4-154.2 cases, and in 2018, the population aged 30-39 had 146.2 cases was the highest. In terms of the source of infection, 83.1 percent of the total cases in 2017-2021 were sexually transmitted.</br> Comparing the prevalence of sexually transmitted infections in the population of Ulaanbaatar by location and the number of cases per 10,000 population, as of 2017-2021, Bagakhangai district had more cases in 2017 and 2019, and Sukhbaatar district had 221.4 cases in 2018, which was the highest in the 5-year period, Nalaikh district recorded 64.7 cases in 2020 and 48.4 in 2021, which was the district with the highest number of cases in these years.</br> In terms of education, people with secondary education or below accounted for 94.1 percent of all cases in the 5-year average.</br> About the marriage status, 35.9 percent of all cases registered in 2017 were never married, and 53.5 percent were married. As of 2018-2021, there has been no significant increase or decrease in this indicator.@*Conclusion@#</br>1. During 2017-2021, the cases of sexually transmitted infections (syphilis, gonorrhea, trichomoniasis) per 10,000 population was in 2018, the incidence of infection decreased by 2.7 cases, in 2019 it increased by 7 cases, and in 2020 it decreased by 2.2 cases, in 2021, it decreased by 18.3 cases from the previous year, and it is believed that sexually transmitted diseases are expected to decrease in the future. </br>2. The average rate of syphilis infection (2017-2021) per 10,000 population in Ulaanbaatar was 4.4 cases higher than the average of the provinces, the average of 4.1 cases of gonorrhea infection is likely to increase, and the average of trichomoniasis was 13.4 cases or was equal to average of the provinces and Ulaanbaatar. The problem affecting the incidence of sexually transmitted diseases is related to the level of education of the citizens. 9 out of 10 people have completed secondary education or less.

Enfermedad gonocócica diseminada: Reporte de caso

Introducción: La infección por Neisseria gonorrhoeae (NG) es la segunda causa enfermedad de transmisión sexual (ETS), con una incidencia en aumento, altas tasas de resistencia antibiótica y con su mayor presentación a nivel genital. Su presentación con bacteriemia es menor del 3 %, con limitante en su diagnóstico por su bajo rendimiento. Por lo anterior reportamos el caso. Presentación caso: Hombre de 60 años con antecedente de diabetes mellitus, quien ingresa por cuadro poliarticular con sinovitis, asociado a un síndrome febril, sin otro hallazgo al examen físico. Se documenta bacteriemia por NG, con nexo temporal con relación sexual previa. Se indica tratamiento antibiótico según antibiograma con profilaxis a pareja. Paciente egresa sin ninguna complicación. Conclusión : La diseminación hemática por NG es una condición rara, con síntomas iniciales muy inespecíficos, con bajo rendimiento de pruebas diagnósticas en esta condición, por lo cual requiere alta sospecha clínica y cobra gran importancia una historia clínica muy detallada. Como en nuestro caso, los síntomas inespecíficos condicionaron a descartar otras condiciones hasta el aislamiento en hemocultivos lleva a diagnósticos definitivo. Es un caso con presentación clínica inusual.

Introduction: Infection by Neisseria gonorrhoeae (NG) is the second cause of sexually transmitted disease (ETS), with an increasing incidence, high rates of antibiotic resistance and with its greatest presentation at the genital level. Its presentation with bacteriemia is less than 3%, limiting its diagnosis due to its low performance. Therefore, we report the case. Case presentation: 60-year-old man with a history of diabetes mellitus, who was admitted due to polyarticular symptoms with synovitis, associated with a febrile syndrome, with no other finding on physical examination. Bacteremia due to Neisseria gonorrhoeae is documented, with a temporal link with previous sexual intercourse. Antibiotic treatment is indicated according to antibiogram with partner prophylaxis. Patient is discharged without any complications. Conclusion: Hematic dissemination by NG is a rare condition, with very non-specific initial symptoms, with low performance of diagnostic tests in this condition, which requires high clinical suspicion, and a very detailed clinical history is of great importance. As in our case, nonspecific symptoms led to ruling out other conditions until isolation in blood cultures leads to a definitive diagnosis. It is a case with unusual clinical presentation

Gonococcal infections of the penile skin and accessory glands in men: high-frequency ultrasound features and their clinical significance / 中华皮肤科杂志

