Causes of the Difference in Risk of Gonorrhea and Trichomoniasis Between Full-time Sex Workers and Parttime Sex Workers in Guangzhou, China

Objective: To describe the different characteristicsbetween full-time sex workers (FTSW) and part-timesex workers (PTSW) in Guangzhou, China, and to de-termine the risk factors which lead to the significantlyhigher prevalence of gonorrhea and trichomoniasisamong FTSW. Methods: From March 1998 to October 1999 femalesex workers were recruited through various outreachmethods, and were interviewed and tested for the pres-ence of sexually transmitted diseases (STDs). In termsof additional regular salary female sex workers weredivided into FTSW who didn't have additional regularsalary and PTSW who had additional regular salary.Univariate and multivariate logistic regression analy-ses were used to identify risk factors for gonorrhea/trichomoniasis and to determine the confounders inthe relationship between no regular salary and gonor-rhea/ trichomoniasis. Results: A total of 442 FTSW and 524 PTSW en-tered this study. Prevalence of gonorrhea and tri-chomoniasis was significantly higher inFTSW compared to PTSW. FTSW were more likely tohave a lower education level, have a history of inject-ing drugs use since 1990, to recruit clients in a mas-sage/sauna, have businessmen as their clients and nothave a steady partner compared to PTSW. In bivariateanalyses models, age leaving education, main types ofclients and recruitment locations appeared to be thestrongest links between no regular salaried positionand gonorrhea. A history of injecting drugs and hav-ing no steady partner (past 12 months) appeared to bethe strongest links in the relationship between no regu-lar salaried position and trichomoniasis. Conclusion: Different education levels, clients, andrecruitment locations between FTSW and PTSW mayaccount for the different gonorrhea prevalence amongsex workers. The higher prevalence of trichomonia-sis among FTSW may be related to the larger propor-tion of women having no steady partner or a history ofinjecting drugs. The results suggest strategies toprevent HIV/STDs among female sex workers shouldinclude condom negotiation with clients and aware-ness of seeking health care.

Bacterial vaginosis:a synthesis of the literature on etiology,prevalence,risk factors,and relationship with chlamydia and gonorrhea infections

Bacterial vaginosis(BV) is a common vaginal disorder in women of reproductive age. Since the initial work of Leopoldo in 1953 and Gardner and Dukes in 1955, researchers have not been able to identify the causative etiologic agent of BV. There is increasing evidence, however, that BV occurs when Lactobacillus spp., the predominant species in healthy vaginal flora, are replaced by anaerobic bacteria, such as Gardenella vaginalis, Mobiluncus curtisii, M. mulieris, other anaerobic bacteria and/or Mycoplasma hominis. Worldwide, it estimated that 20%–30% of women of reproductive age attending sexually transmitted infection(STI) clinics suffer from BV, and that its prevalence can be as high as 50%–60% in high-risk populations(e.g., those who practice commercial sex work(CSW). Epidemiological data show that women are more likely to report BV if they: 1) have had a higher number of lifetime sexual partners; 2) are unmarried; 3) have engaged in their first intercourse at a younger age; 4) have engaged in CSW, and 5) practice regular douching. In the past decade, several studies have provided evidence on the contribution of sexual activity to BV. However, it is difficult to state that BV is a STI without being able to identify the etiologic agent. BV has also emerged as a public health problem due to its association with other STIs, including: human immunodeficiency virus(HIV), herpes simplex virus type 2(HSV-2), Chlamydia trachomatis(CT) and Neisseria gonorrhoeae(NG). The most recent evidence on the association between BV and CT/NG infection comes from two secondary analyses of cohort data conducted among women attending STI clinics. Based on these studies, women with BV had a 1.8 and 1.9-fold increased risk for NG and CT infection, respectively. Taken together, BV is likely a risk factor or at least an important contributor to subsequent NG or CT infection in high-risk women. Additional research is required to determine whether this association is also present in other low-risk sexually active populations, such as among women in the US military. It is essential to conduct large scale cross-sectional or population-based case-control studies to investigate the role of BV as a risk factor for CT/NG infections. These studies could lead to the development of interventions aimed at reducing the burden associated with bacterial STIs worldwide.

