Harms G, Matull R, Randrianasolo D, Andriamiadana J, Rasamindrakotroka A, Kirsch T, Hof U, Rarivoharilala E, Korte R
Institut für Tropenmedizin Berlin, Germany.
Sex Transm Dis. 1994 Nov-Dec;21(6):315-20. doi: 10.1097/00007435-199411000-00004.
Data concerning the spectrum and antimicrobial susceptibility of STDs in Madagascar are scarce.
Improvement of STD patient management in Madagascar.
Assessment of the spectrum of STDs and improvement of therapy.
Etiologic study of 400 patients (169 men, 231 women) under consultation at the major STD service in Antananarivo for one or more of the STD syndromes, urethral discharge, cervicovaginal discharge, genital ulcers, or condylomata according to a fixed diagnostic schedule.
Of genital ulcers, syphilis accounted for 46%, lymphogranuloma venereum for 24%, chancroid for 16%, and herpes for 1%. Of the syphilis cases, 51% presented as condyloma lata. Discharge was found in 124 men and 210 women. Counting concomitant infections separately, gonorrhea occurred in 69% of the men and 20% of the women with discharges, chlamydia infection in 42% and 52%, trichomoniasis in 9% and 31%, candidiasis in 12% and 30%. Bacterial vaginosis was found in 37% of the women with discharges. In 32% of male and 71% of female gonorrhea cases, there was concurrent chlamydia infection. Infection with HIV 1 or 2 was not detected. Determination of the antibiotic susceptibility of Neisseria gonorrhoea revealed high efficacy of ampicillin, ciprofloxacin, and spectinomycin; but frequent resistance to tetracycline and cotrimoxazole.
High priority should be given to the management of infections with chlamydia and with Treponema pallidum as well as to educational measures to increase awareness of genital ulcer disease.
关于马达加斯加性传播疾病（STD）的种类及抗菌药敏性的数据匮乏。
改善马达加斯加性传播疾病患者的管理。
评估性传播疾病的种类并改进治疗方法。
根据固定的诊断流程，对在塔那那利佛主要性传播疾病诊疗机构就诊的400例患者（169名男性，231名女性）进行病因学研究，这些患者患有一种或多种性传播疾病综合征，如尿道分泌物、宫颈阴道分泌物、生殖器溃疡或尖锐湿疣。
在生殖器溃疡病例中，梅毒占46%，性病性淋巴肉芽肿占24%，软下疳占16%，疱疹占1%。梅毒病例中，51%表现为扁平湿疣。124名男性和210名女性有分泌物。分别计算合并感染情况，有分泌物的男性中淋病发生率为69%，女性为20%；衣原体感染在男性和女性中分别为42%和52%；滴虫病在男性和女性中分别为9%和31%；念珠菌病在男性和女性中分别为12%和30%。有分泌物的女性中37%患有细菌性阴道病。在32%的男性淋病病例和71%的女性淋病病例中，同时存在衣原体感染。未检测到HIV - 1或HIV - 2感染。淋病奈瑟菌的抗生素药敏试验结果显示，氨苄西林、环丙沙星和壮观霉素疗效高；但对四环素和复方新诺明耐药频繁。
应高度重视衣原体感染和梅毒螺旋体感染的管理以及提高对生殖器溃疡疾病认识的教育措施。
