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Secondary Syphilis: Pathophysiology, Clinical Manifestations, and Diagnostic Testing 继发性梅毒:病理生理学、临床表现和诊断测试
Pub Date : 2023-04-11 DOI: 10.3390/venereology2020006
Shahrukh Chaudhry, Idris Akinlusi, Ted Shi, J. Cervantes
The subspecies T. pallidum pallidum is the cause of the most infamous sexually and congenitally transmitted disease, syphilis. This disease has an estimated incidence of six million infections every year. Multiple studies have noted that the prevalence of syphilis has been steadily increasing worldwide in recent decades, especially among MSMs and HIV-positive patients. Clinically, syphilis presents in four stages with multiple different clinical manifestations. In this paper, we examine the current literature to determine the history and progression, pathogenesis, clinical features, and testing of secondary syphilis. Secondary syphilis is a stage of the disease with the most exuberant local and systemic clinical manifestations. The basis of the pathogenesis of SS underscores the unique mechanisms by which Treponema pallidum utilizes to escape immune recognition while simultaneously induces inflammation. SS can affect multiple organ systems and become more than just an STD. The most common presentation of secondary syphilis is rash, which manifests as a copper-colored maculopapular lesion on the trunk, palms, and soles. Although the RPR, VDRL, and FTA-ABS tests are perhaps the most commonly used diagnostic tools for syphilis and make up the traditional and reverse algorithms, there are other methods, including morphology and immunohistochemistry.
梅毒T. pallidum pallidum亚种是最臭名昭著的性和先天性传播疾病梅毒的病因。据估计,每年有600万人感染这种疾病。多项研究指出,近几十年来,梅毒的患病率在世界范围内稳步上升,特别是在男同性恋者和艾滋病毒阳性患者中。在临床上,梅毒可分为四个阶段,有多种不同的临床表现。在本文中,我们检查当前的文献,以确定历史和进展,发病机制,临床特点,并测试二期梅毒。二期梅毒是局部和全身临床表现最丰富的一个阶段。SS发病机制的基础强调了梅毒螺旋体利用逃避免疫识别同时诱导炎症的独特机制。继发性梅毒最常见的表现是皮疹,表现为躯干、手掌和脚底出现铜色黄斑丘疹。尽管RPR、VDRL和FTA-ABS测试可能是最常用的梅毒诊断工具,构成了传统和反向算法,但还有其他方法,包括形态学和免疫组织化学。
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引用次数: 1
Current Trends in Syphilis Mortality in the United States, 2015–2020 2015-2020年美国梅毒死亡率的当前趋势
Pub Date : 2023-03-29 DOI: 10.3390/venereology2020005
N. Barragan, Ranjana N. Wickramasekaran, F. Sorvillo, Lisa V. Smith, T. Kuo
Rates of reported cases of syphilis have steadily increased since 2000 in the United States. However, despite the increase in cases, mortality from 2000–2014 declined. The following study examines the latest trends in syphilis-related deaths using 2015–2020 Multiple Cause of Death data. A total of 925 syphilis-related deaths were identified during the study period, 30% of which listed syphilis as the underlying cause of death. On average, age-adjusted syphilis mortality increased by 9.51% annually (95% CI = 5.41%–13.77%). Study findings indicate a marked increase in deaths attributed to syphilis, underscoring the need to more systematically and comprehensively address the growing sexually transmitted infection epidemic in the United States.
