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Santaolaya C, Malhotra J, Fowler JA, Warzywoda S, Debattista J, Mills DJ, Lau C, Furuya-Kanamori L, Durham J, Mullens AB, Istiko SN, Dean JA. Integrating sexual and reproductive health into pre-travel consultations. J Travel Med 2024; 31:taae024. [PMID: 38340322 PMCID: PMC11149722 DOI: 10.1093/jtm/taae024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 02/06/2024] [Accepted: 02/08/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Casual sex during travel is a major preventable factor in the global transmission of sexually transmissible infections (STI). Pre-travel consults present an excellent opportunity for practitioners to educate travellers about sexual and reproductive health (SRH) and safety. This scoping review aims to explore and understand the extent to which SRH is included in pre-travel consultations. METHODS PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, Scopus, Medline and Web of Science were systematically searched for primary research articles exploring whether health care practitioners (HCP) included SRH in pre-travel consultations. Extracted findings were synthesized and presented in narrative form. RESULTS Findings across 13 articles suggest HCPs infrequently broached SRH in pre-travel consultations with HCP discomfort, and lack of time and resources presented as key barriers. Urban practice settings, HCP experience, training in travel medicine and traveller characteristics such as sexual orientation were positively associated with discussions about SRH. SRH advice reported was general in nature, primarily focusing on safer sex, condoms or unspecified STI advice. Risk assessments based solely on age or stereotypes around sexual preferences led to key aspects of SRH care being missed for some (e.g. SRH was less likely to be discussed with older travellers). CONCLUSIONS HCPs frequently miss opportunities to integrate SRH into pre-travel consultations. Strategies to promote HCP confidence and awareness present a promising means to boost the frequency and quality of SRH advice disseminated. Integrating culturally safe and responsive SRH history-taking and advice into pre-travel consultations may contribute to global reductions in STI transmission and promote traveller SRH well-being.
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Affiliation(s)
- Carlos Santaolaya
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4006, Australia
| | - Juhi Malhotra
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4006, Australia
| | - James A Fowler
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4006, Australia
| | - Sarah Warzywoda
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4006, Australia
| | - Joe Debattista
- Metro North Public Health Unit, Metro North Hospital and Health Service, Brisbane, QLD 4053, Australia
| | | | - Colleen Lau
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4006, Australia
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4006, Australia
| | - Luis Furuya-Kanamori
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4006, Australia
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4006, Australia
| | - Jo Durham
- School of Public Health and Social Work, Australian Centre for Health Services Innovation (AusHSI), Centre for Healthcare Transformation, Faculty of Health, Queensland University of Technology, Brisbane, QLD 4059, Australia
| | - Amy B Mullens
- School of Psychology and Wellbeing, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, QLD 4305, Australia
| | - Satrio N Istiko
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4006, Australia
| | - Judith A Dean
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4006, Australia
- UQ Poche Centre for Indigenous Health, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD 4066, Australia
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2
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Guiriguet C, Alberny M, Mora N, Rebagliato O, Roca C, Fina F, Fàbregas M, Benítez M, de la Poza M, Medina M, Flayeh S, Pedrazas D, Sabatés M, Coma E. Sexually transmitted infections, the epidemic that persists after the COVID-19 pandemic: an analysis of the primary care electronic health records covering about 5 million people in Catalonia. BMC PRIMARY CARE 2024; 25:150. [PMID: 38704552 PMCID: PMC11069189 DOI: 10.1186/s12875-024-02395-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 04/17/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND The aim of our study is to analyse the trends in the diagnosis of sexually transmitted infections (STIs) during the COVID-19 pandemic. METHODS We conducted an observational retrospective population-based study using data from primary care electronic health records spanning from January 2016 to December 2022 (involving 5.1 million people older than 14 years). We described the daily number of new STI diagnoses from 2016 to 2022; as well as the monthly accumulation of new STI diagnoses for each year. We compared the monthly averages of new diagnoses in 2019, 2020, 2021 and 2022 using the T-test. Finally, we performed a segmented regression analysis of the daily number of STI diagnoses. RESULTS We analysed 200,676 new STI diagnoses. The number of diagnoses abruptly decreased coinciding with the lockdown. Overall in 2020, we observed a reduction of 15%, with higher reductions for specific STIs such as gonorrhoea (-21%), chlamydia (-24%), and HIV (-31%) compared to 2019. Following this drastic drop, which was temporarily associated with the lockdown, we observed a rapid rebound. In 2021, the number of STI diagnoses was similar to that of 2019. Notably, we found a considerable increase in 2022, particularly for non-specific STI, which lack laboratory confirmation (67% increase). HIV was the only STI with a reduction of up to -38% in diagnoses at the end of 2022 compared to 2019. CONCLUSIONS After a significant reduction in 2020, the number of STIs recorded in primary care rapidly rebounded, and the current trend is similar to that of 2019, except for HIV. These findings underscore the dynamic impact of the COVID-19 pandemic on STI diagnoses and highlight the importance of ongoing monitoring and public health interventions in the post-pandemic period.
