Kura M M, Hira S, Kohli M, Dalal P J, Ramnani V K, Jagtap M R
Department of Skin/STD and Microbiology, Sir J J Group of Hospitals, Bombay, India.
Int J STD AIDS. 1998 Apr;9(4):231-3. doi: 10.1258/0956462981921954.
The pattern of sexually transmitted disease (STD) is the basis for designing surveillance of specific STD, their trends and syndromic management protocols. Two hundred and fifteen consecutive first-time STD clinic attenders at a teaching hospital in Bombay were recruited for the study in October 1995. Thorough clinical examination and the following investigations were done: wet mount, Gram stain, Giemsa stain, modified Thayer-Martin (MTM) medium culture, Fontana stain, Venereal Disease Research Laboratory (VDRL), Treponema pallidium haemagglutination test (TPHA), HBsAg and HIV. Ulcerative STD constituted 73.5% of total STD while 15.8% were discharges and 10.2% were genital growths. Ulcers in decreasing order of frequency were chancroid (51.9%), genital herpes (29.1%) and syphilis (14.5). 76.5% of genital discharges were due to gonococcal infection. The high rate of ulcerative STD is possibly an important co-factor for the high HIV prevalence of 31.2% in Bombay. Of 182 patients tested for HBV, 16 (8.8%) were reactive for HBsAg, revealing a high prevalence among STD attenders. A high co-relation of HBsAg positive with either HIV or VDRL requires urgent attention for HBV intervention strategies in this population.
性传播疾病（STD）模式是设计特定性传播疾病监测、其趋势及综合征管理方案的基础。1995年10月，在孟买一家教学医院招募了215名连续前来性病门诊的初诊患者进行该研究。进行了全面的临床检查及以下检测：湿片检查、革兰氏染色、吉姆萨染色、改良Thayer-Martin（MTM）培养基培养、Fontana染色、性病研究实验室（VDRL）检测、梅毒螺旋体血细胞凝集试验（TPHA）、乙肝表面抗原（HBsAg）及艾滋病病毒（HIV）检测。溃疡性性传播疾病占性传播疾病总数的73.5%，而分泌物增多型占15.8%，生殖器肿物型占10.2%。按发病率递减顺序排列，溃疡依次为软下疳（51.9%）、生殖器疱疹（29.1%）和梅毒（14.5%）。76.5%的生殖器分泌物增多是由淋球菌感染引起的。溃疡性性传播疾病的高发病率可能是孟买艾滋病病毒高流行率（31.2%）的一个重要协同因素。在182名接受乙肝检测的患者中，16名（8.8%）乙肝表面抗原呈阳性，表明在性病门诊患者中乙肝感染率较高。乙肝表面抗原阳性与艾滋病病毒或性病研究实验室检测阳性之间的高度相关性，要求针对该人群的乙肝干预策略给予紧急关注。