自2000年以来,美国报告的梅毒病例率稳步上升。然而,尽管病例有所增加,但2000-2014年期间的死亡率有所下降。以下研究利用2015-2020年多死因数据调查了梅毒相关死亡的最新趋势。在研究期间,共发现925例梅毒相关死亡病例,其中30%将梅毒列为潜在死亡原因。年龄调整后的梅毒死亡率平均每年增加9.51% (95% CI = 5.41%-13.77%)。研究结果表明,梅毒导致的死亡人数显著增加,强调需要更系统和全面地解决美国日益增长的性传播感染流行病。
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引用次数: 0
School-Based Interventions on Human Papillomavirus in Africa: A Systematic Scoping Review 非洲学校对人类乳头瘤病毒的干预:系统范围界定综述
Pub Date : 2023-02-18 DOI: 10.3390/venereology2010004
J. Amzat, K. Kanmodi, K. Aminu, E. Egbedina
School-age youth constitute a neglected but highly vulnerable group concerning sexual health risks in low-resource countries. Robust evidence concerning the research landscape of school-based interventions on human papillomavirus in Africa is currently lacking. Therefore, this systematic scoping review (SSR) aims to map evidence about school-based HPV interventions and identify emerging themes, gaps and lessons learned in Africa. This review was guided by Joanna Brigg’s Institute’s guidelines for SSRs and reported based on the Preferred Reporting Items for Systematic Reviews and Metanalysis for Scoping Reviews. Five databases—PubMed, CINAHL, PsycINFO, SCOPUS, and Allied and Complementary Medicine—were searched for relevant literature using appropriate search terms and Boolean operators. The retrieved literature was extracted, deduplicated and screened using the Rayyan software. Only those articles which met the eligibility criteria were included for data charting, collation, and summarization. Ten articles were included in this review. The articles demonstrate that a life-course approach is significant in health intervention. School-based health interventions help reach adolescents in a dynamic life stage, affecting their vulnerability to sexual health risks. The school-based interventions serve as an ideal platform to offer HPV peer education, improving their HPV knowledge and subsequent testing services and enhancing their acceptability for screening and vaccination. Cervical cancer education and screening can be effectively combined in HPV health services for women. While the studies are geographically diverse, such effective interventions, which help reduce bottlenecks in accessing HPV screening and vaccination, are very few in Africa. In conclusion, school-based intervention is a viable strategy that can be adopted for adolescent protection from HPV-induced diseases. However, the current evidence on the impact of these interventions, particularly HPV vaccination, is inadequate.
在资源匮乏的国家,学龄青年是一个被忽视但在性健康风险方面非常脆弱的群体。目前缺乏关于非洲以学校为基础的人乳头瘤病毒干预措施的研究情况的有力证据。因此,这项系统性范围审查(SSR)旨在绘制关于学校HPV干预措施的证据,并确定非洲的新主题、差距和经验教训。本综述以乔安娜·布里格研究所的ssr指南为指导,并根据系统评价的首选报告项目和范围评价的元分析进行报告。使用合适的检索词和布尔运算符对pubmed、CINAHL、PsycINFO、SCOPUS和Allied and Complementary medicine这5个数据库进行相关文献检索。使用Rayyan软件对检索到的文献进行提取、删除和筛选。只有那些符合资格标准的文章被纳入数据图表、整理和总结。本综述纳入了10篇文章。这些文章表明,生命过程方法在健康干预中是重要的。以学校为基础的保健干预措施有助于接触处于动态生命阶段的青少年,影响他们对性健康风险的脆弱性。以学校为基础的干预措施是提供HPV同伴教育的理想平台,可以提高他们的HPV知识和随后的检测服务,并提高他们对筛查和疫苗接种的接受程度。宫颈癌教育和筛查可有效地结合在妇女的HPV保健服务中。虽然这些研究在地理上是不同的,但这种有助于减少获得HPV筛查和疫苗接种瓶颈的有效干预措施在非洲很少。总之,以学校为基础的干预是一种可行的策略,可以用于保护青少年免受hpv引起的疾病。然而,目前关于这些干预措施,特别是HPV疫苗接种影响的证据不足。
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引用次数: 3
A Smartphone-Based Pilot HIV Prevention Intervention (Sakhi) among Transgender Women who Engage in Sex Work in India: Efficacy of a Pre- and Post-Test Quasi-Experimental Trial. 在印度从事性工作的变性妇女中开展基于智能手机的艾滋病毒预防干预试点(Sakhi):测试前和测试后准实验试验的有效性》(Effectiveness of a Pre- and Post-Test Quasi-Experimental Trial)。
