Ly F, Guéye N, Samb N D, Sow P S, Ndiaye B, Mahé A
Med Trop (Mars). 2006 Feb;66(1):64-8.
The objectives of this study conducted from January to December 2001 at our reference centre for sexualy transmitted infections (STI) were to determine the epidemiological profile of men who consulted our facility for symptomatic STI, describe the clinical manifestations of STI, and propose recommendations for improving therapeutic management of STI in tropical areas. A total of 100 men consulting for symptomatic STI were included over the one-year study period. In addition to administering a standardized questionnaire to each patient, a thorough clinical examination especially of the urogenital tract was performed and blood and urethral discharge specimens were obtained for analysis at the Reference STI laboratory of Institut d'Hygiène Sociale (IHS). Analysis of study data demonstrated that the mean age of patients was 25 years, that 52% were single, and that level of education was generally low (primary school for 37% and secondary school for 27%). However it should be pointed out that 12% of patients had a university level education. Most patients were Wolof people living in or around Dakar and working in the trades sector (shopkeeper, artists, tailors, drivers, and seamen). Thirty-seven percent of patients reported previous STI involving urethral discharge in 34% and genital ulcer in 3%. Risk factors included sex with random partners in 51% including 31% with prostitutes, more than two partners at the time of the study in 34%, and regular alcohol use in 44%. Neisseria gonorrhoea was by far the most frequent infectious agent found in urethral discharge specimens (52%). Genital ulcer was found in only 13 cases. Eight of 13 patients with genital ulcers had positive syphilis serology suggesting that syphilis was the most frequent aetiology. The other aetiologies were uncommon STI, ie., condyloma (n=3), balanitis (n=2), venereal lymphogranuloma (n=1) and secondary syphilis (n=1). Serology was positive for HIV in 4% of patients. The epidemiologic profile of the patients in our study was similar to those previously reported in the literature. However it is interesting to note the non-negligible number of cases of STI transmission involving illegal prostitution, the high incidence of mismanagement of STI by the health care workers who provided initial treatment, the poor availability of drugs used for treatment of STI therapy in the centre's Banako Initiative (BI) pharmacy, and the frequency of condom non-use by patients with STI.
2001年1月至12月在我们的性传播感染（STI）参考中心开展了本研究，其目的是确定因出现症状前来本机构就诊的男性性传播感染的流行病学特征，描述性传播感染的临床表现，并就改善热带地区性传播感染的治疗管理提出建议。在为期一年的研究期间，共有100名因出现症状前来就诊的男性被纳入研究。除了向每位患者发放标准化问卷外，还进行了全面的临床检查，尤其是泌尿生殖道检查，并采集了血液和尿道分泌物样本，送至社会卫生研究所（IHS）的性传播感染参考实验室进行分析。研究数据分析表明，患者的平均年龄为25岁，52%为单身，教育水平普遍较低（37%为小学学历，27%为初中学历）。然而，应该指出的是，12%的患者拥有大学学历。大多数患者是居住在达喀尔及其周边地区、从事贸易行业（店主、艺术家、裁缝、司机和海员）的沃洛夫人。37%的患者报告曾患性传播感染，其中34%出现尿道分泌物，3%出现生殖器溃疡。危险因素包括51%与随机伴侣发生性行为，其中31%与妓女发生性行为；34%在研究期间有两个以上伴侣；44%经常饮酒。淋病奈瑟菌是尿道分泌物样本中迄今为止最常见的感染病原体（52%）。仅发现13例生殖器溃疡病例。13例生殖器溃疡患者中有8例梅毒血清学呈阳性，这表明梅毒是最常见的病因。其他病因是不常见的性传播感染，即尖锐湿疣（n = 3）、龟头炎（n = 2）、性病性淋巴肉芽肿（n = 1）和二期梅毒（n = 1）。4%的患者艾滋病毒血清学呈阳性。我们研究中患者的流行病学特征与文献中先前报道的相似。然而，值得注意的是，涉及非法卖淫的性传播感染病例数量不可忽视，提供初始治疗的医护人员对性传播感染管理不善的发生率很高，该中心的巴纳科倡议（BI）药房用于性传播感染治疗的药物供应不足，以及性传播感染患者不使用避孕套的频率很高。