Objective:To investigate ultrasonographic manifestations of gonococcal infections of the penile skin and accessory glands in men, and to assess their clinical significance.Methods:From January 2014 to January 2021, male patients with gonococcal infections of the penile skin and accessory glands were collected from Department of Dermatology, Changshu No.1 People′s Hospital. The diagnosis had been confirmed by laboratory examinations, and these patients had not received relevant treatment. The real-time ultrasound imaging system SIEMENS ACUSON X300 was used to examine the penile skin and accessory gland lesions infected with Neisseria gonorrhoeae, with the probe frequency ranging from 7.5 to 15 MHz. Patients with tubular anechoic fluid-filled areas on the high-frequency ultrasound images received a single dose of intramuscular ceftriaxone (1 g) ; those with oval-shaped anechoic fluid-filled areas on the high-frequency ultrasound images received incision and drainage followed by intramuscular injection of ceftriaxone at a dose of 1 g once a day for 5 consecutive days; those with hypoechoic or mixed echoic areas on the high-frequency ultrasound images received intramuscular injection of ceftriaxone at a dose of 1 g once a day for 5 consecutive days, and if the nodules did not regress after 1-month treatment, local resection would be performed. One month after the treatment, the patients were followed up, and the efficacy was evaluated. Results:A total of 32 male patients with gonococcal infections of the penile skin and accessory glands were collected. They were aged 28.54 ± 3.27 years, all had a history of non-marital sexual contact, and the duration from non-marital sexual contact to the onset of symptoms was 4.45 ± 1.03 days. The disease course was 8.64 ± 1.87 days. Lesions were all solitary, and located at the external urethral meatus in 16 cases (50.00%) , at the glans penis in 7 cases (21.88%) , beside the foreskin frenulum in 5 cases (15.62%) , and at the penile raphe in 4 cases (12.50%) . Sixteen patients (50.00%) presented with sinus-like lesions, 9 (28.13%) with abscesses, 7 (21.87%) with nodules, and all had tenderness on palpation. High-frequency ultrasound examination showed tubular anechoic fluid-filled areas in 16 cases (50.00%) , oval-shaped anechoic fluid-filled areas in 7 cases (21.88%) , hypoechoic areas in 5 cases (15.62%) , and mixed echoic areas in 4 cases (12.50%) . Gonococcal infections involved the cavernous body of the urethra in 16 cases (50.00%) , cavernous body of the penis in 5 cases (15.62%) , and subcutaneous tissue of the penis in 11 cases (34.38%) . After the treatment, all the patients were cured.Conclusion:High-frequency ultrasound can be used in the assessment of skin lesions and selection of treatment regimens for male patients with gonococcal infections of the penile skin and accessory glands.

Epidemiological characteristics analysis and incidence trend prediction of gonorrhea in Hubei Province in 2010-2021 / 公共卫生与预防医学

Objective To analyze the epidemiological characteristics and incidence trend of gonorrhea in Hubei Province, and to provide reference for scientific formulation of prevention and control measures. Methods Based on the surveillance data of gonorrhea from 2010 to 2021, three-way distribution and ARIMA model were used for data analysis and incidence prediction. Results From 2010 to 2021, the reported incidence rate fluctuated between 3.01/100 000-7.07/100 000, and the average annual reported incidence rate was 4.62/100 000. The reported incidence rate showed the characteristics of “first fall and then rise, and then fall and rise again”, and the peak incidence period was from June to December. The male to female ratio of reported cases was 5.78:1, and the number of reported cases in the age group of 20-39 years old accounted for 62.43% of the total number of cases. The reported cases were mainly housework and unemployed, farmers, and unknown occupation. The severity of the regional incidence was divided into 5 categories by the Q-type clustering, and the most serious category included Shennongjia Forest District, Huangshi City, and Wuhan City. The ARIMA model predicted the incidence rate to be in good agreement with the actual incidence rate, with a predicted number of 3 343 cases in 2022. Conclusion At present, gonorrhea in Hubei Province is still at a high prevalence level. There are obvious differences in gender, age, occupation, and regional distribution. The ARIMA model is suitable for predicting the incidence of gonorrhea, and it is predicted that the incidence will increase slightly in 2022.

Brazilian protocol for sexually transmitted infections, 2020: infections that cause cervicitis

Abstract Infections that cause cervicitis are a topic presented in the "Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections", published by the Brazilian Ministry of Health in 2020. The document was developed based on scientific evidence and validated in discussions with experts. This article presents epidemiological and clinical aspects of infections that cause cervicitis and recommendations on screening, diagnosis, and treatment of affected people and their sexual partnerships. Also, it discusses strategies for surveillance, prevention, and control of these infections for health professionals and health service managers involved in the programmatic and operational management of sexually transmitted infections. Expanding access to diagnostic tests and early treatment are crucial for controlling the spread of pathogens that cause cervicitis.