Pub Date : 2023-02-16 DOI: 10.3390/venereology2010003
Venkatesan Chakrapani, Pushpesh Kumar, Jasvir Kaur, Murali Shunmugam, Debomita Mukherjee

Transgender women (TGW) in India, especially those who engage in sex work, are at high risk for HIV. Guided by the information-motivation-behavioral skills model and qualitative formative research findings, Sakhi (girlfriend), a 3-week smartphone-based pilot intervention consisting of short videos (one/week) and text messages (two/week), was implemented using a one-group pre- and post-test design to test its efficacy in promoting condom use and HIV testing among TGW (N = 50) who engage in sex work in Chennai. Changes in outcomes were assessed by conducting multivariable analyses using generalized estimating equations. Participants' mean age was 26 years, and the mean monthly income was INR 21700 (USD 292). About one-third completed college, and 96% were HIV-negative. Significant changes in the desired direction were observed in the primary outcomes: condom use - decrease in the engagement of condomless anal sex with male partners (12% to 2%, p < 0.05) and HIV testing - increase in intentions to undergo HIV testing every 6 months (34% to 86%, p < 0.001); and in some of the secondary outcomes: decrease in alcohol use before sex, increase in intentions to use condoms consistently and increase in the well-being score. This study demonstrated the feasibility, acceptability, and preliminary efficacy of the Sakhi intervention and warrants a larger randomized trial among diverse sub-groups in diverse settings.

印度的变性妇女(TGW),尤其是从事性工作的变性妇女,是艾滋病的高危人群。在信息-动机-行为技能模型和定性形成性研究结果的指导下,Sakhi(女友)采用单组前后测试设计,实施了一项为期 3 周的基于智能手机的试点干预措施,包括短视频(1 次/周)和短信(2 条/周),以测试其在促进钦奈从事性工作的变性妇女(N = 50)使用安全套和进行 HIV 检测方面的效果。通过使用广义估计方程进行多变量分析来评估结果的变化。参与者的平均年龄为 26 岁,平均月收入为 21700 印度卢比(约合 292 美元)。约三分之一的人完成了大学学业,96% 的人 HIV 阴性。在以下主要结果中观察到了预期方向上的显著变化:安全套的使用--与男性伴侣进行无套肛交的比例下降(从 12% 降至 2%,p < 0.05),HIV 检测--每 6 个月进行一次 HIV 检测的意向增加(从 34% 升至 86%,p < 0.001);在一些次要结果中也观察到了预期方向上的显著变化:性生活前饮酒的比例下降,坚持使用安全套的意向增加,幸福感得分增加。这项研究证明了 Sakhi 干预的可行性、可接受性和初步疗效,值得在不同环境下的不同亚群体中进行更大规模的随机试验。
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引用次数: 0
Determinants of Virological Failure in HIV Patients on Highly Active Antiretroviral Therapy (HAART): A Retrospective Cross-Sectional Study in the Upper East Region of Ghana 高活性抗逆转录病毒疗法(HAART)HIV患者病毒学失败的决定因素:加纳上东部地区的回顾性横断面研究
Pub Date : 2023-01-03 DOI: 10.3390/venereology2010002
A. Abubakari, Habibu Issah, M. Awell, Olives Mutaka, M. Asumah
Background: Even though highly active antiretroviral therapy (HAART) for HIV (Human Immune Deficiency) patients has considerably improved viral load suppression, more people still struggle to reduce viral loads. The aim of the study was to determine the associated factors of virological failure in HIV patients on antiretroviral therapy (ART) in the Upper East Region of Ghana. Methods: A retrospective cross-sectional study involving 366 participants aged 15 years and above who were on HAART for six (6) months or longer with viral load results in 2020. Bivariate and multiple logistic regression analyses were conducted to identify the determinants of virological failure among HIV patients at 95% confidence interval (C.I.) with a significant level pegged at a p value less than 0.05. Results: The prevalence of viral load failure was 47.0% and adherence to antiretroviral therapy was 62.6% among patients on HAART. The significant predicators of virological