Screening for asymptomatic chlamydia and gonorrhea in adolescent males in an urban pediatric emergency department

AIM To determine the prevalence of Chlamydia trachomatis(CT) and Neisseria gonorrhea(GC) in young men seeking care in the emergency department(ED) for non-sexually transmitted infection(STI) related symptoms.METHODS This was a prospective, cross-sectional study in an urban ED. The main outcome was the rate of positive CT and GC on urine nucleic acid amplification testing in males aged 16-21 presenting with non-STI related complaints. RESULTS Two hundred and eighty-four patients were enrolled, 271 were included in the final data analysis [age range 16-21, median: 18(quartiles 16-18, 19-21)]. Overall, 17(6.3%, 95%CI: 4%-10%) tested positive for CT and 0%(95%CI: 0%-2%) were found to have GC. The proportion of sexually active subjects was 71%(95%CI: 65%-76%) and 2%(95%CI: 0.6%-4%) reported sex with men. Previous STI testing was reported in 46%(95%CI: 43%-54%) and 13%(95%CI: 8%-20%) of those patients previously tested had a history of STI. Of the patients who tested positive for CT in the ED, 88%(95%CI: 64%-98%) were successfully followed up. CONCLUSION The prevalence of CT infection found by screening was 6.3%. Screening and follow-up from the ED was successful. The findings justify routine STI screening in male adolescents presenting to the ED with non-STI related complaints.

Longitudinal association of gonorrhea and bacterial vaginosis with repeat chlamydia diagnoses among U.S. Army women: A retrospective cohort analysis

Background: Historically, sexually transmitted infections have affected the health of the U.S. military. To determine whether gonorrhea, bacterial vaginosis, genital herpes, and trichomoniasis are predictors of repeat chlamydia diagnoses among U.S. Army women, medical data reported into the Defense Medical Surveillance System during the 2006–2012 period were analyzed.Methods: For all inpatient and outpatient medical records, the first and second International Classification of Diseases,version 9(ICD-9) diagnostic positions were reviewed for each chlamydia case to determine the occurrence of repeat diagnoses. The Andersen-Gill regression model, an extension of the Cox model for multiple failure-time data, was used to study associations between predictors and repeat chlamydia diagnoses.Results: Among 28,201 women with a first chlamydia diagnosis, 5145(18.2%), 1163(4.1%), 267(0.9%), and 88(0.3%)had one, two, three, and four or more repeat diagnoses, respectively. Overall, the incidence of repeat chlamydia was8.31 cases per 100 person-years, with a median follow-up time of 3.39 years. Gonorrhea(hazard ratio(HR)=1.58, 95%CI: 1.44–1.73) and bacterial vaginosis(HR=1.40, 95% CI: 1.09–1.79) were significant predictors for repeat chlamydia.These estimated hazard ratios were attenuated, but remained significant, after controlling for age, race/ethnicity,marital status, and military rank. No significant association was found for genital herpes(HR=1.13, 95% CI: 0.55–2.29)and trichomoniasis(HR=1.43, 95% CI: 0.43–4.68).Conclusions: This large cohort study suggests that gonorrhea and bacterial vaginosis were associated with repeat chlamydia diagnoses among U.S. Army women. These findings can be used in formulating new interventions to prevent repeat chlamydia diagnoses.

ON THE STABILITY OF THE SOLUTION TO A GONORRHEA DISCRETE MATHEMATICAL MODEL

In this paper, the author studies the stability of the solution to a three-dimension-al gonorrhea discrete mathematical model by Liapunoy method. The parameter es-timator of the slability domain is obtained and the rationality of the model is ex-plained in a theoretic way.

Incidence of Gonorrhea and Chlamydia in Urban Settings: The Case for Neighborhood Level Analysis in Boston

The sexually transmitted infections (STIs) gonorrhea and chlamydia are known to disproportionately affect impoverished communities and communities of color, especially in urban areas. Moreover, socioeconomic and demographic factors such as poverty and race/ethnicity may contribute to a difference in treatment setting choice as well as a delay in care seeking. In an urban metropolitan area such as Boston, the overall gonorrhea and chlamydia rates are higher than national rates, and such differences are even more marked in certain neighborhoods with greater proportions of individuals who are impoverished, young, and of color. Using a retrospective analysis of city wide data, we highlight the effects of socioeconomic and demographic variables on urban STI prevalence. High poverty rates, race/ethnicity and younger adult populations are linked to disproportionately high STI rates. Interestingly, STI rates do not appear to be influenced by the universal health care coverage offered to the whole Massachusetts’ resident populations. We examine the effects of these variables in Boston neighborhoods in conjunction to STI rates and hypothesize that the observed rates are underestimates of the true prevalence of infection. Future studies will investigate how these same socioeconomic and demographic factors influence which treatment settings are chosen and subsequently lead to a delay in treatment.