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Affiliation(s)
- Carolina Guiriguet
- Primary Care Services Information Systems (SISAP), Institut Català de La Salut (ICS), Gran Via de Les Corts Catalanes, 587. 08007, Barcelona, Spain.
- Gotic Primary Care Centre, Institut Català de La Salut (ICS), Barcelona, Spain.
- University of Barcelona, Barcelona, Spain.
| | - Mireia Alberny
- Medical Management of Primary Care Services, STI/HIV Area, Institut Català de La Salut (ICS), Barcelona, Spain
| | - Núria Mora
- Primary Care Services Information Systems (SISAP), Institut Català de La Salut (ICS), Gran Via de Les Corts Catalanes, 587. 08007, Barcelona, Spain
| | - Oriol Rebagliato
- Gotic Primary Care Centre, Institut Català de La Salut (ICS), Barcelona, Spain
| | - Carme Roca
- El Clot Primary Care Centre, Institut Català de La Salut (ICS), Barcelona, Spain
- University of Barcelona, Barcelona, Spain
| | - Francesc Fina
- Primary Care Services Information Systems (SISAP), Institut Català de La Salut (ICS), Gran Via de Les Corts Catalanes, 587. 08007, Barcelona, Spain
| | - Mireia Fàbregas
- Primary Care Services Information Systems (SISAP), Institut Català de La Salut (ICS), Gran Via de Les Corts Catalanes, 587. 08007, Barcelona, Spain
| | - Mència Benítez
- Primary Care Services Information Systems (SISAP), Institut Català de La Salut (ICS), Gran Via de Les Corts Catalanes, 587. 08007, Barcelona, Spain
- Gotic Primary Care Centre, Institut Català de La Salut (ICS), Barcelona, Spain
| | - Mariam de la Poza
- University of Barcelona, Barcelona, Spain
- Doctor Carles Riba Primary Care Centre, Institut Català de La Salut (ICS), Barcelona, Spain
| | - Manuel Medina
- Primary Care Services Information Systems (SISAP), Institut Català de La Salut (ICS), Gran Via de Les Corts Catalanes, 587. 08007, Barcelona, Spain
| | - Souhel Flayeh
- Primary Care Services Information Systems (SISAP), Institut Català de La Salut (ICS), Gran Via de Les Corts Catalanes, 587. 08007, Barcelona, Spain
| | - David Pedrazas
- Gotic Primary Care Centre, Institut Català de La Salut (ICS), Barcelona, Spain
| | - Montserrat Sabatés
- Gotic Primary Care Centre, Institut Català de La Salut (ICS), Barcelona, Spain
| | - Ermengol Coma
- Primary Care Services Information Systems (SISAP), Institut Català de La Salut (ICS), Gran Via de Les Corts Catalanes, 587. 08007, Barcelona, Spain
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3
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Pintea-Trifu ML, Vică ML, Leucuța DC, Coman HG, Nemeș B, Matei HV. Dyadic Adjustment of Couples and State Anxiety in Patients Tested for Sexually Transmitted Infections. J Clin Med 2024; 13:1449. [PMID: 38592274 PMCID: PMC10934529 DOI: 10.3390/jcm13051449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 02/18/2024] [Accepted: 02/28/2024] [Indexed: 04/10/2024] Open
Abstract
Background: While existing literature addresses the psychological impact of HIV, there is a notable gap in data regarding other sexually transmitted infections (STIs). This study aims to fill this gap by evaluating the association between STIs, the psychological profile of patients as measured by anxiety levels, and the impact on couple adaptability. Methods: A prospective investigation was conducted in Romania, from November 2021, including individuals with high suspicion of STI and healthy controls. Data collection comprised a questionnaire, the Dyadic Adjustment Scale (DAS), and State-Trait Anxiety Inventory (STAI Y-1). Statistical methods, including multivariate logistic and linear regressions, were used to carry out the analyses. Results: The participant cohort consisted of 441 individuals. STI participants exhibited consistently lower DAS scores, notably in dyadic adaptability (DA) (p = 0.031), dyadic satisfaction (DS) (p = 0.006), and affectional expression (AE) (p = 0.016). Multivariate logistic regression with adjustment for confounders confirmed a significant association between STIs and atypical DAS responses (2.56-fold increase). STAI T scores were significantly higher in the STI suspected group (p < 0.01), remaining robust after adjusting for confounders in a multiple linear regression model. Conclusions: Our prospectively designed study highlights the mental health repercussions associated with STIs. This is evident through the diminished DAS scores and heightened STAI Y-1 scores observed in individuals with suspected STIs.
