Department of Pathology, Post Graduate Medical Institute, Lahore.
Department of Morbid Anatomy and Histopathology University of Health Sciences Lahore.
J Pak Med Assoc. 2022 May;72(5):940-946. doi: 10.47391/JPMA.4166.
Globally more than a million sexually transmitted infections occur daily, and over 53 000 [47,000-60,000] women aged 15 and over were living with human immunodeficiency virus / acquired immunodeficiency syndrome in Pakistan by the year 2020. This situation becomes graver when the sexually transmitted infections exist as co-infections while remaining undiagnosed or under-diagnosed. Additionally, herpetic or papillomavirus lesions are more recurrent, more extensive and have more serious consequences in human immunodeficiency virus-positive patients. Literature shows a dramatic increase in morbidity and mortality due to the occurrence of malignancies in genital co-infections. There is a key concern that every single adolescent female living in Pakistan is at a high risk of acquiring viral sexually transmitted infections along with malignancy of the cervix. As such, the health and future of this age group is already imperilled. Needless to mention that the practice of routine cervical screening and diagnostic laboratory services offered to a common woman in Pakistan have been less than satisfactory for decades. Therefore, to meet the minimum expectations regarding the Millennium Development Goals for sexual and reproductive health and rights 2030, it has now become imperative for the health sector to develop and implement scientific and community-based policies for comprehensive and multidisciplinary diagnostic strategies leading to early and effective management of viral sexually transmitted infections and subsequent neoplasia.
全球每天有超过 100 万例性传播感染，到 2020 年，巴基斯坦年龄在 15 岁及以上的艾滋病毒/获得性免疫缺陷综合征（艾滋病）感染者中，有超过 5.3 万名[4.7 万至 6 万]妇女。当性传播感染作为合并感染存在且未被诊断或诊断不足时，情况会更加严重。此外，疱疹或乳头瘤病毒病变在艾滋病毒阳性患者中更频繁、更广泛，后果更严重。文献表明，由于生殖器合并感染发生恶性肿瘤，发病率和死亡率显著增加。一个关键的关注点是，巴基斯坦的每一位青少年女性都面临着极高的风险，可能会感染病毒性性传播感染和宫颈癌等恶性肿瘤。因此，这一年龄组的健康和未来已经岌岌可危。不用说，几十年来，向巴基斯坦普通妇女提供的常规宫颈筛查和诊断实验室服务一直不尽如人意。因此，为了满足 2030 年性健康和生殖健康及权利千年发展目标的最低期望，卫生部门现在必须制定和实施科学的、以社区为基础的政策，制定全面的多学科诊断策略，以实现对病毒性性传播感染和随后的肿瘤的早期和有效管理。
