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Pattern of sexually transmitted diseases in the last 5 years in a Tertiary Care Centre of North East India: a retrospective study.

INTRODUCTION

The prevalence and pattern of sexually transmitted diseases (STDs) vary in different countries and even in different parts of the same country. Acquisition and transmission of human immunodeficiency virus (HIV) is increased three times in the presence of Sexually Transmitted Infection (STI). [1] Appropriate prevention and control measures can be devised if there is knowledge of the pattern of STDs and their changing trends. We studied the pattern of STDs in the last 5 years from 2011-2015 in our hospital.

MATERIALS AND METHODS

Case records of patients attending STD clinic from January 2011 to December 2015 were studied after taking ethical clearance. Those patients diagnosed as cases of STD after clinical examination and relevant laboratory investigations were included in the study. Pretest counselling was done and consent obtained before doing HIV test.

RESULTS

* Scrotal swelling, genital scabies, anorectal discharge, genital molluscum, genital pediculosis.

STDs have been classified according to syndrome diagnosis as shown in Table 3. Genital warts accounted for the highest number of cases in males (35.05%) in the last 5 years. In females, genital ulcer (Herpetic) accounted for most (47.22%) of the cases 5 years back. With an increasing trend in the cases of genital warts, it now accounts for the highest number of cases (41.89%) in females. The total number of STD cases in last 5 years was 1067, of which there were 831 males (77.88%) and 236 females (22.11%). Genital warts accounted for 42.08% followed by genital herpes (29.05%), non-herpetic genital ulcer (11.15%), vaginal/cervical discharge (7.59%), urethral discharge (6.56%), inguinal bubo (1.12%), lower abdominal pain (0.84%) and other STIs (1.59%). Of the nonherpetic genital ulcers, most of the cases were due to candidal balanoposthitis (43.69%) followed by syphilis (36.13%), chancroid (8.40%), granuloma inguinale (2.52%), lymphogranuloma venereum (1.68%) and mixed infection (15.12%). The number of females attending STD clinic has also increased significantly from 15.18% in 2011 to 33.18% in 2015.

DISCUSSION

Patients between 25-34 years accounted for maximum number (45.45%) of cases. Similar findings were observed in other studies. [2], [3] The number of male cases exceeded females (3.52:1). This may be due to minimal symptoms in females as compared to males. Moreover, most of the female patients attended Gynaecology OPD first. [4] The number of viral STDs, particularly genital warts have been rising consistently, probably due to increasing usage of antibiotics for treatment of bacterial STDs. [5] Prevalence of HIV among the cases of STD was a median of 6.23%.

A similar study done in Manipur showed the commonest STD in the ulcerative group to be balanoposthitis followed by chancroid. In the discharge group, cases of gonorrhoea exceeded that of non-gonococcal urethritis. [2] Another study by Bhushan et al showed gonorrhoea (16.9%), genital wart (12.4%), chancroid (12.2%), genital herpes (11.4%) and syphilis (10.4%). [5] In a study done in Chengalpattu, Chennai, the commonest STD in men was chancroid (24.4%) and in women was syphilis (29%). Rising trend in the cases of genital wart and a low incidence of lymphogranuloma venereum and granuloma inguinale have also been reported in other studies. [4],[6]

CONCLUSION

UNAIDS has launched a strategy 90-90-90 to end the AIDS epidemic. According to this strategy by 2020, 90% of all HIV positive persons should be aware of their HIV status, 90% of all diagnosed to have HIV infection should receive antiretroviral therapy and 90% of all receiving antiretroviral therapy should have viral suppression. [7] With increasing mass awareness and increased availability of over-the-counter drugs, the number of STD cases are declining. However, there is still a long way to go before we can achieve the target set by UNAIDS to end the AIDS epidemic.

REFERENCES

[1.] World health organisation. Sexually transmitted infections. Fact sheets no. 110. Updated on Nov 2013. Cited on Feb 24 2014. www.who.int/mediacentre/factsheets/fs110/en.

[2.] Zamzachin G, Singh NB, Devi TB. STD trends in regional institute of medical sciences, Manipur. Indian J Dermatol Venereol Leprol 2003;69(2):151-3.

[3.] Jaiswal AK, Banerjee S, Matety AR, et al. Changing trends in sexually transmitted diseases in north eastern India. Indian J Dermatol Venereol Leprol 2002;68(2):65-6.

[4.] Krishnamurthy VR, Ramachandran V. STD trends in chengalpattu hospital. Indian J Dermatol Venereal Leprol 1996;62(1):3-12.

