250例农村地区女性性工作者生殖道沙眼衣原体感染现状和相关因素分析

 目的 分析农村地区女性性工作者生殖道沙眼衣原体的感染情况,并探讨相关的危险因素。方法 在广东省云浮市农村地区采用方便抽样法招募250例女性性工作者。采用问卷调查收集一般人口学特征和性行为学特征。采集静脉血进行梅毒和HIV的检测,采集尿液利用荧光聚合酶链式反应检测淋球菌和沙眼衣原体。结果 生殖道沙眼衣原体的感染率为22.00%（55/250）,淋球菌感染率为11.60%（29/250）,梅毒感染率为0.80%（2/250）,无HIV感染。55例衣原体感染人群中,淋球菌感染率为40.00％,无梅毒感染者。月收入越低（OR=3.052）、教育程度越低（OR=2.611）、最近一个月不持续使用安全套(OR=3.226)和平均每周性伴数量越多(OR=2.109)者生殖道沙眼衣原体感染越高。结论 农村地区的女性性工作者生殖道沙眼衣原体感染率较高,建议加强对农村地区女性性工作者生殖道沙眼衣原体的检测和健康宣教,提高自我防控风险意识。     

非衣原体性非淋球菌性尿道炎的病因研究和治疗

尿道炎是最常见的男性泌尿生殖道病征，可由感染性和非感染性因素所致。在性病门诊中男性尿道炎的常见病因有淋球菌和沙眼衣原体感染，由淋球菌感染之外的其他各种原因导致的尿道炎称为非淋球菌性尿道炎（NGU），但有大约50％的患者既检测不到淋球菌也无沙眼衣原体感染，称为非衣原体性非淋球菌性尿道炎（NCNGU）。     

云南省曲靖市暗娼人群艾滋病、性病感染状况及生殖道沙眼衣原体感染影响因素分析

目的 了解云南省曲靖市暗娼人群艾滋病、性病(梅毒、生殖道沙眼衣原体、淋球菌)的感染现状以及该人群对艾滋病知识的知晓情况,分析生殖道沙眼衣原体感染的相关影响因素.方法 2020年4-6月,在曲靖市麒麟区招募200名暗娼,进行现场一对一问卷调查,同时采集尿液和静脉血标本.其中尿液样本进行生殖道沙眼衣原体(CT)和淋球菌(N...     

沙眼衣原体及淋球菌感染治疗和预防的生物学进展

淋球菌和生殖道沙眼衣原体感染是波及全世界的最常见的性传播疾病(STD)。二者在男性女性都可引起相似的感染类型,并可导致妇女继发性不孕。二者皆寄生于细胞内,沙眼衣原体为专性寄生,淋球菌为兼性寄生。其疫苗研制进展缓慢,但随着免疫生物学和分子遗传学的发展,很有希望通过动物模型最终获得成功。在处置及预防方面,在流行病学上依靠敏感的特异的诊断方法,有效的抗生素治疗,追察有接触史者,筛选确认无症状和高危人群,以及结合其它传统的最新的疾病控制对策。淋球菌和生殖道沙眼衣原体感染是最常     

生殖道沙眼衣原体感染与输卵管性不孕关系的研究

目的:探讨输卵管性不孕与生殖道沙眼衣原体感染相关的直接证据。方法:应用单克隆抗体免疫荧光法对50例输卵管性不孕(观察组)和32例男性不孕(对照组)妇女宫颈细胞沙眼衣原体进行测定。结果:观察组阳性率32.00%,对照组阳性率9.40%,差异显著(P<0.05)。结论:生殖道沙眼衣原体感染引起的输卵管炎及梗阻是输卵管性不孕的主要原因之一,应积极防治。     

汕头性病门诊患者泌尿生殖道沙眼衣原体检测

目的：了解2011-2017年本院11584例性病门诊患者泌尿生殖道沙眼衣原体感染特征。方法：对就诊患者的临床资料进行回顾性分析。结果：（1）11584例患者中沙眼衣原体阳性1480例,阳性率12.78%。6886例男性患者中泌尿生殖道沙眼衣原体感染1023例,阳性率14.86%,4698例女性患者中沙眼衣原体阳性457例,阳性率9.73%,男女患者阳性率比较有显著统计学差异;（2）感染率最高和最低的年龄段为≤19岁和≥60岁的患者,感染率分别为 28.29%（71/251）和9.16%（34/371）;（3）1480例泌尿生殖道沙眼衣原体阳性患者中有991例无症状的体检者（66.96 %）。结论：2011-2017年本院性病门诊患者泌尿生殖道沙眼衣原体感染率较高,泌尿生殖道沙眼衣原体阳性感染者中无症状感染者占比较高。     

