儿科性传播感染

D. Coronel-MartÍnez, Luis Augusto Moya-Barquín
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摘要

性传播疾病对年轻人的影响尤为严重,一半以上的感染发生在15至25岁之间,尽管作为一个年龄组,他们只占性活跃人口的25%。青少年被认为是关键的弱势群体;青少年被认为是边缘化人群(即难以获得适当的保健服务、社会和父母的接受、污名化等)。每年,全世界15至49岁人群中报告的淋病新发病例为8700万例。2016年,全球15- 49岁女性的CT患病率估计为3.8%,男性为2.7%,女性的区域患病率为1.5%至7.0%,男性为1.2%至4.0%。15 - 49岁人群中2型单纯疱疹病毒的全球患病率为11.3%,0 - 49岁人群中1型单纯疱疹病毒的全球患病率为67%。这些数字提醒我们,这些疾病在年轻人群中的发病率正在上升;更开放的性行为可能是这一增长的重要因素;由于难以发现和治疗,这些疾病的治疗具有挑战性;就淋病而言,由于抗菌素耐药性的出现,淋病可能成为一个重大的公共卫生问题;就衣原体而言,尽管有有效的治疗方法,但仍有可能再次感染;对于生殖器疱疹,这种疾病可以控制,但无法治愈。本章将描述这三种疾病最重要的方面,以支持临床医生和研究人员对青少年人群中的性传播疾病的管理。
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Sexually Transmitted Infections in Pediatrics
Sexually transmitted diseases (STDs) disproportionately affect young people, with more than half of the infections occurring in 15- to 25-year-olds, although as an age group they constitute only 25% of the sexually active population. Adolescents have been considered as a key and vulnerable population; adolescents are considered as marginalized populations (i.e., poor access to adequate health services, social and parental acceptance, stigmatization, among others. Every year, 87 million new cases of gonorrhea are reported worldwide in the population from 15 to 49 years old. In 2016, the estimated global prevalence of CT in 15-to 49-year-old women was 3.8% and in men 2.7%, with regional values ranging from 1.5 to 7.0% in women and 1.2 to 4.0% in men. The worldwide prevalence of HSV-2 among 15–49-year old is 11.3% and for HSV-1 among 0–49-year-old is 67%. These numbers alert us about the increase in the frequency of these diseases among young populations; more open sexual behavior could be an important factor for this increase; the treatment of these diseases is challenging due to the difficulties with detection and treatment; in the case of gonorrhea, it could become a major public health problem due to the emerging antimicrobial resistance; in the case of Chlamydia, despite the effective treatment, reinfection is still a possibility and for genital herpes, the disease can be controlled but not cured. This chapter will describe the most important aspects of these three diseases for supporting the clinicians and researchers about the management of sexually transmitted diseases in the adolescent population.
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