Pharyngeal gonorrhea presenting with isolated neck pain

We present a case of a 22-year-old man with isolated neck pain due to pharyngeal gonorrhea.

Gonorrhea cluster detection in Manitoba,Canada:Spatial,temporal,and spatio-temporal analysis

In Canada,Gonorrhea infection ranks as the second most prevalent sexually transmitted infection.In 2018,Manitoba reported an incidence rate three times greater than the national average.This study aims to investigate the spatial,temporal,and spatio-temporal patterns of Gonorrhea infection in Manitoba,using individual-level laboratory-confirmed administrative data provided by Manitoba Health from 2000 to 2016.Age and sex patterns indicate that females are affected by infections at younger ages compared to males.Moreover,there is an increase in repeated infections in 2016,accounting for 16%of the total infections.Spatial analysis at the 96 Manitoba regional health authority districts highlights significant positive spatial autocorrelation,demonstrating a clustered distribution of the infection.Northern districts of Manitoba and central Winnipeg were identified as significant clusters.Temporal analysis shows seasonal patterns,with higher infections in late summer and fall.Additionally,spatio-temporal analysis reveals clusters during high-risk periods,with the most likely cluster in the northern districts of Manitoba from January 2006 to June 2014,and a secondary cluster in central Winnipeg from June 2004 to November 2012.This study identifies that Gonorrhea infection transmission in Manitoba has temporal,spatial,and spatio-temporal variations.The findings provide vital insights for public health and Manitoba Health by revealing high-risk clusters and emphasizing the need for focused and localized prevention,control measures,and resource allocation.

A reliable numerical analysis for stochastic gonorrhea epidemic model with treatment effect

The phenomena of disease spread are unpredictable in nature due to random mixing of individuals in a population.It is of more significance to include this randomness while modeling infectious diseases.Modeling epidemics including tlieir stochastic behavior could be a more realistic approach in many situations.In thus paper,a stochastic gon orrhea epidemic model with treatment effect has been analyzed numerically.Numerical solution of stochastic model is presented in comparison with its deterministic part.The dynamics of the gonorrhea disease is governed by a threshold quantity Ai called basic reproductive number.If.A1<1.then disease eventually dies out while A1>1 shows the persistence of disease in population.The standard numerical schemes like Euler Maruyaina.stochastic Euler and stochastic Rurige Kutta are highly dependent on step size and do not behave well in certain scenarios.A competitive non-standard finite dif ference numerical scheme in stochastic setting is proposed,which is independent of step size and remains consistent with the corresponding deterministic model.

移动医疗APP对提升淋病规范化治疗率的效果

目的 评价移动医疗APP对淋病规范化治疗率的提升效果。方法 选取深圳市罗湖区人民医院的80名医生作为研究对象,将80名医生随机分成干预组和对照组,每组40名。干预组使用移动医疗APP进行最新的淋病治疗指南在线视频培训,对照组使用原有的传统线下课程进行培训,干预时间为18个月。对比分析两组医生干预前后淋病规范化治疗率的差异性变化。结果 干预前两组的淋病规范化治疗率比较无明显差异(χ~2=0.06,P=0.801)。干预后两组的淋病规范化治疗率均较治疗前提升(均P<0.05),但干预组的淋病规范化治疗率明显优于对照组(χ~2=8.71,P=0.003)。结论 移动医疗APP对提升淋病规范化治疗率的效果明显。

淋球菌耐药机制和治疗策略研究进展

淋球菌是引起淋病的病原体,淋球菌对抗生素的耐药性不断增加,影响淋病的有效治疗。随着耐药淋球菌株的不断增加,其临床治疗难度也越来越大。本文就近年来对淋球菌的耐药进展、耐药机制、治疗研究等方面进行综述。