1063例STD门诊患者解脲支原体、沙眼衣原体与淋球菌感染情况分析

目的了解本地区STD门诊患者的解脲支原体、沙眼衣原体和淋球菌的感染情况。指导临床诊断、用药。方法采集女性宫颈口分泌物、男性尿道口分泌物分别做淋球菌培养、沙眼衣原体抗原检测和解脲支原体培养。结果1063例STD门诊患者中查出单一淋球菌感染208例,单一衣原体感染172例,单一解脲支原体感染358例,支原体、衣原体混合感染53例,淋球菌、支原体混合感染68例,淋球菌、衣原体感染60例,淋球菌、衣原体、支原体三重感染5例。结论混合感染率比较高,混合感染女性明显高于男性,支原体感染女性明显高于男性。     

性病病征处理的研究进展

对不同性病病征的病征处理方案的有效性评价结果表明,病征处理能有效地治疗男性淋球菌和沙眼衣原体感染、男女性梅毒和生殖器疱疹。但阴道分泌物病征处理流程图对处理宫颈淋球菌和沙眼衣原体感染的敏感性、特异性和阳性预期值较低,将其应用于淋球菌和沙眼衣原体感染率较高的高危人群及有症状者更为有效。     

非沙眼衣原体非淋球菌性尿道炎

自1965年沙眼衣原体细胞培养技术建立以来,该微生物在非淋球菌性尿道炎(non-gonococcal urethritis,NGU)中的病原学地位逐步确立,目前已将泌尿生殖道的沙眼衣原体感染列为独立的疾病,称之为泌尿生殖道沙眼衣原体感染.     

103例生殖道沙眼衣原体感染患者的临床特征及随访结果分析

目的:分析我院皮肤性病科门诊生殖道沙眼衣原体感染患者的临床特征及随访情况。方法:回顾性分析我院2013年4月至2015年10月经聚合酶链反应(PCR)确诊并有治疗后PCR随访结果的103例生殖道沙眼衣原体感染患者的临床及随访资料。结果:103例生殖道沙眼衣原体感染患者中,男性67例(65.05%),女性36例(34.95%),年龄17~58岁,平均(29.48±6.79)岁。38.83%(40/103)患者无明显临床症状,其中男性患者中29.85%(20/67)无明显临床症状,女性患者中55.56%(20/36)无明显临床症状。56.31%(58/103)患者存在混合感染,45.63%(47/103)合并解脲脲原体感染,10.68%(11/103)合并淋病。92.23%(95/103)患者治疗后PCR复查沙眼衣原体核酸阴性。结论:生殖道沙眼衣原体感染患者常为混合感染,且临床症状轻微或隐匿,临床应对有不安全性行为史的患者及其性伴做全面性病检查。PCR方法值得在生殖道沙眼衣原体感染患者的诊断及随访中推广使用。     

Low prevalence of cervical infections in women with vaginal discharge in west Africa: implications for syndromic management

OBJECTIVES: To measure prevalence and risk factors for cervical infections among a large sample of women consulting for vaginal discharge in west Africa and to evaluate its syndromic management through a two visit algorithm. METHODS: In 11 health centres in Bénin, Burkina Faso, Ghana, Guinée, and Mali 726 women who presented with a vaginal discharge without abdominal pain and who denied being a sex worker (SW) were enrolled. Cervical samples were tested for the detection of Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) with polymerase chain reaction (PCR) assays. All participants were treated with single dose (2 g) metronidazole and clotrimazole cream for 3 days. They were randomised to be told either to come back on day 7 only if there was no improvement in the discharge (group A), or to come back on day 7 regardless of response to treatment (group B). RESULTS: Overall, the prevalence of NG and CT was only 1.9% (14/726) and 3.2% (23/726) respectively. Risk factors previously recommended by the WHO were not associated with the presence of cervical infection, with the exception of the number of sex partners in the past 3 months. When taken together, these risk factors had a positive predictive value of only 6.4% to identify cervical infections. Prevalence of cervical infection was not higher in women who came back on day 7, regardless of the strategy used. Prevalence of NG/CT was lower in Ghana and Bénin (5/280, 1.8%), where comprehensive interventions for SW have been ongoing for years, than in the three other countries (27/446, 6.1%, p = 0.01). CONCLUSIONS: NG and CT infections are uncommon in west African women who consult for vaginal discharge and who are not SW. Syndromic management of vaginal discharge should focus on the proper management of vaginitis. The control of gonococcal and chlamydial infection should be redesigned around interventions focusing on sex workers.     

