Background and objective: Early and accurate diagnosis is one of the critical requirements for successful management of all diseases. Yet, delayed diagnosis and misdiagnosis remain as vital problems, consequently impo...Background and objective: Early and accurate diagnosis is one of the critical requirements for successful management of all diseases. Yet, delayed diagnosis and misdiagnosis remain as vital problems, consequently impose adverse effects on patient treatment. Sexually transmitted disease (STD) is one of the most common infectious diseases, and more than one million of STD cases are acquired every day globally. Misdiagnosis of STD inevitably exists, therefore should not be overlooked. Being a medical diagnostic laboratory providing various STDs diagnosing service in Hong Kong, we aimed to determine the misdiagnosis rate of STDs and investigate the possible underlying cause. Methods: Specimens were collected for STD diagnosis from multiple clinics during 1 June 2021 to 20 October 2021 from different clinics and hospitals were included in the study. DNA extraction was performed using magnetic bead based method;then the extracted DNA was tested using the DiagCor GenoFlow<sup>TM</sup> STD Array kit to detect the existence of any targeted pathogens. Results: 1459 specimens were collected and included during the designated time period, with 643 specimens found to be positive with at least one targeted STD pathogen. 494 of these were found to be aligned with test ordered by physicians, and the remaining 149 positive cases had at least one pathogen detected but not requested to be tested by the physicians resulting in misdiagnosis. The overall misdiagnosis rate was determined to be 23.2% (149/643), with high frequency of misdiagnosis occurred to tests ordered for one to three pathogens detection. Also, Ureaplasma urealyticum and/or Ureaplasma parvum (UU/UP) was the commonest pathogen detected in this study. Conclusion: The findings suggested incorrect test selection made by physicians was one of the major reasons of STDs misdiagnosis in outpatient settings. To reduce diagnostic errors in STD diagnosis, physicians are encouraged to select and request test that allow detection of multiple pathogens, as co-infection of multiple pathogens in STD patients is commonly observed. The correct selection of test would not only benefit the patient, but also the public health.展开更多
A 29-year-old man was admitted for erythema, papules and erosions. Erosions and purulent secretions were seen in the circumference of the mouth, eyes, oral mucosa,tongue, and preputium. Conjunctivas were swollen and t...A 29-year-old man was admitted for erythema, papules and erosions. Erosions and purulent secretions were seen in the circumference of the mouth, eyes, oral mucosa,tongue, and preputium. Conjunctivas were swollen and the urethral orifice was red, both were accompanied by purulent secretions. Multiple vesicles were shown in the penis.The patient was diagnosed with:①Stevens-Johnsonsyndrome;②gonococcal ophthalmoblennorrhea;③nongonococcal urethritis, gonococcal urethritis;④genital herpes;⑤mediastinal tumor.展开更多
Objectives： To understand trends and epidemiology of STDs in Chongqing from 1998 to 2003 and to provide scientific evidence for developing preventive strategies and distributing government health resources effectivel...Objectives： To understand trends and epidemiology of STDs in Chongqing from 1998 to 2003 and to provide scientific evidence for developing preventive strategies and distributing government health resources effectively. Methods： STD case-reporting data collected from 43 counties and districts in Chongqing from 1998 to 2003 were analyzed with STD Data Management Software and Excel Software. Results： A total of 133,323 cases of eight different STDs were reported from 1998-2003. The annual incidence of all eight STDs combined was 71.89/10^5.Generally, reported cases and incidence have decreased since 2001. Although gonorrhoea diagnoses made up a significant proportion of the STD burden, this proportion decreased annually. The proportion of the STD burden attributed to Condyloma accuminatum （CA） was always above 30 percent. The proportions of non-gonoccocal urethritis, genital herpes and syphilis within the combinedSTD burden increased gradually from 1998 to 2003.Reported cases of HIV increased rapidly over this time. A total of 214 HIV cases were reported from 1998 to 2003,the majority of which were among men. For HIV, the maleto-female ratio was 1.17, but CA was found among more women than men. Incidence for all STDs was highest among 20-39 year olds, who accounted for 72.2% of reported infections. The majority of STDs were transmitted through extra-marital intercourse,accounting for 55.3%. Conclusion： The STD epidemic in Chongqing changed from 1998-2003. STD incidence declined, as a result of various factors. The epidemiology of STDs has changed.HIV incidence has increased rapidly. This indicates that the AIDS epidemic has reached a critical period. The results of this study suggest a need for readjusting control measures and redistributing health resources.展开更多
