Global Epidemiology of Sexually Transmitted Diseases

TREATMENT OF COMBINED ACNE AND GENITOURINARY INFECTIONS CAUSED BY CHLAMYDIA AND MYCOPLASMAS

OBJECTIVE

The aim: To substantiate, develop and apply in clinical practice a method for the treatment of combined acne and genitourinary infections caused by chlamydia and mycoplasmas.

PATIENTS AND METHODS

Materials and methods: Acne was diagnosed clinically. Chlamydia trachomatis; Mycoplasma genitalium; Mycoplasma hominis; Ureaplasma urealyticum were identified using polymerase chain reaction. 30 patients with combined acne and urogenital chlamydia and/or mycoplasmas received sequential oral antibiotic therapy with josamycin (1500 mg daily) and gatifloxacin (400 mg daily) for 10 days each. Simultaneously with antibiotic therapy, concomitant symptomatic and topical treatment was provided.

RESULTS

Results: The elimination of pathogens of urogenital chlamydia and/or mycoplasmas was achieved with 29 out of 30 patients (93.3%). At the same time a complete regression of facial rash inflammatory elements was detected at 18 (60%) treated patients, while with the remaining 12 (40%) the regression was significant.

CONCLUSION

Conclusions: Antibiotic therapy was used in the treatment for both acne and urogenital chlamydia and/or mycoplasmas. An original method of complex treatment of combined acne and urogenital chlamydia and/or mycoplasmas was substantiated, developed and successfully applied. The offered method of treatment can be considered as a proof of high effectiveness both for elimination of pathogens from the genitourinary system of patients, and for complete or significant elimination of inflammatory facial rash.

High prevalence of sexually transmitted infections in pregnant adolescent girls in Tanzania: a multi-community cross-sectional study

BACKGROUND

Limited data document sexually transmitted infections (STIs) among pregnant adolescents in sub-Saharan Africa, where prenatal screening typically includes only HIV and syphilis. Given that HIV incidence in this population is among the world's highest, we sought to assess the prevalence and factors associated with STIs in a population of rural pregnant adolescents in Tanzania.

METHODS

We enrolled 403 pregnant adolescent girls from 10 antenatal clinics near Mwanza, Tanzania. Girls answered structured interviews about sexual health and risk factors and were tested for six common STIs.

RESULTS

199 girls (49.4%) had at least one STI. Herpes Simplex Virus- Type 2 was most prevalent (139 girls, 34.5%), followed by trichomoniasis (54 girls, 13.4%), chlamydia (46 girls, 11.4%), gonorrhoea (27 girls, 6.7%), syphilis (21 girls, 5.2%) and HIV (30 girls, 4.7%). Of note, 53/199 (26.6%) of girls with laboratory-proven STIs were asymptomatic. On multivariable analysis, the presence of any STI was associated with being in a long-term (as opposed to short-term) relationship (OR=2.6 (1.4 to 4.9) p=0.004), younger age at first sexual debut (OR=0.9 per year (0.8 to 0.99), p=0.034), increasing age difference between the girl and her partner (OR=1.1 (1.0 to 1.1) per year, p=0.03) and history of prior pregnancy (OR=1.6 (1.0 to 2.6), p=0.04).

CONCLUSIONS

STIs affected half of rural pregnant adolescents in Tanzania. Our work demonstrates the urgent need to incorporate routine STI testing into antenatal care in Tanzania to prevent morbidity and mortality in young girls and their babies. We also identify behavioural and demographic risk factors that can be used to target interventions to those at highest risk.