AIDS， syphilis and gonorrhea testing results among 385 men who have sex with men in Dehong Prefecture in 2018 / 上海预防医学

ObjectiveTo understand the infection of AIDS， syphilis， and gonorrhea in men who have sex with men （MSM）， and the factors influencing the acceptance of gonorrhea testing in Dehong Dai Jingpo Autonomous Prefecture （Dehong Prefecture）， Yunnan Province. MethodsAcross-sectional survey was conducted to describe and analyze the acceptance of AIDS， syphilis， and gonorrhea testing among MSM tracked in Dehong Prefecture in 2018. ResultsA total of 385 MSM were included in the analysis， with a 100.0% HIV and syphilis testing rate. The HIV antibody positivity rate was 10.6% （41/385） and the positivity rate of syphilis antibody was 14.8%（57/385）. Only 30.4% of the subjects were willing to test for gonorrhea， and 13.7%（16/117）of them were test positive. Further multifactorial analysis revealed that local MSM and syphilis co-infected individuals were more likely to be tested for gonorrhea （aOR=2.48， 95%CI=1.33-4.65， P=0.004； aOR=2.59， 95%CI=1.43-4.71， P=0.002）. ConclusionThe positive rates of AIDS， syphilis and gonorrhea in MSM population in Dehong Prefecture are relatively high. Integrated interventions of STD/AIDS and gonorrhoea detection should be strengthened.

AIDS， syphilis and gonorrhea testing results among 385 men who have sex with men in Dehong Prefecture in 2018 / 上海预防医学

ObjectiveTo understand the infection of AIDS， syphilis， and gonorrhea in men who have sex with men （MSM）， and the factors influencing the acceptance of gonorrhea testing in Dehong Dai Jingpo Autonomous Prefecture （Dehong Prefecture）， Yunnan Province. MethodsAcross-sectional survey was conducted to describe and analyze the acceptance of AIDS， syphilis， and gonorrhea testing among MSM tracked in Dehong Prefecture in 2018. ResultsA total of 385 MSM were included in the analysis， with a 100.0% HIV and syphilis testing rate. The HIV antibody positivity rate was 10.6% （41/385） and the positivity rate of syphilis antibody was 14.8%（57/385）. Only 30.4% of the subjects were willing to test for gonorrhea， and 13.7%（16/117）of them were test positive. Further multifactorial analysis revealed that local MSM and syphilis co-infected individuals were more likely to be tested for gonorrhea （aOR=2.48， 95%CI=1.33-4.65， P=0.004； aOR=2.59， 95%CI=1.43-4.71， P=0.002）. ConclusionThe positive rates of AIDS， syphilis and gonorrhea in MSM population in Dehong Prefecture are relatively high. Integrated interventions of STD/AIDS and gonorrhoea detection should be strengthened.

Prevalencia de Neisseria gonorrhoeae, en reclusos del Centro de Detención Preventiva de Arica / Prevalence of Neisseria gonorrhoeae, amongst inmates of the Preventive Reclusion Center in Arica

Resumen Introducción: Los/as trabajadores/as sexuales, personas con adicción a drogas, población de inicio sexual precoz y población penal son considerados los grupos de mayor riesgo de contraer infecciones de transmisión sexual (ITS). Objetivo: Determinar prevalencia de infección por Neisseria gonorrhoeae, en reclusos del Centro de Detención Preventiva (CDP) de la Región de Arica y Parinacota, Chile. Este estudio contó con la aprobación del Cómité Ético Científico de la Universidad de Tarapacá. Material y Método: Participaron 140 reclusos, que aceptaron ser parte del estudio en forma voluntaria y firmaron un consentimiento informado. Se tomó una muestra del meato uretral para pesquisa de N. gonorrhoeae y se aplicó una encuesta epidemiológica que consignó edad, consumo de drogas, hacinamiento, entre otros. Resultados: La prevalencia del agente fue de 16,4% en reclusos del CDP de Arica, resultado menor a lo reportado en otros estudios similares. Conclusiones: Conocer la realidad de la prevalencia de esta ITS y algunos factores de riesgo asociados a la situación de privación de la libertad en una zona tri-fronteriza del norte de Chile, contribuye a las propuestas de programas de prevención en esta población vulnerable y de riesgo.

Abstract Background: Sex workers, people with drug addiction, early onset of sexual activity population, and criminal population, are considered the groups most at risk of contracting sexually transmitted infections (STIs). Aim: To determine the prevalence of infection by Neisseria gonorrhoeae in inmates of the Preventive Detention Center (CDP) at Arica and Parinacota Region, Chile. The Scientific Ethical Committee of Universidad de Tarapacá approved this study. Method: 140 inmates participated, who voluntarily agreed to be part of the study and signed an informed consent. A sample of urethral meatus was taken to investigate N. gonorrhoeae, and an epidemiological survey was applied, which included age, drug use, overcrowding, among others. Results: The prevalence of the agent was 16.4% in inmates of the Arica CDP, a result lower than that reported in other similar studies. Conclusion: Knowing the reality of the prevalence of this STI and some risk factors associated with the situation of deprivation of freedom in a tri-border area of northern Chile, contributes to the proposals for prevention programs in this vulnerable and at-risk population.

