RÉSUMÉ
Background: Genital herpes is caused predominantly by Herpes simplex virus type 2 (HSV-2) and less commonly by HSV-1. Genital HSV-1 infection results from oral sex, with fewer recurrences, mild symptoms, less asymptomatic shedding and poor genital transmission. The present study was undertaken to identify frequency of occurrence of HSV-1 and HSV-2 in genital herpes by microscopy, serology and Real Time Polymerase Chain Reaction (RT-PCR). Methods: Genital ulcer swabs and serum were collected at regional STI centre, Govt Medical College and Hospital, Nagpur. A total of 53 patients of Genital Ulcer Disease from December 2020 -22 were examined for etiology by microscopy, serum IgM and IgG against HSV-1 and 2 by ELISA and HSV-1 and 2 DNA by RT- PCR. Results: Out of 53 genital swabs processed, 6 (11.3%) and 28 (52.8%) samples were positive for HSV-1 and 2 DNA respectively. Of the 6 HSV-1 DNA positive samples, seropositivity for HSV-1 IgM was in 2 (33.3%) samples and for HSV-1 IgG in 4 (66.7%) samples. Of the 28 HSV-2 DNA samples, HSV-2 IgM was positive in 4 (14.3%) samples and HSV-2 IgG was positive in 7 (25%) samples, multi nucleated giant cells were seen in 2 (7.14%) samples. The remaining 15 (53.6%) HSV-2 DNA positive samples were seronegative. Conclusions: HSV-1 was detected in 6 (11.3%) samples. Though these genital ulcers may be mild, it is important to counsel the patients for abstinence or safe sex practices to prevent their partners from acquiring painful non-genital ulcers due to HSV-1.
RÉSUMÉ
Background: Vulvovaginal candidiasis (VVC) affects approximately 75% of women once in lifetime. National AIDS Control Organization has recommended Kit-2/Green (tablet secnidazole 2 gm OD stat and capsule fluconazole 150 mg OD stat) for syndromic case management (SCM) of patients with vaginal discharge since 2007. Patients are frequently revisiting the STI centre with recurrent VVC. The purpose of the study was to determine the effectiveness of fluconazole and other azoles in vulvovaginitis. Methods: Vaginal swabs from 188 patients attending regional STI centre, at Government Medical College, Nagpur between October 2020 to June 2022 were processed. A total of 128 conventionally confirmed isolates of Candida species were tested on RPMI 1640 medium for susceptibility to azoles by E test. An MIC of ?8 ?g/ml for fluconazole and ?1 ?g/ml for itraconazole, ketoconazole and voriconazole was interpreted as resistance as per CLSI M-60. Results: Candida species isolated were Candida albicans, C. glabrata, C. tropicalis, C. parapsilosis, C. dubliniensis and C. krusei. Candida species resistant to fluconazole, itraconazole, ketoconazole and voriconazole were 22 (17.18%), 53 (41.40%), 19 (14.84%), and 3 (2.34%) respectively. C. glabrata was most resistant while C. parapsilosis was least resistant. Voriconazole was most effective. Conclusions: Extensive use of fluconazole in syndromic case management of vaginal discharge could be the probable reason for 17.18% resistance to fluconazole. Withdrawal of fluconazole and replacement with another antifungal azole in SCM of vaginal discharge may prevent recurrent VVC and perhaps lead to emergence of fluconazole sensitive candida.
RÉSUMÉ
Background: Easy access to Suraksha clinics for sexually transmitted infections calls for a review of seroprevalence of syphilis. Methods: Serum samples from attendees of sexually transmitted infections (STI)/ reproductive tract infections (RTI) clinic/antenatal clinic, and samples of high-risk group (HRG: female sex workers and men having sex with men) brought by non-government organizations from 2017-22 were screened for syphilis by Venereal Disease Research Laboratory (VDRL) and Treponema pallidum hemagglutination (TPHA) tests. Samples positive by both tests were considered seropositive for syphilis. Statistical methods used for analysis were chi square test for linear trends and Kruskal Wallis test. Results: In STI clinic percentage positivity for syphilis has shown a statistically significant decline from 2017-22. In RTI clinic the decline was significant from 2017-19 but not significant in the years 2019-22. In antenatal clinic and in HRGs the change in seroprevalence was not significant from 2017-22 and 2017-20 respectively. However, the HRGs showed a significantly increasing trend in syphilis seropositivity from 2020-22. Conclusions: There is a significantly declining trend in the seroprevalence of syphilis in patients attending the STI/RTI clinic from 2017-22 and in HRGs from 2017-20. However, a significant increase in trend in HRG from 2020-22 may have been due to behavioural changes during the lockdown for covid 19 pandemic. A significant decline in syphilis in patients attending the STI and RTI clinic and in HRGs attending the regional centre indicates the effectiveness of consistent detection, treatment and counselling efforts of the national control program on STI in the region.
RÉSUMÉ
Background: Easy access to Suraksha clinics for sexually transmitted infections calls for a review of seroprevalence of syphilis. Methods: Serum samples from attendees of sexually transmitted infections (STI)/ reproductive tract infections (RTI) clinic/antenatal clinic, and samples of high-risk group (HRG: female sex workers and men having sex with men) brought by non-government organizations from 2017-22 were screened for syphilis by Venereal Disease Research Laboratory (VDRL) and Treponema pallidum hemagglutination (TPHA) tests. Samples positive by both tests were considered seropositive for syphilis. Statistical methods used for analysis were chi square test for linear trends and Kruskal Wallis test. Results: In STI clinic percentage positivity for syphilis has shown a statistically significant decline from 2017-22. In RTI clinic the decline was significant from 2017-19 but not significant in the years 2019-22. In antenatal clinic and in HRGs the change in seroprevalence was not significant from 2017-22 and 2017-20 respectively. However, the HRGs showed a significantly increasing trend in syphilis seropositivity from 2020-22. Conclusions: There is a significantly declining trend in the seroprevalence of syphilis in patients attending the STI/RTI clinic from 2017-22 and in HRGs from 2017-20. However, a significant increase in trend in HRG from 2020-22 may have been due to behavioural changes during the lockdown for covid 19 pandemic. A significant decline in syphilis in patients attending the STI and RTI clinic and in HRGs attending the regional centre indicates the effectiveness of consistent detection, treatment and counselling efforts of the national control program on STI in the region.
RÉSUMÉ
In Nagpur, Maharashtra in 1993, V. cholerae serogroup O139 emerged as a novel epidemic strain. The decline in the isolation rate of this serogroup in subsequent year was followed by its re-emergence during 1998 indicating that this serotype requires careful monitoring.