Distribución de virus de papiloma humano de alto riesgo oncogénico y otras infecciones de transmisión sexual en mujeres paraguayas con y sin virus de la inmunodeficiencia humana

El virus de papiloma humano de alto riesgo oncogénico (VPH-AR) es causa necesaria pero no suficiente para la ocurrencia de cáncer de cuello uterino (CCU). Mujeres portadoras del virus de inmunodeficiencia humana (VIH) presentan mayor riesgo de desarrollar lesiones precursoras del cáncer de cuello de útero, por ello, el objetivo del presente trabajo prospectivo de corte transversal fue determinar la frecuencia de VPH-AR y otras infecciones de transmisión sexual-ITS (condilomas, sífilis, virus del herpes simple, gonorrea, citomegalovirus, hepatitis B) en 218 mujeres con y sin VIH que acudieron al Programa Nacional de Lucha contra el SIDA (PRONASIDA) desde julio 2017 hasta marzo 2021. Se encontró que 16/54 (29,6%) mujeres VIH-positivas presentaron infección por VPH-AR en comparación a 41/164 (25%) mujeres VIH-negativas (p>0,05). En relación a la edad, mujeres VIH positivas presentaron una frecuencia comparable de infección por VPH-AR (30 años 30,2%), a diferencia de mujeres VIH negativas donde hubo una disminución significativa de la infección por VPH-AR luego de los 30 años (30 años 18,8%, p= 0,028). Esto podría explicarse por la inmunosupresión observada en mujeres VIH positivas que podría favorecer infecciones persistentes, sugiriendo que deben ser controladas más cercanamente. Además, se observó mayor frecuencia de otras ITS en mujeres VIH positivas (29,6% vs 15,8%, p=0,026), lo cual sugiere que aparte del monitoreo más cercano, es fundamental fortalecer la educación sobre factores de riesgo para la ITS sobre todo VPH y VIH, así como la realización de prevención primaria por vacunación contra el VPH.

High-risk human papillomavirus (HPV-HR) is a necessary but not sufficient cause for cervical cancer (CC). Women carriers of human immunodeficiency virus (HIV) present an increased risk for the development of cervical cancer precursor lesions, therefore, the objective of the present prospective cross-sectional study was to determine the frequency of HPV-HR and other sexually transmitted infections-STIs (condylomas, syphilis, herpes simplex virus, gonorrhoea, cytomegalovirus, hepatitis B) in 218 women with and without HIV who attended the Ministry of Health from July 2017 to March 2021. It was found that 16/54 (29.6%) HIV-positive women had HPV infection compared to 41/164 (25%) HIV-negative women (p>0.05). In relation to age, HIV-positive women had a comparable frequency of HPV infection (30 years 30.2%), unlike HIV-negative women whom above 30 years of age presented a significant decrease in HPV-AR infection (30 years 18.8%, p:0.028). This could be explained by the immunosuppression observed in HIV-positive women which could favour persistent infections, suggesting that they should be controlled more closely. In addition, other STIs were observed to be more frequent in HIV-positive women (29.6% vs 15.8%, p:0.026), which suggests that apart from closer monitoring, it is essential to strengthen education on risk factors for STIs, especially HPV and HIV, as well as the implementation of primary prevention by vaccination against HPV.

Epidemiological characteristics of sexually transmitted diseases from 2005 to 2017 in Mengla County， Yunnan Province / 上海预防医学