Sexual behavior characteristics and influencing factors of gonorrhea patients in Yunnan Province / 中华疾病控制杂志

Objective To investigate the sexual behavior types, condom use and influencing factors of gonorrhea patients in Yunnan Province, and to provide evidence for the adjustment of sexually transmitted disease (STD) prevention and control strategy. Methods A cross-sectional study was carried out to investigate gonorrhea patients in 14 STD clinics in 7 more prevalent prefectures (cities) of Yunnan Province. A questionnaire survey was conducted to investigate the socio-demographic and sexual characteristics of the patients in a one-to-one way. Multiple Logistic regression model was used to analyze the influencing factors of sexual behavior. Results A total of 179 cases of gonorrhea were investigated. The average age was (29.01±8.93) years old. 95.53% (171/179) patients were 40 years old and 88.27% were male patients (158/179). Unmarried patients accounted for 55.31% (99/179). Service and self-employed patients accounted for 34.64% (62/179) and 23.46% (42/179) respectively. The rate of sexual intercourse with opposite sex was 98.32% (176/179), the rate of men who have sex with men was 1.68% (3/179) and the rate of having more than two sexual partners was 27.93% (50/179). The rate of sexual intercourse between temporary partners, spouses/fixed partners and commercial partners were 53.07% (95/179), 37.99% (68/179) and 8.94% (16/179) respectively. Recent sexual activity had lower condom use rate, 17.89% (17/95), 19.12% (13/68) and 18.75% (3/16) respectively. The main ways for gonorrhea patients to make temporary partners were friend introductions or gatherings, accounting for 66.32% (63/95). Condom use in male patients was worse than that in female patients (OR=0.234, 95% CI: 0.084-0.656, P=0.006). Conclusions The patients with gonorrhea were mainly unmarried young adults. The main risk behaviors were unprotected behaviors between heterosexual temporary and spouse/fixed sexual partners. The condom use consciousness was generally low. The promotion of safe sex education for young adults should be further strengthened, with special attention to the use of condoms for temporary sexual behavior and spouse/fixed sexual intercourse.

The Feature of Patients Treated with Daiobotampito, Especially About Urination, Before and During the Song Dynasty / 日本東洋医学雑誌

It is written about daiobotampito in ‘Jin Gui Yao Lue' that the patients who should be treated with the for­mula urinated smoothly. On the other hand, Kampo doctors today tend to use daiobotampito for difficulty of urination. We investigated the feature of daiobotampito in old medical textbooks, especially about “urination,” “gonorrhea,” and “intestinal abscess.” We searched old medical textbooks for daiobotampito, which were writ­ten or published before or during the Song Dynasty. In the textbooks other than ‘Jin Gui Yao Lue,' it is written that the patients urinated frequently. In the textbooks other than ‘Jin Gui Yao Lue' and ‘Ishimpo,' it is written that the patients sometimes urinated difficultly. In the old medical textbooks before or during the Song Dynasty, urination of the patients who should be treated with daiobotampito was smooth but sometimes difficult.

La búsqueda de información y su asociación con la producción científica: el ejemplo de la sífilis y la gonorrea / Information search and its association to scientific production: the example of syphilis and gonorrhea

El objetivo de este trabajo fue analizar la asociación entre la búsqueda de información sobre sífilis y gonorrea a través de Google, y la producción científica sobre estas dos infecciones de transmisión sexual. Se realizó estudio descriptivo transversal. Los datos se obtuvieron de la consulta directa, online, Google Trends y MEDLINE (vía PubMed), con el uso de los términos Syphilis y Gonorrhea. Las variables estudiadas fueron: volumen de búsqueda relativo (VBR), VBR mensual medio (VBRm), referencias (REF) y REF mensuales medias (REFm). La VBRm para el término Syphilis presentó ligera progresión creciente y ajuste exponencial (R2= 0,05; p= 0,42); Para Gonorrhea la evolución VBRm fue creciente con ajuste lineal (R2= 0,67; p< 0,01). La REFm para la producción científica sobre la Syphilis mostró un ajuste lineal creciente (R2= 0,42; p= 0,01) y para la REFm sobre la Gonorrhea fue un ajuste exponencial creciente (R2= 0,47; p= 0,01). La relación del VBRm para el término Syphilis en relación con su REFm dio una asociación escasa (R= 0,11; p= 0,69). Esta relación para la Gonorrhea mostró una significativa correlación positiva (R= 0,67; p= 0,01). Los resultados obtenidos no permitieron obtener una conclusión firme que contestara el objetivo de este trabajo. A partir de ahora, con un mayor seguimiento, se podrán obtener resultados que confirmen, o no, la asociación entre la búsqueda de información y la producción científica sobre los temas relacionados con la salud(AU)