男性性工作者血清HIV/STDs检测和相关危险因素分析

目的：对男性性工作者进行相关血清学检测，以了解该人群的性传播疾病感染情况，为预防干预提供依据。方法：对男性性工作者采取知情同意进行问卷调查，取血清进行艾滋病病毒、梅毒、单纯疱疹病毒2型检测。结果：82例男性性工作者，HIV抗体检测均阴性，RPR初筛、TPPA确证梅毒抗体阳性率19．5％，抗HSV-2-IgG阳性率6．1％。年龄和首次性交年龄是其危险因素。结论：男性性工作者中有一定程度的性传播感染，对这一人群进行血清学监测和行为监测是必要的。     

Motorcycle taxi drivers and sexually transmitted infections in a Peruvian Amazon City

BACKGROUND: In Iquitos, Peru, motorcycle taxis are a common form of public transportation used both by residents and visitors. GOAL: To evaluate the prevalence of factors associated with sexually transmitted disease risk and of Neisseria gonorrhoeae and Chlamydia trachomatis infections among motorcycle taxi drivers working in Iquitos, Peru. STUDY DESIGN: A convenience sample of motorcycle taxi drivers was recruited through street outreach. Participants were confidentially interviewed and provided urine specimens for gonococcal and chlamydial infection testing. RESULTS: A history of sexually transmitted disease (62%) or symptoms in the past year (35%) and of referral of clients to commercial sex workers (60%) was common. The prevalence of gonococcal or chlamydial infection was 3.5%. CONCLUSIONS: Motorcycle taxi drivers are a major means of public transportation in Iquitos, Peru, have high personal risks for sexually transmitted disease, and interface often with at-risk persons.     

Prevalence of human immunodeficiency virus, Chlamydia trachomatis, and Neisseria gonorrhoeae and risk factors for sexually transmitted infections among immigrant female sex workers in Catalonia, Spain

OBJECTIVES: To determine the prevalence of human immunodeficiency virus (HIV), Chlamydia trachomatis (CT), and Neisseria gonorrhoeae (NG) among immigrant female sex workers (FSW) according to their geographic area of origin and identify possible risk factors independently associated with current infection with CT and/or NG. STUDY DESIGN: Cross-sectional study of 357 FSW in Catalonia in 2005. Information on sociodemographic and sex work characteristics, use of alcohol and drugs, sexual practices, and the use of social and health care services was collected. Oral fluid and urine samples were collected to determine the prevalence of HIV and CT/NG, respectively. Factors independently associated with CT/NG were assessed using multivariate logistic regression models. RESULTS: A total of 36.4% of women were from Eastern Europe, 34.5% from Latin America, and 29.1% from Africa. Overall CT and NG prevalence were 5.9% [95% confidence interval (CI): 3.7-8.9] and 0.6% (95% CI: 0.1-2.0), respectively. No differences were observed by geographic origin. Three African women were HIV positive (overall HIV prevalence was 0.8%, 95% CI: 0.2-2.4). In multivariate analysis, younger age and unprotected sex with clients were associated with the presence of CT/NG. CONCLUSIONS: The prevalence of sexually transmitted infections among FSW in Catalonia was lower than in other European countries. Even though the prevalence of HIV was only 0.8%, it could increase in the future given the high vulnerability of these women and their wide geographic mobility. It is necessary to continue with the work carried out by nongovernmental organizations (harm reduction programs, outreach programs, and safe sex workshops) as well as to facilitate the access to health centers, especially for the youngest women.     