National Guidelines on Diagnosis and Treatment of Gonorrhea in China (2020)

Gonorrhea is one of the main sexually transmitted diseases in China.It mainly affects the genitourinary tract,and its clinical manifestations vary from asymptomatic to complicated types.The diagnosis of gonorrhea should be based on the patient's epidemiologicai history,clinical manifestations,and laboratory examination results.Treatment should be prompt and standardized and should involve the recommended treatment regimens.Patients should be appropriately followed up after treatment.The antimicrobial resistance of gonococcal isolates has become a severe problem of clinical concern.In order to provide technical guidance of the diagnosis and treatment of gonorrhea for health care workers,the authors developed the guidelines based on the version of 2014,which will be of important in the standardizing medical care of gonorrhea,and further facilitating control and prevention of the disease.

Gonorrhea in China, 2018

Objective:Gonorrhea is a globally widespread sexually transmitted infection caused by Neisseria gonorrhoeae.This study is aimed to analyze the epidemiological characteristics of gonorrhea cases reported in China in 2018 and provide evidence for strategies making in the gonorrhea prevention and control programme.Methods:Gonorrhea cases were extracted from National Notifiable Disease Report System (NNDRS) covering 31 provinces,autonomous regions,arnd municipalities in the mainland of China.The overall incidence rate was calculated,as were rate per province,sex,age group,and occupation group.ResultS:in 2018,133,156 new cases of gonorrhea were reported in China,corresponding to an incidence rate of 9.59 cases per 100,000 population and having a 36.03% increase from 2014 (7.05 cases per 100,000 population).Zhejiang,Hainan,Guangdong,Fujian provinces,and Shanghai city had a higher reported rate (14.05-28.00 per 100,000 population).Hebei,Tianjin,Tibet,Heilongjiang,and Jilin provinces had a lower rerted rate (1.56-5.19 per 100,000 population).The males had a much higher incidence than the females (15.81 per 100,000 vs.3.08 per 100,000) and a faster rising rate (38.32% vs.27.27%).The highest rate was detected in the aged 25-29 years both of male and female (46.37 and 6.60 per 100,000,respectively),followed by those aged 30-34 years (41.12 and 6.39 per 100,000,respectively).The largest proportion of gonorrhea cases was among the farmers accounting for 27.74%,followed by the unemployed persons (24.67%),business persons (17.02%) and industrial workers (9.50%).Conclusion:In general,gonorrhea has an increasing trend from 2014 and remains a common notifiable disease in China in 2018.Young males who are sexually active are high risk populations for gonococ~ infection.The southeast coastal areas with developed economy have a higher rate of gonorrhea reported.Corresponding strategies on disease prevention and control should be performed on the high risk populations and regions.

淄博市2012~2021年淋病流行特征分析

目的分析淄博市2012~2021年淋病流行特征,为淋病防治工作提供科学依据。方法通过中国疾病预防控制信息系统传染病监测信息系统,下载2012~2021年淄博市淋病报告病例资料并进行描述性分析。结果①2012~2021年,淄博市淋病累计报告病例数为1206例,报告发病率由2012年的2.52/10万下降至2015年的1.77/10万,由2017年的3.29/10万下降至2020年的2.24/10万,2021年上升至3.08/10万,年均增长率2.25%。②淄博市不同地区的淋病报告发病率存在明显差异(χ^(2)=299.372,P<0.05)。临淄区各年间报告发病率最高,2021年报告发病率为10.48/10万,淄川区最低,2021年报告发病率为0.22/10万,临淄区淋病报告发病率呈显著上升趋势。③2012~2021年淄博市报告淋病病例数中男性占比83.58%,女性占比16.42%,男女报告发病率均呈增长趋势,其中男性报告发病率年均增长率2.38%,女性报告发病率年均增长率1.54%。男女性别比由2012年的4.23∶1上升至2013年的14.25∶1,2021年下降至4.58∶1。④2012~2021年淄博市各年龄组淋病报告发病率呈明显差异(χ^(2)=120.268,P<0.05);15~19岁组和20~24岁组报告发病率呈显著上升趋势,0~14岁组报告发病率呈显著下降趋势,≥55岁组呈下降趋势。⑤2012~2021年淄博市淋病报告病例职业以农民、家务及待业、商业服务为主,以上三类人员共报告845例,占累计报告病例数的70.07%。2012~2021年淄博市淋病报告病例职业分布存在明显差异(χ^(2)=210.458,P<0.05)。结论2012~2021年,淄博市淋病报告发病率呈波动上升趋势,临淄区报告发病率明显上升,15~24岁人群报告发病率呈显著上升趋势,应加大淄博市重点地区及青少年学生的淋病防控力度。