The purpose of the study was to analyze the association between information search about syphilis and gonorrhea in Google, and the scientific production about these two sexually transmitted infections. A descriptive cross-sectional study was conducted. Data were obtained by direct online consultation of Google Trends and MEDLINE (via PubMed) using the search terms syphilis and gonorrhea. The variables analyzed were relative search volume (RSV), mean monthly RSV (RSVm), references (REF) and mean monthly REF (REFm). The RSVm for the term syphilis showed slight increasing progression and exponential adjustment (R2= 0.05; p= 0.42); while for gonorrhea the RSVm evolution was increasing with linear adjustment (R2= 0.67; p< 0.01). The REFm for the scientific production about syphilis displayed increasing linear adjustment (R2= 0.42; p= 0.01), whereas the REFm for gonorrhea showed increasing exponential adjustment (R2= 0.47; p= 0.01). The association of the RSVm for the term syphilis with its REFm was scant (R= 0.11; p= 0.69), while the term gonorrhea exhibited a significant positive correlation (R= 0.67; p= 0.01). The results obtained were not sufficient to reach a definitive conclusion in response to the aim of the study. From this moment onwards, with greater follow-up, further results may be obtained which will either confirm or disprove the association between information search and scientific production about health topics(AU)

Prevalence and Risk Factors of Sexually Transmitted Infections in Selected Health Facilities in Southwest Region of Cameroon

Background:Gonorrhoea and Syphilis are common STIs,particularly among the reproductive age group in most developing countries. Their control is important considering the high incidence of acute infections, complications and their socioeconomic impact and a means of effecting control measures against Human Immunodeficiency Virus (HIV). Knowledge of the prevalence and risk factors of these infections in a student residential area will enable development of better strategies for STI control.Methods:A health facility based historical study design was conducted where laboratory records of patients screened for Syphilis and/or Gonorrhea and HIV in selected Primary Health Care (PHC)Original Research Article facilities in Buea Health District (BHD) between 2010 and 2015 were reviewed. Data analysis was done using EPI Info version 3.5.4. with a level of error set at 5%.Results:A total of 1106 records were reviewed. Majority 472(42.7%) were between 21-30 years old, while 923(83.4%) were females. A significant proportion 78 (8.1%) were HIV positive. The prevalence of the both STIs was highest in 2015. The prevalence of gonorrhoea was 12.9% and that of syphilis was 16.9%. The odds of testing positive for syphilis for female compared to males was 0.33 (95% CI: 0.18-0.62); p-value of 0.001, while that for gonorrhoea was 0.22 (95%CI: 0.11, 0.44); p-value of 0.0001. Patients between 21 and 30 years were 2.46 times as likely to be syphilis positive compared to those below 21. Compared to those tested positive, patients who were negative for were 3.33 (95%CI 1.66-6.69) times as likely to test negative for HIV (p value of 0.001).Conclusion:The study revealed a high prevalence of gonorrhoeaand syphilis. Although these infections have similar risk factors, there are distributed differently in the sexually active student residential area. This thus calls for the implementation of targeted screening and to revise control measures for STIs in the population

Prevalence and antimicrobial susceptibility patterns of Neisseria gonorrhea among the Symptomatic Patients attending Outpatient Department in Lyatonde District Hospital Southwestern Uganda

Background:Neisseria gonorrhea is one of the neglected diseases of public health importance causing symptomatic, suppurativedischarge in males and being asymptomatic in females. This cross-sectional study was aimed at determining the prevalence and susceptibility pattern of Neisseria gonorrheato the commonly used antibiotics among symptomatic patients attending outpatient department in Lyatonde district hospital. Methods:Urethral and endocervical swabs were collected by the attending medical laboratory technologists. The presence of gonorrhea was confirmed by culture, Gram staining and biochemical tests. Antimicrobial sensitivity test was performed using the disc diffusion method and the result was interpreted using the National Committee for Clinical Laboratory Standards guidelines.Results:Overall prevalence of N. gonorrheawas 4.9% with high prevalence rates of 7.7% among the young age group of 15-25 years. Low level of antimicrobial susceptibility to cefuroxime (50%) followed by erythromycin and gentamycin both at 25% was observed. An alarming resistance to ceftriaxone and ciprofloxacin at 100% followed by penicillin 75% was exhibited by the colonies.Conclusions:The high resistant rate to ceftriaxone and ciprofloxacin obviates their use as the first line of syndromic treatment of gonorrhea in SouthwesternUganda. The use of laboratory culture for diagnosis and management of N. gonorrhea, especially with cefuroxime therapy is highly recommended

