妇科门诊就诊者生殖道感染调查

A survey of prevalence of reproductive tract infections in visitors to gynecologic clinics

目的 了解妇科门诊阴道分泌物异常就诊者生殖道感染状况,为制订妇女性病艾滋病干预计划提供基础信息.方法 对2004年1～12月上海市闸北区妇幼保健所和宁波市海曙区马园卫生院妇科门诊,主诉阴道分泌物异常的1 565例初诊病例进行生殖道感染调查.结果 上海、宁波本地户口病例753例,以无待业、工人居多;外地812例,以工人、服务员居多.3.9%的人近3个月有1个以上新性伴,8.1%的人经常使用安全套.60.2%（942例）有生殖道感染.12.6%（197例）合并2～4种感染,多为外地病例.检出率最高的是细菌性阴道病（23.2%）,其次是衣原体感染（16.7%）.外地病例淋菌感染检出率（5.3%）、近3个月有1个以上新性伴的比例（6.8%）、初中以下文化的比例（87.2%）,均高于当地病例（43.6%）.经常使用安全套的比例（3.2%）低于当地病例（13.3%）.结论 妇科门诊就诊者以常见生殖道感染居多.法定报告的性病（淋菌和衣原体感染）占一定比例,应引起足够重视.外地病例合并生殖道感染较多,安全套使用率低,存在较多传播性病艾滋病的危险因素.应针对她们文化程度较低的特点和对生殖健康的需求,加强有关性病艾滋病防治的宣传和咨询,积极开展生殖道感染预防、性病诊疗、安全套促进和行为干预工作.

Objective To investigate the prevalence of reproductive tract infections（RTI）in women with vaginal discharge attending gynecologic clinics, in order to provide evidence for the formulation of STD/AIDS intervention strategies for women. Methods A total of 1565 women with vaginal discharge were recruited,at their respective first visits to Zhabei Women and Child Health Care Hospital in Shanghai, and to Mayuan Hospital in Ningbo of Zhejiang, from January to December, 2004. RTIs were detected and behaviors were surveyed in these women.Results A total of 753 local women were surveyed,most of them being unemployed or workers, and meanwhile 812 women emigrating from other regions were also surveyed,most of them being workers and employees of entertainment establishments. It was found that 3.9 % of the emigrant women had more than one sexual partner in the recent 3 months, and 8.1% them used condom.A total of 942（60.2%）women had RTIs, among whom 197 （12.6%）had co-infections,most of them being emigrants.The highest prevalence of RTIs was bacterial vaginosis（23.2% ）,and the next was chlamydial infections（16.7% ）.Compared with local women,higher rates of gonococcal infection（5.3% vs 2.5% ） were found among emigrant women who had more than 1 sex parmer（6.8% vs 0.8% ） ,lower education,less than junior middle school education（87.2% vs 43.6% ） ,and lower rate of frequent condom use（3.2% vs 13.3% ）.Conclusions Attention should be paid to sexually transmitted infections（chlamydial infection and gonorrhea）in women attending gynecologic clinics, although other RTIs were common. RTIs are frequent,and condom use rates are low in emigrant women. There are many STD/AIDS risk factors in this population group.Considering their low education and reproductive health needs, it is important to strengthen RTI/ STD/AIDS health education, counseling, prevention, management of RTIs, condom promotion and behavior intervention in this particular population group.