Objective:To determine the epidemiological characteristics and incidence trends of sexually transmitted diseases （STD） in Mengla County of Yunnan Province， and provide evidence for future prevention and control of STD. Methods:STD case information from 2005 to 2017 was extracted from the National Notifiable Infectious Disease Report Information System. Data were collected by year and disease type，and the incidence rate， epidemic characteristics and suspicious contact history of STD were statistically analyzed. Results:A total of 1 251 STD cases were reported in Mengla county from 2005 to 2017， including 490 gonorrhea， 483 syphilis， 216 condyloma acuminatum， 16 genital chlamydial infection and 46 genital herpes. The average annual incidence of STD was 35.57/100 000. The majority of STD cases were 20-29 years old （n=541，43.25%）， married （n=603，48.20%）， Han people （n=638，50.10%）， with education of middle school （n=536，42.85%）， and occupation of farmers （n=702， 56.12%）. The 42.61% of STD cases had non-marital sexual contact history， in which the proportion was significantly higher among male （55.05%） than female （28.98%）. In addition， the proportion of non-marital sex among STD cases increased gradually by year and significantly differed. Conclusion:The epidemic status of STD in Mengla county is relatively low. However， STD incidence increased gradually by year， which warrants more and specific measures on the STD control and prevention.

A surveillance model for sexually transmitted infections in India.

The strategy for prevention and control of sexually transmitted infections (STIs) in India is based on syndromic case management delivered through designated STI/reproductive tract infection (RTI) centers (DSRCs) situated in medical colleges, district hospitals, and STI-clinics of targeted interventions programs. Laboratory tests for enhanced syndromic management are available at some sites. To ensure country-level planning and effective local implementation of STI services, reliable and consistent epidemiologic information is required on the distribution of STI cases, rate and trends of newly acquired infections, and STI prevalence in specific population groups. The present STI management information system is inadequate to meet these requirements because it is based on syndromic data and limited laboratory investigations on STIs reported passively by DSRCs and laboratories. Geographically representative information on the etiology of STI syndromes and antimicrobial susceptibility of STI pathogens although essential for optimizing available treatment options, is deficient. Surveillance must provide high quality information on: (a) prevalence of STIs such as syphilis, trichomoniasis, gonorrhea, and chlamydia among high-risk groups; syphilis in the general population and pregnant antenatal women; (b) demographic characteristics such as age, sex, new/recurrent episode, and type of syndromically diagnosed STI cases; (c) proportion of acute infections such as urethral discharge (UD) in men and nonherpetic genital ulcer disease (GUD) in men and women; (d) etiology of STI syndromes; and (e) gonococcal antimicrobial susceptibility. We describe here a framework for an STI sentinel surveillance system in India, building on the existing STI reporting systems and infrastructure, an overview of the components of the proposed surveillance system, and operational challenges in its implementation.

Analisis of External Quality Assessment of Neisseria Gonorrhoeae Identification and Validation in STD Laboratories of Zhuhai Area / 现代检验医学杂志

Objective To recognize the ability to identify and validate N .gonorrhoeae in Zhuhai STD laboratories to timely find out the factors or problems influencing the results.Methods Samples were uniformly delivered to STD laboratories in 2011~2014.The laboratories identified and validated N .gonorrhoeae and PPNG.Test results were analyzed and evaluation results were fed back to participating laboratories.Results 220 samples were delivered to STD laboratories in four years. The average percentage of qualified labs was 88.6% (39/44).The coincidence rates for N .gonorrhoeae quality control sam-ples respectively were 78.8% (26/33),90.3% (28/31),87.9% (29/33)and 100% (33/33)in 2011 ~ 2014.The coinci-dence rates for PPNG respectively were 80.8% (21/26),78.6% (22/28),86.2% (25/29)and 100% (33/33).Conclusion Through the construction of STD standardization laboratory and the external quality assessment every year,the STD labora-tories of Zhuhai area improved the ability to validate and identify N .gonorrhoeae obviously.But several laboratories had some problem,such as careless technicians and inaccurate reports.So quality control should be still strengthened.