A meningococcal B vaccine induces cross-protection against gonorrhea

PURPOSE: Neisseria meningitidis and Neisseria gonorrhoeae share between 80% and 90% of their genetic sequence. Meningococcal serogroup B vaccines based on outer membrane vesicles—such as VA-MENGOC-BC—could cross-protect against gonorrhea. The aim of this study was to analyze the incidence rates of gonorrhea and other sexually transmitted diseases with respect to the use of the VA-MENGOC-BC vaccine. MATERIALS AND METHODS: Health statistics between 1970 and 2017 were reviewed and the incidence of meningococcal disease and sexually transmitted diseases (gonorrhea, syphilis, condyloma acuminatum, hepatitis B and human immunodeficiency virus infection) were analyzed during the pre- and post-vaccination periods. Gonorrhea incidence was also analyzed by age groups. RESULTS: VA-MENGOC-BC was successfully used to control a meningococcal epidemic in Cuba. The strategy to combat the epidemic was carried out in two stages. The first one was a nationwide mass-vaccination campaign from 1989 to 1990, targeting the population at highest-risk aged 3 months to 24 years. During the second stage, begun in 1991, it was included in the Expanded Immunization Program. Gonorrhea incidence increased from 1970 to 1989. However, after the VA-MENGOC-BC massive vaccination campaign a sharp decrease of gonorrhea incidence was observed. It lasted between 1989 and 1993. A second incidence peak was detected in 1995, but it dropped again. Data clearly show a decline in the incidence of gonorrhea following massive vaccination, in contrast with other sexually transmitted diseases. Incidence rates in unvaccinated age groups also decreased, probably due to herd immunity. CONCLUSION: There is evidence that VA-MENGOC-BC could induce a moderate protection against gonorrhea.

Informe Anual 2016 Situación epidemiológica de gonorrea (CIE 10: A54) / Anual Report Epidemiology of gonorrohea (CIE 10: A54)

Resumen La gonorrea producida por Neisseria gonorrhoeae, es capaz de infectar diferentes tipos de mucosas dependiendo de las prácticas sexuales. Se ubica de preferencia en la uretra del hombre y en el cuello uterino de la mujer, también en el recto y la faringe. Su principal forma de transmisión es por relaciones sexuales no protegidas y, ocasionalmente, a través del conducto del parto en los recién nacidos. Este informe presenta la situación epidemiológica de la gonorrea hasta el año 2016 en Chile. Se realizó un análisis descriptivo de los casos que ingresaron a la vigilancia. Desde el año 2000, se observa una tendencia progresiva a la disminución de las tasas de gonorrea; sin embargo, en el año 2015 y 2016 se produjo un aumento de la tasa con relación al año 2014. En el año 2016 se presentaron 2.039 casos, lo que representa un incremento de 38% con respecto a la mediana del quinquenio anterior (1.473 casos). En relación con la edad de los casos, el mayor riesgo se encontró en el grupo de 15 a 24 años, destacándose que, a partir del año 2013, la tasa del grupo de 15 a 19 años superó al grupo de 25 a 29 años. Según distribución geográfica, las mayores tasas de notificación se presentaron en las regiones del extremo norte y sur del país, siendo las de mayor riesgo las regiones de Tarapacá, Antofagasta, Los Lagos y Aysén.

Gonorrhea is produced by the bacterium Neisseria gonorrhoeae, which is capable of infecting different types of mucous membranes depending on sexual practices. It is located preferably in the man's urethra and in the woman's cervix, also in the rectum and pharynx. Its main form of transmission is through unprotected sex and, occasionally, through the birth canal in newborns. This report presents the epidemiological situation of gonorrhea until 2016 in Chile. A descriptive analysis of the cases that entered the surveillance was carried out. Since 2000, there has been a progressive trend towards decreasing gonorrhea rates; However, in 2015 and 2016 there was an increase in the rate in relation to 2014. In 2016, 2,039 cases were presented, representing an increase of 38% with respect to the median of the previous five-year period (1,473 cases). Regarding the age of the cases, the greatest risk was found in the group of 15 to 24 years, highlighting that, as of 2013, the group rate of 15 to 19 years exceeded the group of 25 to 29 years. According to geographical distribution, the highest reporting rates were in the regions of the extreme north and south of the country, with the highest risk regions being Tarapacá, Antofagasta, Los Lagos and Aysén.

Resistência de Neisseria gonorrhoeae a antimicrobianos na prática clínica: como está o Brasil? / Antimicrobials resistance of Neisseria gonorrhoeae in clinical practice: where Brazil stands?

