Neringa Guobytė, Andrius Jurėnas, Tadas Raudonis, Rita Buivydaitė, Jūratė Grigaitienė
Abstract
Sexually transmitted infections (STIs) are the infections which can be caught during all types of sexual intercourse. Althought, some of the infections can be transmitted without sexual contact: by sharing infected syringes and needles, through the infected blood and its products, during pregnancy and the perinatal period. Over 1 million people in the world are infected by STIs every day, most of them are young, sexually active men. The most wide spread infections are syphilis, gonorrhea, chlamydia, trichomoniasis, hepatitis B, Herpes simplex, HIV, HPV. The main risk factors are: frequent change of sexual partners, unprotected sex, alcohol or drugs before sex. Around 90% of infections are asymptomatic or the symptoms are insignificant, the asymptomatic period of STIs is highly variable and depends on the specific agent. Untreated or unsuccessfully treated infections can cause serious complications. Objective. To evaluate the data of medical history, diagnostics, treatment and its effectiveness to the patients who have tested positive for the molecular testing of 7 sexually transmitted pathogens. Materials and methods. In Vilnius University Hospital Santariskiu clinic’s Centre of Dermatovenerology (VUL SK DVC) 245 patients were diagnosed with an STI by molecular analysis. The effectiveness of the treatment was evaluated for 103 patients who came for a follow-up within 3 months. The statistical significance was calculated using the Chi-square test (p≤0.05). Results. 75% (n=184) studied patients were women, the average age was 36 years, men constituted 25% (n=61), average age – 33 years. 5.4% of women and 14.8% of men claimed having unprotected sex. Women mostly complained of joint pain (57.1%), excessive discharge (47.3%), men – joint pain (27.9%), rash. Most of the patients had complaints that have been lasting for more than 6 months. One pathogen was identified in 73.9% of patients and a few (two or three) – in 26.1% of patients. Most commonly identified pathogens or their combinations: U. parvum (53.5%) U. urealyticum (11%), U. parvum together with M. hominis (8.6%), C. trachomatis (4.9%), U. parvum together with U. urealyticum (4.5%). 75.5% of women and 83.6% men were treated. In 68% of women and 85.7% of men the treatment was successful. The efficiency of the treatment was measured in the U. parvum group: 46.8% of patients received a total of 2.8 g of doxycycline (77.3% cure rate) and 8.5% of patients received a total of 4.2 g of doxycycline (100% cure rate), (p=1.000). 12.8% of patients received a total of 1.5 g of azithromycin (66.7% cure rate) and 31.9% of patients received >1.5 g of azithromycin (66.7% cure rate), (p=0.065). Conclusions. Women with STIs present to doctors more often than men. The risk of getting infected by STIs for men is 3 times higher than that for women. More than half of women and one third of men complained of joint pain. Most patients delay seeking medical care. U. parvum infection was diagnosed for more than half of all the patients. 78% of patients were treated and three-quarters of them were cured. No statistically significant correlation was identified between the positive treatment effect, the chosen medicine (azithromycin or doxycycline) and the extended duration of its use.
Keyword(s): sexually transmitted diseases; STIs; molecular analysis; microscopic examination; treatment efficiency.
DOI: 10.5200/sm-hs.2017.015
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