2020—2023年厦门市湖里区淋病流行特征及变化趋势

目的 了解近年来厦门市湖里区淋病的流行特征及变化趋势,从而为淋病的防控提供科学依据。方法 随机选取2020—2023年在我院产检的孕妇及就诊的患者共24 807例,平均年龄为(29.24±5.68)岁,其中男性2421例,孕妇18 542例,非孕妇女性3844例,均接受淋球菌(NG)核酸检测。根据性别及是否怀孕,分为男性组、孕妇组和非孕妇组。根据年龄,分为<20岁组、20~29岁组、30~39岁组、40~49岁组及≥50岁组。对受试者的年龄、性别、NG检测结果等信息进行回顾性分析。结果 NG年阳性率为0.48%~0.69%。共152例NG阳性,其中男性32例(21.05%)、孕妇26例(17.11%)、非孕妇94例(61.84%),20~29岁和30~39岁者分别占50.66%和24.34%。每年男性组、孕妇组和非孕妇组的NG阳性率均有统计学差异(均P <0.05),分别为0.77%~2.11%、0.06%~0.25%和1.37%~3.19%。非孕妇组的NG阳性率逐年下降,2023年较2020年低(1.37%vs.3.19%,P <0.05)。各年度的男性组NG阳性占比有统计学差异(P <0.05),2023年高于2020年(40.00%vs.8.00%,P <0.05)。每年各年龄组间的NG阳性率均有统计学差异(均P <0.05),<20岁组为3.06%~3.67%,20~49岁的3个组每年均<1%,≥50岁组为3.08%~14.29%。20~29岁组的NG阳性占比最高(48.00%~55.26%),30~39岁组次之(16.00%~28.00%)。2020—2023年,各年龄组的NG阳性率和阳性占比的变化均无统计学意义(均P> 0.05)。结论 2020—2023年厦门市湖里区孕妇NG阳性率低,而就诊患者阳性率较高;男性NG阳性占比趋于上升,而非孕妇女性阳性率逐年下降;<20岁和≥50岁就诊者NG阳性率较高,而感染者集中在20~39岁。

2018—2022年438株淋球菌临床分离株耐药性分析

目的 总结青霉素、四环素、环丙沙星、头孢克肟、头孢曲松、大观霉素和阿奇霉素等7种抗生素的耐药性监测结果,分析番禺区淋球菌耐药株的流行状况。方法 2018—2022年间收集番禺区性病门诊患者尿道或宫颈、阴道等泌尿生殖道分泌物中分离得到的淋球菌菌株,采用琼脂稀释法测定菌株对7种抗生素的最小抑菌浓度(MIC),用纸片酸度法检测产青霉素酶淋球菌(PPNG),比较各年度的淋球菌菌株对抗生素敏感性和流行率。结果 共收集并检测了438株淋球菌,其中PPNG和四环素高水平耐药淋球菌(TRNG)流行率分别为48.86%和38.13%。四环素、环丙沙星、阿奇霉素的总耐药率分别为90.18%、96.12%和13.47%,青霉素的耐药率从2018年的50.60%升高至2022年的84.00%,差异有统计学意义(χ~2=23.59,P<0.01),未发现大观霉素、头孢曲松和头孢克肟耐药菌株。但头孢曲松和头孢克肟中敏菌株分别由2018年的2.41%(2/83)和3.61%(3/83)上升至2022年的13.00%(13/100)和25.00%(25/100),差异均有统计学意义(χ~2值分别为6.76、14.39,均P<0.01),呈动态升高趋势。结论 2018—2022年番禺区淋球菌菌株对大观霉素、头孢曲松和头孢克肟均敏感,头孢曲松和头孢克肟中度敏感率呈逐年升高态势,PPNG和TRNG也呈高度流行状态。