Estima-se que um milhão de infecções sexualmente transmissíveis (IST) sejam adquiridas por dia no mundo, segundo a Organização Mundial da Saúde. Elas podem ser causadas por diversos micro-organismos pelo contato sexual. Embora tratáveis, as infecções, como a clamidiana, sífilis, tricomoníase e gonorreia, são responsáveis por 350 milhões de novos casos de IST anualmente no mundo. A gonorreia é a segunda IST bacteriana mais prevalente no planeta e tem chamado atenção nos últimos anos em decorrência da baixa eficácia em seu tratamento. O agente etiológico é a Neisseria gonorrhoeae. Na maioria das mulheres, a infecção por esse micro-organismo é assintomática, dificultando ainda mais seu diagnóstico e tratamento e, portanto, aumentando o risco de desenvolvimento de suas complicações associadas. Mesmo quando diagnosticada, essa infecção está sujeita a um alto índice de insucesso terapêutico que se deve, principalmente, à grande plasticidade genética da N. gonorrhoeae para aquisição de genes cromossômicos ou plasmidiais de resistência. O aumento da resistência desse micro-organismo a antimicrobianos comumente utilizados no tratamento, como penicilina, tetraciclina e ciprofloxacina, tem sido relatado em diversos países. No Brasil, poucos estudos estão disponíveis, mas em alguns estados já foram relatadas linhagens resistentes à ciprofloxacina. Dessa forma, deve-se ressaltar a importância de novos estudos que visem descrever o perfil da resistência da N. gonorrhoeae a antimicrobianos. Tais achados certamente nortearão a implementação de sistemas de vigilância epidemiológica no país visto que, até o momento, as infecções por N. gonorrhoeae sequer estão incluídas na lista nacional de doenças e agravos de notificação compulsória.(AU)

According to the World Health Organization, approximately one million sexually transmitted infections (STI) are acquired daily in the world. These infections can be caused by several microorganisms via contact. The treatable STI, such as chlamydia, syphilis, trichomoniasis and gonorrhea, account for 350 million new cases of STI each year worldwide. Gonorrhoea is caused by Neisseria gonorrhoeae and is the second most common bacterial STI in the world. It has drawn more attention in the last years due to the low efficacy in its treatment. Most women with this infection are asymptomatic, which makes its diagnosis and treatment troublesome increasing the risk for its associated complications. Even when diagnosed, this infection is subject to a high rate of therapeutic failure mainly due to the great genetic plasticity of N. gonorrhoeae for the acquisition of chromosomal or resistance plasmid enes. Increased resistance of this microorganism to antimicrobials commonly used in treatment such as penicillin, tetracycline and ciprofloxacin has been reported in several countries. In Brazil, few studies are available, but in some states strains resistant to ciprofloxacin were alreadyreported. The refore, it is important to highlight the importance of new studies aimed at describing the resistance profile of N. gonorrhoeae to antimicrobials in Brazil context. These findings will certainly guide the implementation of epidemiological surveillance systems in the country, since until now N. gonorrhoeae infections do not figure into the national list of compulsorily notifiable diseases.(AU)

Prevalence and incidence estimates for syphilis, chlamydia, gonorrhea, and congenital syphilis in Colombia, 1995-2016 / Estimaciones sobre la prevalencia y la incidencia de sífilis, clamidiasis, gonorrea y sífilis congénita en Colombia, 1995-2016 / Estimativas da incidência e prevalência de sífilis, clamídia, gonorreia e sífilis congênita na Colômbia, 1995-2016

ABSTRACT Objectives To estimate adult (15-49 years old) prevalence and incidence of active syphilis, gonorrhea, and chlamydia, and incidence of congenital syphilis (CS) and adverse birth outcomes (ABOs) in Colombia, over 1995-2016. Methods The Spectrum-STI epidemiological model tool estimated gonorrhea and chlamydia prevalences as moving averages across prevalences observed in representative general population surveys. For adult syphilis, Spectrum-STI applied segmented polynomial regression through prevalence data from antenatal care (ANC) surveys, routine ANC-based screening, and general population surveys. CS cases and ABOs were estimated from Spectrum's maternal syphilis estimates and proportions of women screened and treated for syphilis, applying World Health Organization case definitions and risk probabilities. Results The Spectrum model estimated prevalences in 2016 of 0.70% (95% confidence interval (CI): 0.15%-1.9%) in women and 0.60% (0.1%-1.9%) in men for gonorrhea and of 9.2% (4.4%-15.4%) in women and 7.4% (3.5%-14.7%) in men for chlamydia, without evidence for trends over 1995-2016. The prevalence of active syphilis in 2016 was 1.25% (1.22-1.29%) in women and 1.25% (1.1%-1.4%) in men, decreasing from 2.6% (2.1%-3.2%) in women in 1995. Corresponding CS cases in 2016 (including cases without clinical symptoms) totaled 3 851, of which 2 245 were ABOs. Annual CS and ABO estimates decreased over 2008-2016, reflecting decreasing maternal prevalence and increasing cases averted through ANC-based screening and treatment. Conclusions The available surveillance and monitoring data synthesized in Spectrum-STI— and the resulting first-ever national STI estimates for Colombia—highlighted Colombia's persistently high STI burden. Adult syphilis and congenital syphilis are estimated to be falling, reflecting improving screening efforts. Strengthened surveillance, including with periodic screening in low-risk populations and future refined Spectrum estimations, should support planning and implementation of STI prevention and control, including CS elimination.