Mulheres monogâmicas e suas percepções quanto à vulnerabilidade a DST/HIV/aids / Monogamic women and their perceptions about their vulnerability to DST/HIV/aids

Introdução: o HIV/aids é considerado uma epidemia mundial e atualmente segue quatro tendências: heterossexualização, interiorização, pauperização e feminização. A mulher está especialmente vulnerável a esta epidemia, considerando suas características biológicas e anatômicas específicas, além da pressão exercida pelos parceiros, levando-as a ter um poder de escolha e de tomada de decisão nas relações afetivo-sexuais e reprodutivas, submetendo-se conscientemente a situações de risco para aquisição das DST/HIV/aids. Objetivo: verificar a porcentagem de DST/HIV/aids em mulheres monogâmicas, conhecer as percepções destas quanto à vulnerabilidade aos mesmos agravos e identificar fatores protetores às DST/HIV/aids no grupo estudado. Métodos: estudo transversal, descritivo-exploratório, realizado com 27 mulheres, em abril e maio de 2008, no ambulatório de DST/HIV/aids de um hospitaluniversitário de Fortaleza - CE. Resultados: vinte e quatro (88,9%) mulheres encontravam-se na fase reprodutiva (21 a 49 anos); 16 (59,3%) tinham o ensino médio; e 14 (51,9%) não tinham renda própria, dependendo financeiramente dos seus parceiros. Sete (26,0%) não detinham conhecimento sobre as formas de transmissão das DST/HIV/aids. Somente seis (22,2%) usavam o preservativo masculino "sempre" e 26 (96,3%) afirmaram não uso de drogasinjetáveis. Dezesseis mulheres (59,2%) percebiam-se sem risco para DST/HIV/aids, sendo a justificativa mais frequente a confiança no parceiro único, com 12 (44,4%). Conclusão: promoção do sexo seguro junto às mulheres monogâmicas deve trazer como foco a vulnerabilidade às DST/HIV/aids, visto que essas mulheres podem estar se relacionando com um parceiro que é bígamo.

Introduction: the HIV/aids is considered as a world epidemy and it currently follows four tendencies: heterosexualization, interiorization, pauperization and feminization. The woman is especially vulnerable to this epidemy, considering its specific biological and anatomic characteristics, besides the pressure done by the partners, leading them to have a power of choice in the affective-sexual and reproductive relations, submitting themselves unconsciously to risky situations to get DST/HIV/aids. Objectives: to verify the percentage of DST/HIV/aids in monogamic women; to know their perceptions concerning their vulnerability to the same damages; and to identify protective factors to the DST/HIV/aids in the group studied. Methods: transversal, descriptive exploratory study, conducted with 27 women, in April and May, 2008, in the fi rst aid post of DST/HIV/aids of a University Hospital in Fortaleza-CE.Results: twenty-four (88.9%) women were in the reproductive phase (21 to 49 years old); 16 (59.3%) had high school; and 14 (51.9%) did not have their own salary, depending financially on their partners. Seven did not have knowledge about the ways of transmition of DST/HIV/aids. Only six (22.2%) used the male condoms "always" and 26 (96.3%) affirmed non-use of injectable drugs. Sixteen women (59.2%) noticed themselves without risk for DST/HIV/ aids, being the most frequent justification the confidence in the only partner, with 12 (44.4%). Conclusion: promotion of safe sex together with monogamic women should focus on the vulnerability to DST/HIV/aids, as these women might be having a relationship with a bigamist.

Vacina contra DST: onde estamos e para onde vamos? / Viral STD vaccines: where we are and where we will go?

Introdução: as doenças sexualmente transmissíveis (DST) são uma questão que preocupa os órgãos gestores da saúde. Apesar de as pesquisas mostrarem um aumento na conscientização da população para a prevenção com o uso de preservativos, a cada ano aumenta o número de pacientes infectados por doenças de transmissão sexual. Felizmente, para algumas destas doenças, já foi possível desenvolver vacinas, como o caso da hepatite B e do HPV. Entretanto, para outras doenças como a aids, as pesquisas mostram-se distantes de apresentar resultado conclusivo. Conclusão: a utilização de vacinas tem se apresentado como uma tendência nesta área, e vem sendo apontada como uma das soluções mais viáveis para a prevenção e mesmo para o tratamento destas entidades no futuro.