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Affiliation(s)
- Martina-Luciana Pintea-Trifu
- Department of Cellular and Molecular Biology, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania; (M.-L.P.-T.); (M.-L.V.); (H.-V.M.)
| | - Mihaela-Laura Vică
- Department of Cellular and Molecular Biology, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania; (M.-L.P.-T.); (M.-L.V.); (H.-V.M.)
| | - Daniel-Corneliu Leucuța
- Department of Medical Informatics and Biostatistics, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
| | - Horia George Coman
- Department of Medical Psychology and Psychiatry, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (H.G.C.); (B.N.)
| | - Bogdan Nemeș
- Department of Medical Psychology and Psychiatry, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (H.G.C.); (B.N.)
| | - Horea-Vladi Matei
- Department of Cellular and Molecular Biology, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania; (M.-L.P.-T.); (M.-L.V.); (H.-V.M.)
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4
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Sinka K. The global burden of sexually transmitted infections. Clin Dermatol 2024; 42:110-118. [PMID: 38142791 DOI: 10.1016/j.clindermatol.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2023]
Abstract
Understanding the global burden of sexually transmitted infections (STIs) is fundamental to being able to address and control these infections and the health harms they cause. The World Health Organization has renewed its global health sector strategy for the prevention and control of STIs. Reducing STIs remains an integral part of HIV prevention and of sexual and reproductive health programs. Data to measure and describe the global burden continue to improve, with systematic reviews and modeling providing global and regional data for the major STIs. Although substantial gaps remain, as many countries have limited data, the measures available demonstrate the scale of the problem for the main curable STIs, gonorrhea, chlamydia, syphilis, and trichomoniasis; the most common viral STIs, human papillomavirus and genital herpes; the interrelation between STIs and HIV; and the substantially unequal burden of these infections globally and among key populations. Regional and global trends in these infections are affected by population changes; the impact and availability of interventions, such as vaccination; changing behaviors that alter the dynamics of STI transmission; and the role of international travel in promulgating STIs in an increasingly interconnected world.
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Affiliation(s)
- Katy Sinka
- STI Section, Blood Safety, Hepatitis, STI, and HIV Division, UK Health Security Agency, London, United Kingdom.
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5
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Potin M, Carron PN, Genton B. Injuries and medical emergencies among international travellers. J Travel Med 2024; 31:taad088. [PMID: 37405992 DOI: 10.1093/jtm/taad088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 06/07/2023] [Accepted: 06/12/2023] [Indexed: 07/07/2023]
Abstract
BACKGROUND Tropical infectious diseases and vaccine-preventable emergencies are the mainstay of pre-travel consultations. However, non-communicable diseases, injuries and accidents that occur during travel are not emphasized enough in these settings. METHODS We performed a narrative review based on a literature search of PubMed, Google Scholar, UpToDate, DynaMed and LiSSa and on reference textbooks and medical journals dedicated to travel, emergency and wilderness medicine. Relevant secondary references were extracted. We also aimed to discuss newer or neglected issues, such as medical tourism, Coronavirus Disease 2019, exacerbations of co-morbidities associated with international travel, insurance coverage, health care seeking abroad, medical evacuation or repatriation and tips for different types of travellers' emergency medical kits (personal, group, physician handled). RESULTS All sources reviewed led to the selection of >170 references. Among epidemiological data on morbidity and deaths while abroad, only retrospective data are available. Deaths are estimated to occur in 1 in 100 000 travellers, with 40% caused by trauma and 60% by diseases, and <3% linked to infectious diseases. Trauma and other injuries acquired during travel, such as traffic accidents and drowning, can be reduced by up to 85% with simple preventive recommendations such as avoiding simultaneous alcohol intake. In-flight emergencies occur on 1 in 604 flights on average. Thrombosis risk is two to three times greater for travellers than for non-travellers. Fever during or after travel can occur in 2-4% of travellers, but in up to 25-30% in tertiary centres. Traveller's diarrhoea, although rarely severe, is the most common disease associated with travel. Autochthonous emergencies (acute appendicitis, ectopic pregnancy, dental abscess) can also occur. CONCLUSIONS Pre-travel medicine encounters must include the topic of injuries and medical emergencies, such as the risk-taking behaviours and foster better planning in a comprehensive approach along with vaccines and infectious diseases advices.