failure were basic education (AOR (adjusted odds ratio) = 7.36, 95% C.I = 4.91–59.71), High school/Vocational /Technical education (AOR = 4.70, 95% C.I. = 1.90–9.69), monthly salary/income ˂ GHS 375.00 (AOR = 7.20, 95% C.I. = 1.73–29.95), duration on ART for ˂1 year (AOR = 0.27, 95% C.I. = 0.10–0.75), ART regimen (Tenofovir + Lamivudine + Efavirenz) (AOR = 3.26, 95% C.I. = 1.95–11.25), 3–5 times missed medication per month (AOR = 2.86, 95% C.I. = 1.34–6.08) and ≥6 missed medication per month (AOR = 23.87, 95% C.I. = 10.57–53.92). Conclusion: Educational status, salary/income, ART duration, ART combination regimen, and number of doses missed were statistically significantly associated with virological failure in patients on antiretroviral therapy. The majority of the respondents adhered to ART, which led to moderate viral load suppression but lower than the target for 2020. There is the need to strengthen the ongoing accelerated social behavior change communication among patients on ART to enhance adherence in order to attain the new UNAIDS target of 95% viral load suppression by 2030 in the Upper East Region of Ghana.
背景:尽管针对HIV(人类免疫缺陷)患者的高活性抗逆转录病毒疗法(HAART)显著改善了病毒载量的抑制,但仍有更多的人在努力降低病毒载量。该研究的目的是确定加纳上东部地区接受抗逆转录病毒疗法(ART)的HIV患者病毒学失败的相关因素。方法:一项回顾性横断面研究涉及366名年龄在15岁及以上的参与者,他们在2020年接受HAART治疗六(6)个月或更长时间,并获得病毒载量结果。进行双变量和多元逻辑回归分析,以95%置信区间(C.I.)确定HIV患者病毒学失败的决定因素,显著水平与p值小于0.05挂钩。结果:在接受HAART的患者中,病毒载量失败的发生率为47.0%,坚持抗逆转录病毒疗法的发生率是62.6%。病毒学失败的重要预测因素是基础教育(AOR(调整后的比值比)=7.36,95%C.I=4.91–59.71)、高中/职业/技术教育(AOR=4.70,95%C.I.=1.90–9.69)、月薪/收入375.00 GHS(AOR=7.20,95%C.=1.73–29.95)、抗逆转录病毒疗法持续时间1年(AOR=0.27,95%C.I.=0.10–0.75),ART方案(替诺福韦+拉米夫定+埃法韦仑)(AOR=3.26,95%CI=1.95-11.25),每月漏药3-5次(AOR=2.86,95%CI=1.34-6.08)和每月漏药≥6次(AOR=23.87,95%CI=10.57-53.92),和漏服剂量数在统计学上与抗逆转录病毒治疗患者的病毒学失败显著相关。大多数受访者坚持抗逆转录病毒疗法,这导致了适度的病毒载量抑制,但低于2020年的目标。有必要加强抗逆转录病毒疗法患者之间正在进行的加速社会行为改变沟通,以提高依从性,从而实现联合国艾滋病规划署到2030年在加纳上东部地区抑制95%病毒载量的新目标。
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引用次数: 2
Prevalence of Comorbidities and Associated Factors among HIV Patients Attending Antiretroviral Clinics in the Tamale Metropolis, Ghana 加纳塔马勒市抗逆转录病毒诊所HIV患者合并症患病率及相关因素
Pub Date : 2022-12-28 DOI: 10.3390/venereology2010001
Kingsley Aseye Hattoh, Bryan Aapentuo Sienso, E. Kuugbee
Human Immunodeficiency Virus (HIV) is a chronic infectious disease, and without antiretroviral therapy (ART), it is associated with comorbidities. The prevalence of comorbidities, adherence to ART and quality of life (QoL) of HIV patients were studied. A cross-sectional study design involving 360 HIV patients from two ART clinics across the Tamale metropolis was employed. Socio-demography, adherence to therapy, and QoL data were taken with the help of a questionnaire and analyzed using SPSS version 24. The prevalence of comorbidities was 30.3% (109), with Hepatitis B infection (73, 20.3%) being the most prevalent. Adherence levels were high (192, 53.3%), moderate (108, 30.0%) and low (60, 16.7%). Overall, QoL was excellent amongst 149 (41.4%), good in 169 (46.7%), and poor in 42 (11.7%) respondents. Marital status, presence or absence of HIV symptoms, adherence level to ART and overall QoL, especially Physical, Psychological, and independence domains (p < 0.05), were factors associated with the presence of comorbidities. There is a high level of comorbidities among persons living with HIV (PLWH) in the Tamale metropolis influenced by QoL and adherence to ART. We recommend a multifaceted approach to the management of PLWH.