Rapid assessment of sexually transmitted diseases in a sentinel population in Thailand: prevalence of chlamydial infection, gonorrhoea, and syphilis among pregnant women--1996

OBJECTIVE: To determine the prevalence of sexually transmitted diseases (STDs) among pregnant women in Thailand, where case reporting suggests a marked decrease in STDs following a campaign promoting condom use during commercial sex. DESIGN: Cross sectional study of women at their first visit to the study hospitals' antenatal clinics in Chiang Rai (n = 500) and Bangkok (n = 521). METHODS: First catch urine specimens were tested for Chlamydia trachomatis and Neisseria gonorrhoeae using the Amplicor CT/NG polymerase chain reaction assay. Syphilis and HIV serological testing were performed in the study hospitals' laboratories. RESULTS: The prevalence of chlamydial infection was 5.7%, gonorrhoea 0.2%, and syphilis 0.5% (all VDRL or RPR titres were < or = 1:4). The prevalence of HIV infection was 7.1% in Chiang Rai and 2.9% in Bangkok. In a multivariate logistic regression analysis, chlamydial infection was associated with younger age and with higher gestational age at first antenatal clinic visit, but was not associated with marital status, gravidity, city of enrollment, or HIV infection status. CONCLUSIONS: There was a low prevalence of gonorrhoea and syphilis among these pregnant women in Thailand. Chlamydial infection was detected at a higher prevalence, especially among younger women and women registering later for antenatal care. Testing of pregnant women using easily collected urine specimens and a sensitive nucleic acid amplification assay is a feasible method of rapidly assessing chlamydial and gonococcal prevalence.


     

Screening women in jails for chlamydial and gonococcal infection using urine tests: feasibility, acceptability, prevalence, and treatment rates

BACKGROUND: Women entering jails are at high risk for sexually transmitted diseases; however, screening for chlamydial and gonococcal infection is not routinely performed in most jails. New urine tests have made it easier to screen for these infections in nonclinical settings. GOAL: The feasibility and acceptability of urine-based screening for women entering jails and the prevalence of and treatment rates for chlamydial and gonococcal infections were determined. STUDY DESIGN: Women entering jails in Chicago, Illinois; Birmingham, Alabama; and Baltimore, Maryland, who signed consent forms were tested for chlamydial and gonococcal infection by means of the urine ligase chain reaction assay. Those testing positive were treated in jail; health department staff members attempted to contact those already released. RESULTS: Most women who were approached agreed to be tested (range, 87-98%, depending on city), and most of these women provided a specimen (range, 92-100%). Among 5364 women aged 16 to 75 years who were tested, the prevalence of chlamydial and gonococcal infections was high, especially among those <25 years of age (range, 15.3-21.5% for chlamydial infection and 8.2-9.2% for gonorrhea, depending on city). The majority of women testing positive were treated in jail or outside of jail (61-85%). CONCLUSIONS: Screening women in jails for chlamydial and gonococcal infection with urine tests is feasible, is acceptable to most women, and leads to detection and treatment of many infections. Routine screening should reduce medical complications in this population and should prevent transmission in the community, given that many women are soon released.     

Sexually transmitted infections among female sex workers in Kupang,Indonesia: searching for a screening algorithm to detect cervical gonococcal and chlamydial infections

BACKGROUND AND GOAL: Notifications of HIV infection in Indonesia are increasing, but there are few data on other sexually transmitted infections (STIs), especially in the eastern islands of Indonesia. We aimed to measure the prevalence of STIs among female sex workers (FSWs) in Kupang, West Timor, and to develop screening algorithms to detect cervical infections with Neisseria gonorrhoeae and/or Chlamydia trachomatis (NG/CT). STUDY DESIGN: During 6 months in 1999, we recruited all the FSWs at Kupang's only brothel complex and a smaller number of independent FSWs. The women were examined at dedicated clinics and most laboratory tests were performed at provincial laboratories. Algorithms based on the strongest associations of variables with NG/CT were compared with the laboratory diagnoses. RESULTS: We recruited 288 women. The prevalence of N gonorrhoeae infection was 31%, that of C trachomatis infection was 24%, that of Trichomonas vaginalis infection was 5%, and that of syphilis was 13%. No case of HIV infection was detected. Few women had symptoms of STI. The only variables significantly associated with NG/CT after logistic regression analysis were the presence of cervical discharge (either yellow or clear) and a high count of polymorphonuclear leukocytes on gram-stained endocervical smear. Several algorithms to screen for NG/CT achieved high (>80%) sensitivity, but the highest specificity among these was only 50%. CONCLUSIONS: Although several of the generated algorithms may be useful in the absence of simple, accurate, affordable diagnostic tests, the high rates of STIs in this population could justify a more aggressive strategy incorporating periodic presumptive treatment to rapidly reduce prevalence.     