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Affiliation(s)
- Mathieu Potin
- ISTM CTH (Certificate of Travel Health), Chemin des Croix-Rouges 12, Lausanne CH-1007, Switzerland
| | - Pierre-Nicolas Carron
- Emergency Department, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, Lausanne CH-1011, Switzerland
| | - Blaise Genton
- Policlinic of Tropical, Travel Medicine and Vaccination, Centre for Primary Care and Public Health, Unisanté, University of Lausanne, Rue du Bugnon 44, Lausanne CH-1011, Switzerland
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6
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Silva CDA, Silva GRDC, Martins TLS, Moura WÉA, Gomes DO, Bandeira GN, Carneiro MADS, Gonzalez RIC, Pacheco LR, Zanchetta MS, Lima JDORE, Teles SA, Caetano KAA. Getting knowledge to provide care: prevalence and factors associated with Sexually Transmitted Infections in immigrants from Goiás. Rev Esc Enferm USP 2024; 57:e20230034. [PMID: 38197674 PMCID: PMC10781298 DOI: 10.1590/1980-220x-reeusp-2023-0034en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 09/26/2023] [Indexed: 01/11/2024] Open
Abstract
OBJECTIVE To estimate the prevalence of Sexually Transmitted Infections (STIs) in immigrants and refugees living in the metropolitan region of Goiânia, Goiás. METHOD This is a cross-sectional and analytical study. Data collection was carried out from July 2019 to January 2020 and 308 immigrants and refugees were included in the sample. All were underwent face-to-face interviews and were tested for HIV, Syphilis, and Hepatitis B, using rapid tests. RESULTS The general prevalence for any of the STIs investigated was 8.8% (95%CI 6.0% - 12.3%), being 5.8% (95%CI 3.6% - 8.9%) for Hepatitis B, 2.3% for Syphilis (95%CI 1.00% - 4.4%) and 0.7% for HIV (95%CI 0.1% - 2.1%). Multiple analysis, using logistic regression, showed that the variables male gender (OR = 2.7) and length of time living in Brazil (OR = 2.6) were significantly associated with STIs (p < 0.05). CONCLUSION The results of this study suggest that STIs are a health problem in immigrants/refugees, which appear to be enhanced with the length of migration in the country. Public policies that guarantee health care for this population shall be considered.
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Affiliation(s)
- Carla de Almeida Silva
- Universidade Federal de Goiás, Faculdade de Enfermagem, Departamento
de Enfermagem, Goiânia, GO, Brasil
| | | | | | - Winny Éveny Alves Moura
- Universidade Federal de Goiás, Faculdade de Enfermagem, Departamento
de Enfermagem, Goiânia, GO, Brasil
| | - Davi Oliveira Gomes
- Universidade Federal de Goiás, Faculdade de Enfermagem, Departamento
de Enfermagem, Goiânia, GO, Brasil
| | - Gabriela Nolasco Bandeira
- Universidade Federal de Goiás, Faculdade de Enfermagem, Departamento
de Enfermagem, Goiânia, GO, Brasil
| | | | | | - Leonora Rezende Pacheco
- Universidade Federal de Goiás, Faculdade de Enfermagem, Departamento
de Enfermagem, Goiânia, GO, Brasil
| | | | | | - Sheila Araujo Teles
- Universidade Federal de Goiás, Faculdade de Enfermagem, Departamento
de Enfermagem, Goiânia, GO, Brasil
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7
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Chen T, Wan B, Wang M, Lin S, Wu Y, Huang J. Evaluating the global, regional, and national impact of syphilis: results from the global burden of disease study 2019. Sci Rep 2023; 13:11386. [PMID: 37452074 PMCID: PMC10349077 DOI: 10.1038/s41598-023-38294-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 07/06/2023] [Indexed: 07/18/2023] Open
Abstract
Syphilis is a global public health concern. This study aimed to assess the global and regional burden of syphilis from 1990 to 2019. Disease burden was evaluated using disability-adjusted life-years (DALYs) and prevalence. Data were extracted from the 2019 global burden of disease Study, an open database available for download. Age-standardized rates (ASR) and estimated annual percentage changes (EAPC) were calculated to evaluate the syphilis burden over time. In 2019, the total number of prevalent cases of syphilis was 49.71 million worldwide. The ASR of prevalence was stable from 1990 to 2019 with an EAPC of 0.00 (95% CI - 0.10-0.11). The number of DALYs caused by syphilis was 7.36 million in 