人类免疫缺陷病毒(HIV)是一种慢性传染病,没有抗逆转录病毒治疗(ART),它与合并症有关。研究艾滋病患者的合并症发生率、抗逆转录病毒治疗依从性和生活质量。采用横断面研究设计,涉及来自Tamale大都市两家ART诊所的360名HIV患者。社会人口学、治疗依从性和生活质量数据在问卷调查的帮助下进行,并使用SPSS version 24进行分析。合并症发生率为30.3%(109例),其中乙型肝炎感染发生率最高(73例,20.3%)。依从性高(192人,53.3%)、中(108人,30.0%)、低(60人,16.7%)。总体而言,有149人(41.4%)认为生活质量很好,169人(46.7%)认为生活质量好,42人(11.7%)认为生活质量差。婚姻状况、是否存在HIV症状、抗逆转录病毒治疗的依从性水平和总体生活质量,特别是身体、心理和独立领域(p < 0.05),是与合并症存在相关的因素。在Tamale大都会,受生活质量和抗逆转录病毒治疗依从性的影响,艾滋病毒感染者(PLWH)的合并症水平很高。我们建议采用多方面的方法来管理PLWH。
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引用次数: 1
Trends and Factors Associated with HIV Testing among Adolescent Girls and Young Women in Lesotho: Results from 2004 to 2014 Lesotho Demographic and Health Surveys 莱索托少女和年轻妇女艾滋病毒检测的趋势和相关因素:2004年至2014年莱索托人口与健康调查结果
Pub Date : 2022-11-07 DOI: 10.3390/venereology1030019
Onalethata Ntshadi Sonny, A. Musekiwa
HIV/AIDS is prevalent among adolescent girls and young women (AGYW) in Lesotho, and among the top five infectious diseases causing a high mortality rate in Africa. The paramount management of HIV is based on screening, prevention, and therapeutic interventions, of which HIV testing and counselling (HTC) is the gateway. The utilization of HTC services among AGYW is limited owing to numerous barriers encountered by this population group. The aim of this study was to assess trends and factors associated with HTC among AGYW in Lesotho. A secondary data analysis was used to analyze data sets extracted from the 2004, 2009, and 2014 Lesotho Demographic Health Surveys (LDHS). The LDHS was conducted using a cross-sectional study design and samples drawn were representative of the whole population of Lesotho. We used descriptive analysis to determine trends in HTC. In determining factors associated with the uptake of HTC, univariate and multivariable logistic regression models were applied on the 2014 LDHS. All analyses were adjusted for unequal sampling probabilities using survey weights. The number of AGYWs analyzed were 2743 in 2004, 2393 in 2009, and 2842 in 2014. The overall prevalence estimates of HTC uptake were 12%, 62.2%, and 72.5%, respectively. For the 15–19 years AGYW, HTC uptake rose from 6.2% (2004), 46.3% (2009), to 57.9% (2014), while for the 20–24 years age group, the rates were 18.7%, 80.2%, and 88.3%, respectively. For the 2842 AGYW in 2014, the odds of ever having an HIV test were significantly higher for those aged 20–24 years (aOR 2.15, 95% CI 1.61 to 2.87, p < 0.001), in a union (aOR 3.21, 95%CI 2.25 to 4.58, p < 0.001), with Mother-to-child transmission of HIV (MTCT) knowledge (aOR 1.53, 95%CI: 1.21 to 1.94, p < 0.001), with HIV non-discriminatory attitudes (aOR 2.50, 95%CI 1.87 to 3.34, p < 0.001), and those who had ever been pregnant (aOR 11.53, 95%CI 7.46 to 17.84, p < 0.001). HTC uptake among AGYW in Lesotho is below expected targets, hence we recommend optimizing access to HTC services, especially for AGYW aged 15–19 years.