Background:Delayed or inappropriate treatment for sexually transmitted diseases(STDs)increases the risk of HIV acquisition and may cause other harmful outcomes.However,studies on STD treatment-seeking behaviour and co...Background:Delayed or inappropriate treatment for sexually transmitted diseases(STDs)increases the risk of HIV acquisition and may cause other harmful outcomes.However,studies on STD treatment-seeking behaviour and correlated factors in men who have sex with men(MSM)are scarce.This information is crucial for the promotion of STD treatment-seeking behaviour and reduction of HIV transmission among Chinese MSM.Methods:During 2012-2013,a multicentre cross-sectional study was conducted in 7 Chinese cities.Participants completed an interview-questionnaire and gave venous blood samples,which were then tested for antibodies to HIV,syphilis,and herpes simplex virus-2(HSV-2).MSM who tested positive for syphilis/HSV-2 or had obvious STD-related symptoms within the last 12 months were defined as suspected STD-infected MSM.Results:Of the 4496 eligible MSM who completed this survey,24.4%(1096/4496)were categorized as suspected STD-infected MSM.35.7%(391/1096)of these MSM with suspected STD infections sought STD treatment in clinics within the last 12 months.Among MSM who did not attend STD clinics for treatment,the prevalence of syphilis and HSV-2 was significantly higher;the HIV prevalence and incidence within this subpopulation reached as high as 14.5%and 12.2/100 person-years,respectively.Multivariate logistic regression analysis indicated that having 7-12 years of education(vs.≤6 years;aOR,2.5;95%CI,1.0-6.1),≥13 years of education(vs.≤6 years:aOR,2.8;95%CI,1.2-7.0),monthly income>500 USD(vs.≤500 USD:aOR,1.5;95%CI,1.1-2.1),obvious STD-related symptoms within last 12 months(aOR,5.3;95%CI,3.7-7.5),being HIV infected(aOR,1.7;95%CI,1.1-2.6),currently syphilis infected(aOR,0.6;95%CI,0.4-0.9)and HSV-2 infected(aOR,0.6;95%CI,0.5-0.9)were independent correlates with seeking STD treatment in clinics among Chinese MSM.Conclusions:The high prevalence of STD infection coupled with a low proportion of individuals who exhibit appropriate treatment-seeking behaviour create a high risk of a growing HIV epidemic among Chinese MSM.Models that prioritize better screening for and education about STDs should be urgently implemented,especially among low-income MSM.展开更多
文摘Background and objective: Early and accurate diagnosis is one of the critical requirements for successful management of all diseases. Yet, delayed diagnosis and misdiagnosis remain as vital problems, consequently impose adverse effects on patient treatment. Sexually transmitted disease (STD) is one of the most common infectious diseases, and more than one million of STD cases are acquired every day globally. Misdiagnosis of STD inevitably exists, therefore should not be overlooked. Being a medical diagnostic laboratory providing various STDs diagnosing service in Hong Kong, we aimed to determine the misdiagnosis rate of STDs and investigate the possible underlying cause. Methods: Specimens were collected for STD diagnosis from multiple clinics during 1 June 2021 to 20 October 2021 from different clinics and hospitals were included in the study. DNA extraction was performed using magnetic bead based method;then the extracted DNA was tested using the DiagCor GenoFlow<sup>TM</sup> STD Array kit to detect the existence of any targeted pathogens. Results: 1459 specimens were collected and included during the designated time period, with 643 specimens found to be positive with at least one targeted STD pathogen. 494 of these were found to be aligned with test ordered by physicians, and the remaining 149 positive cases had at least one pathogen detected but not requested to be tested by the physicians resulting in misdiagnosis. The overall misdiagnosis rate was determined to be 23.2% (149/643), with high frequency of misdiagnosis occurred to tests ordered for one to three pathogens detection. Also, Ureaplasma urealyticum and/or Ureaplasma parvum (UU/UP) was the commonest pathogen detected in this study. Conclusion: The findings suggested incorrect test selection made by physicians was one of the major reasons of STDs misdiagnosis in outpatient settings. To reduce diagnostic errors in STD diagnosis, physicians are encouraged to select and request test that allow detection of multiple pathogens, as co-infection of multiple pathogens in STD patients is commonly observed. The correct selection of test would not only benefit the patient, but also the public health.