2019, reflecting a reduction of 16.38% compared with that in 1990 (8.80 million). The ASR of DALYs exhibited a decreasing trend from 1990 to 2019 (EAPC = - 1.01; 95% CI - 1.19 to - 0.84), with the highest rates observed in the younger age group (< 14 years old). In 2019, the highest ASR of DALYs was found in low sociodemographic index (SDI) regions (239.21/100,000), and the lowest in high SDI regions (3.14/100,000). Generally, the ASR of DALYs decreased as the SDI increased. The top three countries with the highest ASR of DALYs for syphilis were the Solomon Islands, Equatorial Guinea, and Liberia. While the global prevalence of syphilis remained persistently high from 1990 to 2019, there has been a recent decrease in the ASR of DALYs. Increased attention should be dedicated to younger populations and regions characterized by low SDIs.
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Affiliation(s)
- Tao Chen
- The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
| | - Bo Wan
- The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
- Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Mingfang Wang
- Department of Hepatology, Hepatology Research Institute, The First Affiliated Hospital, Fujian Medical University, No. 20, Chazhong Road, Taijiang District, Fuzhou, 350005, Fujian, China
- Fujian Clinical Research Center for Liver and Intestinal Diseases, The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
- Department of Hepatology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
| | - Su Lin
- Department of Hepatology, Hepatology Research Institute, The First Affiliated Hospital, Fujian Medical University, No. 20, Chazhong Road, Taijiang District, Fuzhou, 350005, Fujian, China
- Fujian Clinical Research Center for Liver and Intestinal Diseases, The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
- Department of Hepatology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
| | - Yinlian Wu
- Department of Hepatology, Hepatology Research Institute, The First Affiliated Hospital, Fujian Medical University, No. 20, Chazhong Road, Taijiang District, Fuzhou, 350005, Fujian, China
- Fujian Clinical Research Center for Liver and Intestinal Diseases, The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
- Department of Hepatology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
| | - Jiaofeng Huang
- Department of Hepatology, Hepatology Research Institute, The First Affiliated Hospital, Fujian Medical University, No. 20, Chazhong Road, Taijiang District, Fuzhou, 350005, Fujian, China.
- Fujian Clinical Research Center for Liver and Intestinal Diseases, The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China.
- Department of Hepatology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China.
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8
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Sulyok M, Walker M. Social mobility and gonorrhoea in Germany during 2020. Sex Transm Infect 2022; 98:371-375. [PMID: 34510006 PMCID: PMC8440122 DOI: 10.1136/sextrans-2021-055159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 09/03/2021] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES The incidence of STIs is likely to be related to levels of social activity and mobility. Novel datasets detailing levels of social activity were made widely available during the COVID-19 pandemic. These allow the relationship between activity and STI incidence to be examined. METHODS The correlation between social activities and the reported number of gonorrhoea cases between March and December 2020 in Germany was studied. Regression through Autoregressive Integrated Moving Average (ARIMA) time series modelling identified those activities associated with case numbers. RESULTS ARIMA regression identified a significant association with 'transit' activity within the Apple data and 'parks' within Google. CONCLUSIONS This study illustrates the potential newly available measures of social activity provided for STI research. Reductions in STI incidence are likely to have occurred due to COVID-19 social restrictions. Although other studies report reductions in infectious diseases during this period, few examine the potential social factors mediating this. The results illustrate the continual need for sexual health services throughout the pandemic.