Epidemiology of anorectal chlamydial and gonococcal infections among men having sex with men in Seattle: utilizing serovar and auxotype strain typing

BACKGROUND: Bacterial sexually transmitted diseases (STDs) among men who have sex with men (MSM) have recently increased in Seattle. GOALS: Serovar and auxotype typing of strains was used to assess the epidemiology of anorectal chlamydial and gonococcal infections among MSM attending an STD clinic. STUDY DESIGN: The prevalences of anorectal chlamydial infection and gonorrhea among MSM attending an STD clinic during the period of 1994 to 1996 were compared with prevalences during 1997 to 1999. A retrospective case-control study of MSM attending an STD clinic between 1997 and 1999 was performed. Anorectal chlamydial isolates were characterized by serovar and gonococcal isolates were characterized by serovar and auxotype. Infected MSM were mapped by residence and strain type. RESULTS: Prevalences of anorectal chlamydial and gonococcal infections increased from 4.0% and 6.3%, respectively, during 1994-1996 to 7.6% and 8.7%, respectively, during 1997-1999 (P = 0.004 and P = 0.013 for chlamydial infection and gonorrhea, respectively). Most chlamydial infections were caused by serovars G (47.9%) and D (29.6%), and most gonococcal infections were caused by auxotype/serovar classes Proto/IB-1 (43.3%), Proto/IB-3 (16.5%), and Proto/IB-2 (10.3%). MSM with anorectal chlamydial infection more often had chlamydial urethritis (P = 0.005) and were not white (P = 0.046), in comparison with controls. MSM with anorectal gonorrhea more often had pharyngeal gonorrhea (P < 0.001), had a history of gonorrhea (P = 0.003), and were younger than age 30 years (P = 0.039), in comparison with controls. Residences of MSM with anorectal gonorrhea were clustered in urban areas, whereas those of MSM with anorectal chlamydial infection were more dispersed. CONCLUSION: Prevalences of anorectal chlamydial infection and gonorrhea among MSM in Seattle have increased dramatically over the past 3 years. Serovar and auxotype analyses indicate these increases are not clonal but are due to the spread of unique distributions of strains that differ from those causing urogenital infections in the same community.     

Prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae infections in Greenland. A seroepidemiological study.

In a sero-epidemiological study of the prevalence of chlamydial and gonococcal infections in Greenland three groups of subjects were studied--262 patients attending an outpatient department in the town of Nuuk (of whom 12% harboured Chlamydia trachomatis and 54% Neisseria gonorrhoeae), 63 controls from the same town, and the entire population of 150 in the settlement of Uvkusigsat. Using a microimmunofluorescence test evidence of exposure to C trachomatis was found in 79% of the female and 26% of the male patients, in 12% and 50% of the female and male controls respectively, and in 51% and 21% of the female and male populations of Uvkusigsat respectively. Using an indirect haemagglutination test antibodies to gonococcal pili were found in sera of 92% of the female and 70% of the male patients, in 30% of the male and 10% of the female controls, and in 41% of the women and 33% of the men in Uvkusigsat. The study indicates that genital chlamydial and gonococcal infections are serious public health problems in Greenland and that such infections are acquired early in both sexes and often occur concomitantly.     

Prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae infections in Greenland. A seroepidemiological study

In a sero-epidemiological study of the prevalence of chlamydial and gonococcal infections in Greenland three groups of subjects were studied--262 patients attending an outpatient department in the town of Nuuk (of whom 12% harboured Chlamydia trachomatis and 54% Neisseria gonorrhoeae), 63 controls from the same town, and the entire population of 150 in the settlement of Uvkusigsat. Using a microimmunofluorescence test evidence of exposure to C trachomatis was found in 79% of the female and 26% of the male patients, in 12% and 50% of the female and male controls respectively, and in 51% and 21% of the female and male populations of Uvkusigsat respectively. Using an indirect haemagglutination test antibodies to gonococcal pili were found in sera of 92% of the female and 70% of the male patients, in 30% of the male and 10% of the female controls, and in 41% of the women and 33% of the men in Uvkusigsat. The study indicates that genital chlamydial and gonococcal infections are serious public health problems in Greenland and that such infections are acquired early in both sexes and often occur concomitantly.