兰茂辨治男科病证方药运用的临证发微

兰茂所著《医门擥要》医药结合且论医用药,医理明达简要,治法方药详悉。文章通过研究兰茂辨治男科病证的方药,并结合自己的临证心悟,分析其治疗淋浊、遗精、精癃的学术思想:(1)先攻邪,后扶正,宜补肾为主治淋浊;(2)保心滋肾,因寒因热治遗精;(3)滋肾清肺,气化通利治精癃。

基于CiteSpace的中医药治疗尿路感染的可视化分析

目的 对近20年中医药治疗尿路感染研究文献进行可视化分析。方法 检索中国知网、维普网和万方数据知识服务平台2003—2023年关于中医药治疗尿路感染的相关文献,利用Cite Space软件分析其年度发文量、作者、机构与关键词情况。结果 共纳入1 562篇文献,近年来发文量整体呈下降趋势,不同作者中孙伟教授发文量最多,机构中发文最多的是天津中医药大学。关键词图谱显示中西医结合治疗慢性肾盂肾炎热度较高,近期突现较强的关键词为数据挖掘、热淋清颗粒、复发性尿路感染。结论 近20年来中医药治疗尿路感染受到业界广泛关注,慢性肾盂肾炎及中西医结合治疗是目前主要的研究热点;未来的研究发展趋势可能是对于复发性尿路感染治疗的深入研究及热淋清颗粒的作用机制及临床疗效评价。

2019-2021年四川成都某医院淋病奈瑟菌对大观霉素、阿奇霉素及头孢菌素类药物敏感性检测及结果分析

目的检测我院2019—2021年淋病奈瑟菌临床分离菌株对大观霉素、阿奇霉素及头孢菌素类药物的敏感性,为淋病的治疗和防控提供参考。方法收集并保存淋病奈瑟菌临床分离株,琼脂稀释法和微量肉汤稀释法测定大观霉素、阿奇霉素、头孢曲松和头孢克肟的最小抑菌浓度(MIC),分析比较菌株对各药物的耐药率或低敏率。结果2019—2021年共分离收集淋病奈瑟菌菌株279株。其中未发现对大观霉素的耐药菌株;发现对阿奇霉素耐药菌株31株,耐药率分别为16.00%、8.82%和8.11%,平均耐药率为11.11%;发现对头孢曲松低敏菌株43株,低敏率分别为12.00%、14.71%和18.92%,平均低敏率为15.41%;发现对头孢克肟低敏菌株27株,低敏率分别为4.00%、2.94%和18.92%,平均低敏率为9.68%。每年发现同时对头孢曲松低敏和阿奇霉素耐药的菌株数量均为2株,占比分别为2.00%、2.94%和1.80%,总体占比2.15%。结论大观霉素和头孢曲松仍适合本地区作为治疗淋病的一线药物,需关注本地区淋病奈瑟菌对头孢曲松低敏率的逐年增长趋势。

2018-2022年海安市淋病流行病学特征分析和防控体会探讨

目的分析2018-2022年海安市淋病流行病学特征,探讨淋病的预防控制体会。方法通过传染病报告信息管理系统收集2018-2022年海安市报告的淋病病例资料,运用描述流行病学方法分析流行病学特征,总结预防控制的心得体会。结果2018-2022年海安市淋病年均报告发病率为9.03/万人,处于全国平均水平。男性发病率高于女性,18~30岁和30~45岁年龄组发病率高于0~18岁、45~60岁和>60岁年龄组,单身、离异、丧偶等未婚状况者发病率高于已婚者,小学及以下文化程度者高于初中、高中和大学文化程度者,农民、待业或职业不详者高于服务行业、工人和其他职业者,流动人口发病率高于常住人口,门诊就诊的检出者高于住院和体检筛查者,性接触感染发病率高于间接接触和母婴传播者,治愈率高于好转和去向不详者,差异均有统计学意义(P<0.05)。不同季节的发病率比较无差异(P>0.05)。结论本地区的淋病发病率处于低水平的稳态趋势,应进一步完善防控机制,做好重点人群的宣教和监管工作,有效降低淋病的发病率。