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Affiliation(s)
- Mihály Sulyok
- Department of Pathology, Eberhard Karls University of Tübingen, Tubingen, Germany
- Institute of Tropical Medicine, Eberhard Karls University of Tübingen, Tubingen, Germany
| | - Mark Walker
- Faculty of Development and Society, Sheffield Hallam University, Sheffield, UK
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9
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Novel strategies for prevention and treatment of antimicrobial resistance in sexually-transmitted infections. Curr Opin Infect Dis 2021; 34:591-598. [PMID: 34545855 DOI: 10.1097/qco.0000000000000793] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
PURPOSE OF REVIEW Antimicrobial resistance in sexually acquired infection (STI) pathogens is an important global public health threat. There is an urgent need for novel STI treatment and prevention strategies to tackle the rising incidence of STIs in high-income settings and the static progress in low- and middle-income settings over the past decade. The purpose of this review was to describe the research outlining the emergence of resistance in common STI pathogens and new strategies for their treatment and prevention. RECENT FINDINGS Rates of STIs have dramatically increased over the past decade. Further, antimicrobial resistance to first-line agents among key STI pathogens continues to emerge globally. Recent findings demonstrate promising results regarding the efficacy of novel antimicrobial treatment strategies for these pathogens, including several new, repurposed and unique combinations of antimicrobials. In addition, a number of new biomedical prevention strategies, such as antibacterial mouthwash and doxycycline chemoprophylaxis, are being investigated as novel prevention strategies for bacterial STIs. SUMMARY Significant progress has been made in the development of novel antimicrobials for the treatment of antimicrobial-resistant sexually acquired pathogens. However, due to the rapid development of resistance to antimicrobials demonstrated by these pathogens in the past, further research and development of effective prevention strategies should be prioritized.
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10
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Mirzadeh M, Olfatifar M, Eslahi AV, Abdoli A, Houshmand E, Majidiani H, Johkool MG, Askari S, Hashemipour S, Badri M. Global prevalence of Trichomonas vaginalis among female sex workers: a systematic review and meta-analysis. Parasitol Res 2021; 120:2311-2322. [PMID: 34170387 DOI: 10.1007/s00436-021-07216-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 06/08/2021] [Indexed: 10/21/2022]
Abstract
Trichomoniasis is a sexually transmitted infection (STI), caused by the protozoan parasite, Trichomonas vaginalis. Female sex workers are intensely affected by the infection, since they have frequent direct physical contact. The current systematic review and meta-analysis represents the global prevalence of T. vaginalis in female sex workers. Five databases (Science Direct, Scopus, PubMed, Web of Science, and Google Scholar) were explored for literatures that published from July 1985 to June 2020. Totally, 85 studies (54,515 participants) from 46 countries met the inclusion criteria. The global pooled prevalence of T. vaginalis was 16% (95% CI 13-19%). The estimated pooled prevalence based on methods including wet mount, culture, and molecular techniques was 15% (95% CI 12-19%), 16% (95% CI 10-24%), and 22% (95% CI 13-32%), respectively. Moreover, the infection was most prevalent at the mean age of 30-36 (20%, 95% CI 11-30%). Regarding the World Health Organization (WHO) regions, the highest pooled prevalence was estimated to be in the African region (23%, 95% CI 7-46%). In addition, we indicated that countries with low-income level have the highest pooled prevalence (23%, 95% CI 14-34%). Our results revealed that the worldwide prevalence of T. vaginalis was significant in female sex workers. Therefore, considering a precise strategy such as a health education program with regard to safe intercourse is needed to increase knowledge and prevent T. vaginalis infection in sex workers.
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Affiliation(s)
- Monirsadat Mirzadeh
- Metabolic Diseases Research Center, Research Institute For Prevention Of Non-Communicable Diseases, Qazvin University Of Medical Sciences, Qazvin, Iran
| | - Meysam Olfatifar
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Aida Vafae Eslahi
- Clinical Research Development Unit, Velayat Hospital, Qazvin University Of Medical Sciences, Qazvin, Iran
| | - Amir Abdoli
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Elham Houshmand
- Department of Parasitology, Faculty of veterinary medicine, Rasht Branch, Islamic Azad University, Rasht, Gilan, Iran
| | - Hamidreza Majidiani
- Zoonotic Diseases Research Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Morteza Ghanbari Johkool
- Metabolic Diseases Research Center, Research Institute For Prevention Of Non-Communicable Diseases, Qazvin University Of Medical Sciences, Qazvin, Iran
| | - Setareh Askari
- Department of Medical Parasitology & Mycology, School of Public Health, Tehran University of Medical Science, Tehran, Iran
| | - Sima Hashemipour
- Metabolic Diseases Research Center, Research Institute For Prevention Of Non-Communicable Diseases, Qazvin University Of Medical Sciences, Qazvin, Iran.