艾滋病毒/艾滋病在莱索托的少女和年轻妇女中很普遍,是非洲造成高死亡率的五大传染病之一。艾滋病毒的最高管理是基于筛查、预防和治疗干预,其中艾滋病毒检测和咨询是其中的门户。AGYW对HTC服务的利用受到限制,因为这一群体遇到了许多障碍。本研究的目的是评估莱索托AGYW中与HTC相关的趋势和因素。二次数据分析用于分析从2004年、2009年和2014年莱索托人口健康调查(LDHS)中提取的数据集。LDHS采用横断面研究设计进行,抽取的样本代表莱索托全体人口。我们使用描述性分析来确定HTC的趋势。在确定与HTC摄取相关的因素时,对2014年LDHS应用了单变量和多变量逻辑回归模型。所有分析都使用调查权重对不相等的抽样概率进行了调整。分析的AGYW数量在2004年为2743个,2009年为2393个,2014年为2842个。HTC摄取的总体患病率估计值分别为12%、62.2%和72.5%。在15-19岁的AGYW中,HTC的摄取率从6.2%(2004年)、46.3%(2009年)上升到57.9%(2014年),而在20-24岁的年龄组中,摄取率分别为18.7%、80.2%和88.3%。在2014年的2842名AGYW中,20-24岁(aOR 2.15,95%CI 1.61至2.87,p<0.001)、联合(aOR 3.21,95%CI 2.25至4.58,p<001)、母婴传播艾滋病毒(MTCT)知识(aOR 1.53,95%CI 1.21至1.94,p<.001)、艾滋病毒非歧视态度,以及那些曾经怀孕的人(aOR 11.53,95%CI 7.46至17.84,p<0.001)。莱索托AGYW的HTC摄取量低于预期目标,因此我们建议优化HTC服务的使用,尤其是15-19岁的AGYW。
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引用次数: 0
Sub-Regional Variations in Sexually Transmitted Infections Manifesting as Vaginitis among Reproductive-Aged Women in Sub-Saharan Countries 撒哈拉以南国家育龄妇女性传播感染表现为阴道炎的亚区域差异
Pub Date : 2022-11-02 DOI: 10.3390/venereology1030018
Michael Ekholuenetale, CHIMEZIE IGWEGBE NZOPUTAM, Osaretin Christabel Okonji
Sexually transmitted infection refers to a group of clinical syndromes that can be acquired and transmitted through sexual activity and are caused by a variety of pathogens such as bacteria, fungi, viruses, and parasites. Methods: Demographic and Health Survey data involving women aged 15–49 years were analyzed for this study. The surveys were conducted between 2006–2021. Statistical significance was determined at p < 0.05. Results: From the results, Liberia (33.0%), Mali (14.0%), Guinea (13%), Uganda, and Sierra Leone (12.0% each) had the highest STI prevalence. Prominently from Western sub-Saharan Africa sub-region, Liberia (40.0%), Guinea (31.0%), Mali (28.0%), Cote d’Ivoire (24.0%), Ghana (23.0%) and Mauritania (22.0%) have the highest prevalence of reporting a bad smelling or abnormal genital discharge. In addition, Liberia (30.0%), Uganda (13.0%) and Malawi (10.0%) have the highest prevalence of reporting genital sores or ulcers. Liberia (48.0%), Guinea (34.0%), Mali (32.0%), Ghana and Mauritania (25.0% each) and Uganda (24.0%) reported the leading prevalence of STI, genital discharge, or a sore or ulcer. Conclusion: The prevalence of vaginitis varied according to women’s characteristics. In many countries, younger women, urban dwellers, educated women, rich and unmarried women reported a higher prevalence of STI, genital discharge, or a sore or ulcer. Women should be educated on the advantages of proper hygiene, and prevention and control of STIs. Program planners and policymakers should assess and improve the collaboration and coordination of nutritional and family health programs aimed at addressing women’s health issues.