[5.] Bhushan Kumar, Sharma VK, Malhotra S, et al. Pattern of sexually transmitted diseases in Chandigarh. Indian J Dermatol Venereal Leprol 1987;53(4):286-91.

[6.] Kapur TR. Pattern of sexually transmitted diseases in India. Indian J Dermatol Venereal Leprol 1982;48:23-34.

[7.] 90-90-90-An ambitious treatment target to help end the AIDS epidemic. UNAIDS JC2684 (English original, October) 2014.

Bhaskar Gupta (1), Vaswatee Madhab (2), Mahimanjan Saha (3), Adhyatm Bhandari (4)

(1) Professor and HOD, Department of Dermatology, Silchar Medical College, Silchar, Assam, India.

(2) Post Graduate Resident, Department of Dermatology, Silchar Medical College, Silchar, Assam, India.

(3) Post Graduate Resident, Department of Dermatology, Silchar Medical College, Silchar, Assam, India.

(4) Post Graduate Resident, Department of Dermatology, Silchar Medical College, Silchar, Assam, India.

Financial or Other, Competing Interest: None.

Submission 15-04-2016, Peer Review 10-05-2016, Acceptance 16-05-2016, Published 30-05-2016.

Corresponding Author: Dr. Bhaskar Gupta, Professor and HOD, Department of Dermatology, Silchar Medical College, Silchar-788014, Assam, India.

E-mail: bhaskargupta_10@rediffmail.com

DOI: 10.14260/jemds/2016/629
Table 1: Shows the Number of Patients Attending STD
Clinic in the Last 5 Years

Year         Male    Female    Total     M:F

2011         201       36       237     5.58:1
2012         186       50       236     3.72:1
2013         141       28       169     5.03:1
2014         154       48       202     3.20:1
2015         149       74       223     2.01:1

Table 2: Shows the Age Distribution of STDs

 Age            2011                 2012                 2013
Group
          M      F      T      M      F      T      M      F      T

0-14      0      0      0      5      2      7      0      0      0
15-24     48     14     62     41     26     67     31     13     44
25-34    106     19    125     83     19    102     78     11     89
35-44     37     1      38     45     8      53     21     2      23
>45       10     2      12     12     2      14     11     2      13

 Age            2014                 2015
Group
          M      F      T      M      F      T

0-14      0      1      1      5      4      9
15-24     21     19     40     32     26     58
25-34     70     21     91     57     21     78
35-44     46     8      54     33     16     49
>45       17     0      17     12     7      19

Table 3: Shows the Sex Distribution of STDs in the Last 5 Years

    Syndrome Diagnosis               2011                 2012

                               M      F      T      M      F      T

Urethral discharge             12     0      12     18     0      18
Genital ulcer
  --herpetic                   67     17     84     41     14     55
  --non herpetic               31     0      31     38     3      41
Lower abdominal pain           0      5      5      0      0      0
Vaginal/cervical discharge     0      10     10     0      17     17
Inguinal bubo                  5      0      5      4      1      5
Genital wart                   86     4      90     75     15     90
Other STIs *                   0      0      0      10     0      10
Total                         201     36    237    186     50    236

    Syndrome Diagnosis               2013                 2014

                               M      F      T      M      F      T

Urethral discharge             13     0      13     14     0      14
Genital ulcer
  --herpetic                   43     9      52     45     13     58
  --non herpetic               27     0      27     13     2      15
Lower abdominal pain           0      0      0      0      0      0
Vaginal/cervical discharge     0      12     12     0      15     15
Inguinal bubo                  2      0      2      0      0      0
Genital wart                   53     7      60     78     18     96
Other STIs *                   3      0      3      4      0      4
Total                         141     28    169    154     48    202

    Syndrome Diagnosis               2015

                               M      F      T

Urethral discharge             13     0      13
Genital ulcer
  --herpetic                   49     12     61
  --non herpetic               5      0      5
Lower abdominal pain           0      4      4
Vaginal/cervical discharge     0      27     27
Inguinal bubo                  0      0      0
Genital wart                   82     3     113
Other STIs *                   0      0      0
Total                         149     74    223

* Scrotal swelling, genital scabies, anorectal discharge,
genital molluscum, genital pediculosis.
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Author:Gupta, Bhaskar; Madhab, Vaswatee; Saha, Mahimanjan; Bhandari, Adhyatm
Publication:Journal of Evolution of Medical and Dental Sciences
Article Type:Report
Date:May 30, 2016
Words:1319
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