| | - Milad Badri
- Medical Microbiology Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
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de Miguel Buckley R, Trigo E, de la Calle-Prieto F, Arsuaga M, Díaz-Menéndez M. Social distancing to combat COVID-19 led to a marked decrease in food-borne infections and sexually transmitted diseases in Spain. J Travel Med 2020; 27:5897022. [PMID: 32841356 PMCID: PMC7499626 DOI: 10.1093/jtm/taaa134] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 08/13/2020] [Accepted: 08/18/2020] [Indexed: 01/28/2023]
Abstract
Data from a recent epidemiological surveillance network showed a decrease in the reported number of sexually transmitted diseases (STDs) and food-borne infections. We reflect on the possible drivers and consequences of a decrease in these transmittable infectious diseases linked to human contact in relation to social distancing due to the COVID-19 pandemic in Madrid (Spain).
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Affiliation(s)
- R de Miguel Buckley
- National Referral Unit for Imported Tropical Diseases, Tropical & Travel medicine Unit, Infectious Diseases Department, La Paz- Carlos III University Hospital-IdiPAZ, Paseo de la Castellana, 261 28046 Madrid, Spain
| | - E Trigo
- National Referral Unit for Imported Tropical Diseases, Tropical & Travel medicine Unit, Infectious Diseases Department, La Paz- Carlos III University Hospital-IdiPAZ, Paseo de la Castellana, 261 28046 Madrid, Spain
| | - F de la Calle-Prieto
- National Referral Unit for Imported Tropical Diseases, Tropical & Travel medicine Unit, Infectious Diseases Department, La Paz- Carlos III University Hospital-IdiPAZ, Paseo de la Castellana, 261 28046 Madrid, Spain
| | - M Arsuaga
- National Referral Unit for Imported Tropical Diseases, Tropical & Travel medicine Unit, Infectious Diseases Department, La Paz- Carlos III University Hospital-IdiPAZ, Paseo de la Castellana, 261 28046 Madrid, Spain
| | - M Díaz-Menéndez
- National Referral Unit for Imported Tropical Diseases, Tropical & Travel medicine Unit, Infectious Diseases Department, La Paz- Carlos III University Hospital-IdiPAZ, Paseo de la Castellana, 261 28046 Madrid, Spain
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Beach boys in Galle, Sri Lanka: multiple HIV risk behaviours and potential for HIV bridging. BMC Public Health 2020; 20:1604. [PMID: 33097015 PMCID: PMC7585175 DOI: 10.1186/s12889-020-09699-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 10/14/2020] [Indexed: 11/10/2022] Open
Abstract
Background There are limited data globally on HIV in men who engage in casual and transactional sex with female tourists. Methods In 2018 we carried out a respondent-driven sampling (RDS) survey among beach boys in Galle, Sri Lanka, to determine prevalence of HIV and other infections, HIV risk behaviours and utilisation of HIV prevention services. Eligibility criteria included men who cruise in and around beach areas and who had anal and/or vaginal sex with female or male tourists in the 12 months before the survey. Results We recruited 373 beach boys. Approximately 49.6% of the participants were married, while 45.7% were single and 4.7% divorced, separated or widowed. A lower percentage of beach boys reported regular partners in the past 12 months (52.3%) compared to casual partners (95.4%). Condom use at last sex with a casual partner was higher (76.7%) compared to condom use with regular partners (58.3%). Condom use at last sex with a tourist was reported by 75.3%. Ever receiving money, goods or services in exchange for sex was reported by 39.7%. For 85.5% of beach boys who sold sex, the last paying partner was a tourist (85.5%) and a woman (82.0%). In the past 12 months before the survey, 32.3% of beach boys paid money for sex, and 99.5% did so from women. Ever been tested for HIV was reported by 35.3, and 69.1% of those were tested in the 6 months before the survey. In the adjusted multivariate analysis, significant correlates of never testing for HIV were lack of comprehensive knowledge about HIV and unprotected last sexual intercourse with tourists. The prevalent infections were: HIV, 0.3% (95% CI 0.0–0.4%); syphilis, 0.5% (0.0–1.2%); herpes virus type-2, 5.0% (2.5–7.5%). Conclusions There are low level HIV and syphilis prevalence among beach boys in Galle but a high level of sexual risk taking. Beach boys may be acting as a bridge for HIV transmission between higher-risk groups (paying female tourists, men who have sex with men) and lower-risk heterosexual female population in Sri Lanka. More research is needed in South-East Asia on men who trade sexual services to female and male tourists.