性传播感染是指由细菌、真菌、病毒和寄生虫等多种病原体引起的一组可通过性活动获得和传播的临床综合征。方法:本研究分析了涉及15-49岁女性的人口与健康调查数据。调查于2006年至2021年间进行。统计学意义确定为p<0.05。结果:从结果来看,利比里亚(33.0%)、马里(14.0%)、几内亚(13%)、乌干达和塞拉利昂(各12.0%)的STI患病率最高。特别是在撒哈拉以南非洲西部次区域,利比里亚(40.0%)、几内亚(31.0%)、马里(28.0%)、科特迪瓦(24.0%)、加纳(23.0%)和毛里塔尼亚(22.0%)的生殖器分泌物臭味或异常报告率最高。此外,利比里亚(30.0%)、乌干达(13.0%)和马拉维(10.0%)报告生殖器溃疡或溃疡的患病率最高。利比里亚(48.0%)、几内亚(34.0%)、马里(32.0%)、加纳和毛里塔尼亚(各25.0%)以及乌干达(24.0%)报告了STI、生殖器分泌物或疼痛或溃疡的主要流行率。结论:阴道炎的患病率因女性的特点而异。在许多国家,年轻女性、城市居民、受过教育的女性、富人和未婚女性报告说,性传播感染、生殖器分泌物或疼痛或溃疡的患病率较高。应当对妇女进行适当卫生以及预防和控制性传播感染的好处教育。方案规划者和政策制定者应评估和改进旨在解决妇女健康问题的营养和家庭健康方案的合作与协调。
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引用次数: 1
Treatment of Sexually Transmitted Infections (STIs) Caused by Neisseria gonorrhoeae and the Global Shortage of Antibiotics 淋病奈瑟菌引起的性传播感染的治疗和全球抗生素短缺
Pub Date : 2022-10-24 DOI: 10.3390/venereology1030017
J. L. R. Martins, E. M. H. Pinto, Salomão Antonio Oliveira, Fernanda Almeida Costa Gomes, O. N. Silva
The gonorrhoea caused by the bacterium Neisseria gonorrhoeae remains a major global public health problem with high morbidity. Gonorrhoea can affect both women and men, being more prevalent in sexually active young individuals. Even after infection from N. gonorrhoeae, many patients may remain asymptomatic, making the diagnosis and adequate treatment of the disease difficult. The treatment and control of gonorrhoea have been difficult in recent years in most populations, being an example of how behavioural, social, and demographic factors can influence the epidemiology of an infectious disease. The emergence of strains of N. gonorrhoeae resistant to multiple antimicrobials, especially to extended-spectrum cephalosporins, indicates that gonorrhoea has the potential to become untreatable in the current reality of treatment options, especially in places that have a high prevalence of gonococcal infections. The loss of available and effective treatment options can lead to significant increases in new cases of the disease, as well as increased morbidity and mortality. This review provides an overview of current therapeutic options for gonorrhoea, as well as ongoing experimental studies and clinical trials with new antigonococcal agents.