resumen está disponible en el texto completo

RESUMO Objetivos Estimar a incidência e a prevalência na população adulta (com idade de 15-49 anos) de sífilis ativa, gonorreia e clamídia e a incidência de sífilis congênita (SC) e desfechos adversos congênitos na Colômbia no período de 1995 a 2016. Métodos O modelo epidemiológico Spectrum-STI foi o instrumento usado para estimar a prevalência de gonorreia e clamídia como médias móveis nas prevalências observadas em pesquisas representativas da população geral. A sífilis em adultos foi estimada com a regressão polinomial segmentada aplicada ao modelo Spectrum-STI com dados de prevalência obtidos de pesquisas da atenção pré-natal, exames pré-natais de rotina de detecção precoce e pesquisas da população geral. Casos de SC e desfechos adversos congênitos foram estimados a partir das estimativas de sífilis materna do modelo Spectrum e percentuais de mulheres que fizeram testes de detecção e foram tratadas para sífilis, segundo as definições de casos da Organização Mundial da Saúde (OMS) e probabilidades de risco. Resultados O modelo Spectrum estimou, para 2016, uma prevalência de gonorreia de 0,70% (intervalo de confiança de 95% [IC 95%] 0,15%-1,9%) no sexo feminino e 0,60% (0,1%-1,9%) no sexo masculino e uma prevalência de clamídia de 9,2% (4,4%-15,4%) no sexo feminino e 7,4% (3,5%-14.7%) no sexo masculino, sem evidência de tendências no período 1995-2016. A prevalência de sífilis ativa em 2016 foi de 1,25% (1,22-1,29%) no sexo feminino e 1,25% (1,1%-1,4%) no sexo masculino, demonstrando um declínio da prevalência de 2,6% (2,1%-3,2%) observada em 1995 para o sexo feminino. Houve, ao todo, 3.851 casos correspondentes de SC em 2016 (incluindo casos assintomáticos), dos quais 2.245 foram desfechos adversos congênitos. Observou-se uma redução nas estimativas anuais de SC e desfechos adversos congênitos em 2008-2016, refletindo a diminuição da prevalência materna e o número crescente de casos evitados com exames pré-natais de detecção e tratamento. Conclusões Os dados disponíveis de vigilância e monitoramento condensados no modelo Spectrum-STI, e as resultantes estimativas nacionais de infeções sexualmente transmissíveis (IST) obtidas pela primeira vez na Colômbia, evidenciam a alta carga persistente de IST no país. Estima-se que a ocorrência de sífilis do adulto e sífilis congênita esteja diminuindo em decorrência da melhoria nos esforços de detecção precoce. A vigilância reforçada, consistindo também de exames periódicos de detecção precoce nas populações de baixo risco e estimavas futuras aprimoradas do instrumento Spectrum, deve sustentar o planejamento e a implementação de controle e prevenção de IST e a eliminação da SC.

Diagnosis and treatment of Neisseria gonorrhoeae, Chlamydia trachomatis and Mycoplasma infections in female genital tract / 中华检验医学杂志

Neisseria gonorrhoeae, Chlamydia trachomatis and Mycoplasma are common in female genital tract infections,which are associated with urethritis,cervicitis,pelvic inflammatory disease,ectopic pregnancy,infertility,chronic pelvic pain and perinatal infections.They can cause the infectious diseases asymptomatically,which would be easily neglected.Nucleic acid amplification test(NAAT)can provide an accurate diagnosis for these diseases,and qualified laboratories should be suggested to develop the project. Appropriate sensitive antibiotics and sex partners participation are essential for treatment.Noticeably, asymptomatic carrier should be differentiated during the treatment of Mycoplasma infections.It should increase awareness of these infectious diseases,in order to reduce the harm caused by misdiagnosis.(Chin J Lab Med,2018,41:263-266)