文摘A 29-year-old man was admitted for erythema, papules and erosions. Erosions and purulent secretions were seen in the circumference of the mouth, eyes, oral mucosa,tongue, and preputium. Conjunctivas were swollen and the urethral orifice was red, both were accompanied by purulent secretions. Multiple vesicles were shown in the penis.The patient was diagnosed with:①Stevens-Johnsonsyndrome;②gonococcal ophthalmoblennorrhea;③nongonococcal urethritis, gonococcal urethritis;④genital herpes;⑤mediastinal tumor.
文摘Objectives： To understand trends and epidemiology of STDs in Chongqing from 1998 to 2003 and to provide scientific evidence for developing preventive strategies and distributing government health resources effectively. Methods： STD case-reporting data collected from 43 counties and districts in Chongqing from 1998 to 2003 were analyzed with STD Data Management Software and Excel Software. Results： A total of 133,323 cases of eight different STDs were reported from 1998-2003. The annual incidence of all eight STDs combined was 71.89/10^5.Generally, reported cases and incidence have decreased since 2001. Although gonorrhoea diagnoses made up a significant proportion of the STD burden, this proportion decreased annually. The proportion of the STD burden attributed to Condyloma accuminatum （CA） was always above 30 percent. The proportions of non-gonoccocal urethritis, genital herpes and syphilis within the combinedSTD burden increased gradually from 1998 to 2003.Reported cases of HIV increased rapidly over this time. A total of 214 HIV cases were reported from 1998 to 2003,the majority of which were among men. For HIV, the maleto-female ratio was 1.17, but CA was found among more women than men. Incidence for all STDs was highest among 20-39 year olds, who accounted for 72.2% of reported infections. The majority of STDs were transmitted through extra-marital intercourse,accounting for 55.3%. Conclusion： The STD epidemic in Chongqing changed from 1998-2003. STD incidence declined, as a result of various factors. The epidemiology of STDs has changed.HIV incidence has increased rapidly. This indicates that the AIDS epidemic has reached a critical period. The results of this study suggest a need for readjusting control measures and redistributing health resources.
基金The study was supported by the Mega-Projects of national science research for the 12th 5-Year Plan(2012ZX10001-006)China-Gates Foundation Cooperation Programme(grant no.2012)+1 种基金Liaoning educational department research project(grant no.LZ2014038)Research project of the first hospital of CMU(grant no.FSFH1512)。
文摘Background:Delayed or inappropriate treatment for sexually transmitted diseases(STDs)increases the risk of HIV acquisition and may cause other harmful outcomes.However,studies on STD treatment-seeking behaviour and correlated factors in men who have sex with men(MSM)are scarce.This information is crucial for the promotion of STD treatment-seeking behaviour and reduction of HIV transmission among Chinese MSM.Methods:During 2012-2013,a multicentre cross-sectional study was conducted in 7 Chinese cities.Participants completed an interview-questionnaire and gave venous blood samples,which were then tested for antibodies to HIV,syphilis,and herpes simplex virus-2(HSV-2).MSM who tested positive for syphilis/HSV-2 or had obvious STD-related symptoms within the last 12 months were defined as suspected STD-infected MSM.Results:Of the 4496 eligible MSM who completed this survey,24.4%(1096/4496)were categorized as suspected STD-infected MSM.35.7%(391/1096)of these MSM with suspected STD infections sought STD treatment in clinics within the last 12 months.Among MSM who did not attend STD clinics for treatment,the prevalence of syphilis and HSV-2 was significantly higher;the HIV prevalence and incidence within this subpopulation reached as high as 14.5%and 12.2/100 person-years,respectively.Multivariate logistic regression analysis indicated that having 7-12 years of education(vs.≤6 years;aOR,2.5;95%CI,1.0-6.1),≥13 years of education(vs.≤6 years:aOR,2.8;95%CI,1.2-7.0),monthly income>500 USD(vs.≤500 USD:aOR,1.5;95%CI,1.1-2.1),obvious STD-related symptoms within last 12 months(aOR,5.3;95%CI,3.7-7.5),being HIV infected(aOR,1.7;95%CI,1.1-2.6),currently syphilis infected(aOR,0.6;95%CI,0.4-0.9)and HSV-2 infected(aOR,0.6;95%CI,0.5-0.9)were independent correlates with seeking STD treatment in clinics among Chinese MSM.Conclusions:The high prevalence of STD infection coupled with a low proportion of individuals who exhibit appropriate treatment-seeking behaviour create a high risk of a growing HIV epidemic among Chinese MSM.Models that prioritize better screening for and education about STDs should be urgently implemented,especially among low-income MSM.