由淋病奈瑟菌引起的淋病仍然是一个发病率高的主要全球公共卫生问题。淋病对女性和男性都有影响,在性活跃的年轻人中更为普遍。即使感染了淋病奈瑟菌,许多患者仍可能没有症状,这使得该疾病的诊断和充分治疗变得困难。近年来,淋病的治疗和控制在大多数人群中都很困难,这是行为、社会和人口因素如何影响传染病流行病学的一个例子。淋病奈瑟菌菌株对多种抗菌药物,特别是对广谱头孢菌素产生耐药性,这表明在目前的治疗选择中,淋病有可能变得无法治疗,尤其是在淋球菌感染率高的地方。失去可用和有效的治疗选择可能导致新病例的显著增加,以及发病率和死亡率的增加。这篇综述概述了目前淋病的治疗方案,以及正在进行的新抗淋球菌药物的实验研究和临床试验。
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引用次数: 0
Factors Associated with the Use of Industrial Liquid Silicone among Travesti and Transgender Women in Salvador, Northeast Brazil 巴西东北部萨尔瓦多的Travesti和变性妇女使用工业液体硅酮的相关因素
Pub Date : 2022-10-10 DOI: 10.3390/venereology1030016
Ricardo Araújo da Silva, L. A. V. da Silva, Fabiane Soares, I. Dourado
Background: The illicit use of industrial liquid silicone (ILS) is a common practice among travesti and transgender Women (TrTW) in the process of bodily change. The “pumped ladies” apply the ILS without any preparation regarding biosafety, and this practice poses serious risks to the health of TrTW, including death. This study aims to describe the prevalence of ILS use and estimate the associated factors among TrTW in a Brazilian city. Methods: This behavioral and serological survey employed the Respondent-Driven Sampling (RDS) recruitment technique. Participants who declared themselves to be travesti or transgender women over 15 years were considered eligible. The sample consisted of 127 TrTW. The bivariate analysis estimated the prevalence of ILS use by sociodemographic, cultural, and behavioral variables. Multivariate analysis used Poisson regression for adjusted estimates with respective 95% confidence intervals. Results: Approximately 31.6% of the TrTW (n = 44) used ILS and 57.2% (n = 67) were under 25 years old. Most (73.2%, n = 79) had access to more than eight years of schooling. Nine percent (n = 15) tested positive for HIV, and 31.6% (n = 48) tested positive for syphilis. The TrTW who felt more comfortable with their body image had a threefold higher prevalence of ILS use and those who performed an HIV test before the study had a 4.5 times higher prevalence of ILS. Conclusion: ILS is widely used by TrTW in Brazil. Although public policies for the transgenderizing process exist, this process still occurs illicitly.
背景:工业液体硅胶(ILS)的非法使用是旅行者和变性妇女(TrTW)在身体改变过程中的常见做法。"抽脂女士"在没有任何生物安全准备的情况下使用ILS,这种做法对TrTW的健康构成严重风险,包括死亡。本研究旨在描述巴西某城市中ILS使用的流行程度,并估计与TrTW相关的因素。方法:行为和血清学调查采用受访者驱动抽样(RDS)招募技术。15年以上自称为旅行者或变性女性的参与者被认为是合格的。样品由127个TrTW组成。双变量分析通过社会人口学、文化和行为变量估计了ILS使用的流行程度。多变量分析使用泊松回归对调整后的估计值进行了相应的95%置信区间分析。结果:约31.6%的TrTW (n = 44)使用ILS, 57.2% (n = 67)年龄在25岁以下。大多数(73.2%,n = 79)接受过8年以上的学校教育。9% (n = 15)的艾滋病病毒检测呈阳性,31.6% (n = 48)的梅毒检测呈阳性。那些对自己的身体形象感到更舒适的TrTW使用ILS的几率要高出三倍,而那些在研究之前进行过HIV检测的人使用ILS的几率要高出4.5倍。结论:巴西TrTW广泛应用ILS。虽然存在跨性别过程的公共政策,但这一过程仍然非法发生。
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引用次数: 0
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Venereology (Basel, Switzerland)
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