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Tien V, Punjabi C, Holubar MK. Antimicrobial resistance in sexually transmitted infections. J Travel Med 2020; 27:5678669. [PMID: 31840758 DOI: 10.1093/jtm/taz101] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 12/06/2019] [Accepted: 12/11/2019] [Indexed: 12/13/2022]
Abstract
RATIONALE FOR REVIEW International travel facilitates the spread of drug-resistant infections, including sexually transmitted infections (STIs). In 2016, the World Health Organization highlighted the global burden of 'curable' STIs, estimating 376 million new infections of gonorrhoea, chlamydia, syphilis and trichomoniasis annually, with considerable geographic variation in both the burden of disease and prevalence of resistance. Travelers' risk of contracting and transmitting drug-resistant STIs depends in part on their geographic exposure. In this review, we describe the epidemiology of antimicrobial resistance (AMR) and the management of these four common STIs and Mycoplasma genitalium, an increasingly recognized cause of non-gonococcal urethritis. KEY FINDINGS Multi-drug and extensively drug resistant gonorrhoea strains have been associated with international spread, particularly in travelers returning from Southeast Asia. Chlamydia is the most common bacterial STI worldwide. Although in vitro resistance has been reported, surveillance data suggest that clinically significant resistance to macrolides and tetracyclines is rare. Macrolide resistance in syphilis is now endemic in much of the world but there is no documented penicillin resistance, which remains first-line therapy. Trichomoniasis is the most common non-viral STI worldwide. Although clinical failure after treatment occurs, resistance to metronidazole is thought to be uncommon. Mycoplasma genitalium exhibits intrinsic resistance to many antibiotics, and the prevalence of resistance to both first- and second-line regimens (macrolides and fluoroquinolones) is increasing worldwide, with limited alternative therapeutic options. RECOMMENDATIONS International travelers are at risk for acquiring resistant STIs with limited therapeutic options. Improved diagnostics are urgently needed to improve AMR surveillance and the management of infected patients. As no vaccinations are currently available for these STIs, and pre-exposure prophylaxis is an area of active study with limited data, condom use is critical for prevention. Travel medicine providers should incorporate STI risk reduction counselling, with an emphasis on condom use, into the routine pre-travel consultation.
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Affiliation(s)
- Vivian Tien
- Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Chitra Punjabi
- Department of Medicine, Division of Infectious Diseases, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Marisa K Holubar
- Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA
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Gottwald C, Schwarz NG, Frickmann H. Sexually Transmitted Infections in Soldiers - A Cross-Sectional Assessment in German Paratroopers and Navy Soldiers and a Literature Review. Eur J Microbiol Immunol (Bp) 2019; 9:138-143. [PMID: 31934366 PMCID: PMC6945994 DOI: 10.1556/1886.2019.00023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 10/14/2019] [Indexed: 02/06/2023] Open
Abstract
Introduction The study was performed to estimate the prevalence and determinants of occurrence of sexually transmitted infections (STIs) in paratroopers and navy soldiers by anonymously analyzing medical records from the medical departments of two large German barracks in order to assess the need for medical STI prevention. Methods Medical records from 80 paratroopers and 80 navy soldiers were screened for records of STI. Results were anonymously collected next to information on risk factors, as well as diagnostic and therapeutic management, and comparatively assessed. Results Proportions of suspected STIs were 17.5% and 20%, and proportions of diagnosed STIs were 13.9% and 11.3% for paratroopers and navy soldiers, respectively. Chlamydia trachomatis, human papillomavirus, and genital scabies were observed in paratroopers and navy soldiers, while Gardnerella vaginalis, herpes simplex virus, Molluscum contagiosum virus, Neisseria gonorrhoeae, and Trichomonas vaginalis were additionally identified in navy soldiers. Conclusions Although clinical hints for STIs were frequently observed, clinical management was usually restricted to syndrome-based antibiotic treatment without detailed diagnostic workup, leaving room for procedural improvement. Ongoing need for medical STI prevention in the military could be confirmed.
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Affiliation(s)
- Carina Gottwald
- Bundeswehr Military Medical Department Wilhelmshaven, Wilhelmshaven, Germany
| | - Norbert Georg Schwarz
- Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine Hamburg, Hamburg, Germany
| | - Hagen Frickmann
- Department of Microbiology and Hospital Hygiene, Bundeswehr Hospital Hamburg, Hamburg, Germany.,Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, Rostock, Germany
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