Introduction: sexually transmitted diseases (STDs) are an issue that concerns the health governing bodies. Despite research showing an increased population awareness to prevent the STD each year increases the number of patients infected with sexually transmitted diseases. Fortunately for some of these diseases, was possible to develop vaccines, like hepatitis B and HPV vaccines. However, for other diseases like aids, research project seems far from conclusive result presenting. Conclusion: the use of vaccines is reported as a trend in this area and has been blamed as one of the best alternatives for the prevention and even treatment of these illnesses in the future.

Historical Changes and the Present Situation of Sexually Transmitted Diseases

STDs (sexually transmitted diseases) refer to a variety of bacterial, viral, and parasitic infections that are acquired through sexual activity including vaginal intercourse, oral sex, and anal sex. The term sexually transmitted infection (STI) is used increasingly because it has a broader range of meaning; a person may be infected and may potentially infect others without showing signs of diseases. Approximately 340 million new cases of STDs occur each year in the world. According to the Korea Centers for Disease Control and Prevention, notified cases of STDs in Korea decreased from 32,872 in 2002 to 12,486 in 2007. Bacterial STDs such as gonorrhea and chlamydial infection declined continuously but syphilis and chlamydial infection increased again. Viral STDs such as genital herpes and condyloma acuminatum increased continuously. Gonorrhea and chlamydial infection are still the two most commonly reported STDs in Korea. Bacterial STDs can be cured. However, the problem is that viral STDs cannot be cured completely at present. Safe sex with proper education and the correct use of condom are important to prevent STDs and unwanted pregnancy. Early diagnosis and screening, proper treatment, and appropriate counseling from qualified physicians are necessary to prevent the complications and spread of STDs. Also, continuous monitoring and strategies of prevention of STDs will be necessary for improvement of the public health.

Diagnosis and Clinical Symptoms of Sexually Transmitted Diseases

Screening and detecting sexually transmitted diseases (STDs) is a form of secondary prevention, which interrupts further transmission as well as progression of the infection and its sequelae. Unfortunately, primary prevention, by means of education and taking safe sex partners, has not been enough to significantly curb the prevalence and high cost of STDs. Bacterial STDs are decreasing in their prevalence whereas the prevalence of viral STDs has increased significantly in recent years. The differential diagnosis for genital ulcers, urethritis, and genital warts is very important. For example, syphilis, chancroid, lymphogranuloma venereum, and herpes simplex for genital ulcer are mistaken for other causes such as Behcet's syndrome, drug eruption, erythema multiforme, amebiasis, trauma, and carcinoma. Confirmatory testings made by cultures, PCR, or serologic studies are important for appropriate treatment and eradication of the disease in both patients and their partners. The physicians treating STDs should make special efforts to be sure that his or her methods of diagnosis and treatment reflect the latest knowledge, since the epidemiologic characteristics and treatment trends are rapidly changing based on newly appearing resistant strains.

Clinical Analysis of 799 Cases of Female Sexually Transmitted Diseases / 中国医师杂志

Objective To evaluate 3 female sexually transmitted diseases(STD).Methods 799 cases of female STD were tested by means of polyerase chain reaction(PCR) we analyzed the incidence age,types,diagnosis and treatment.Results The peak incidence was ranged from 25 to 30 years.The highest incidence was non-gonococcal cervicitis (urethritis),cervicitis type was frequently,often infertility.The treatment of condyloma acuminata key was removal of warts by laser and antiviral therapy.Mucopus and urinary irritation symptoms were the clinical features of gonrrhea.Mixed infections were common,needs to use antimicrobial agents which were effective to four pathogens.Conclusion The risk of non-gonococcal cervicitis(urethritis) is increasing,it could infect cervix,induce to infertility.It is necessary to increase the search,prevention and treatment for the STD.