Harms G, Iyambo S N, Corea A, Radebe F, Fehler H G, Ballard R C
National AIDS Control Programme, Windhoek, Namibia.
Int J STD AIDS. 1998 Dec;9(12):744-50. doi: 10.1258/0956462981921503.
Syndromic management of sexually transmitted diseases (STDs) is strongly promoted in Namibia. However, no data are available on rates of asymptomatic reproductive tract infections (RTIs) which would remain undetected and thus untreated in the general population. This study was aimed at assessing the prevalence of RTIs in a young rural population and to gain an insight into their health-care seeking behaviour for RTIs. A total of 97 patients (44 male, 53 female) <30 years of age attending the outpatient clinic of a rural hospital in Northern Namibia for problems unrelated to RTIs were interviewed and examined. Specimens were taken for investigation of RTIs according to a non-invasive diagnostic schedule. Laboratory examinations revealed 58 infections of the reproductive tract in 42 of the 97 patients (43%). In addition, HIV infection was detected in 13 cases (13%). RTI rates were highest in female teenagers (68%), but no infections were detected in their male counterparts. Of those 42 patients with a laboratory-diagnosed infection, 7 had both symptoms and signs (symptomatic), 16 had neither symptoms nor signs (asymptomatic), and 19 had signs on examination but no symptoms (inapparent). Awareness and perception of symptoms and signs of RTIs were low in the studied population. Provision of adequate treatment for RTIs alone is unlikely to have a major impact on the overall burden of disease since the largest burden of disease was found among those patients (predominantly females) with inapparent infections. Health education on RTIs including STDs and the symptoms they cause together with the importance of early attendance at health facilities and improved access to treatment need to be addressed urgently.
纳米比亚大力推广性传播疾病（STDs）的综合征管理。然而，目前尚无关于无症状生殖道感染（RTIs）发生率的数据，这类感染在普通人群中可能未被发现，因而未得到治疗。本研究旨在评估纳米比亚北部农村年轻人群中RTIs的患病率，并深入了解他们针对RTIs的就医行为。共有97名年龄小于30岁、因与RTIs无关的问题前往纳米比亚北部一家农村医院门诊就诊的患者（44名男性，53名女性）接受了访谈和检查。根据无创诊断方案采集样本以调查RTIs。实验室检查显示，97名患者中有42名（43%）存在58例生殖道感染。此外，检测出13例（13%）感染艾滋病毒。女性青少年的RTIs发生率最高（68%），但男性青少年未检测到感染。在42例经实验室诊断感染的患者中，7例有症状和体征（有症状），16例既无症状也无体征（无症状），19例检查时有体征但无症状（隐匿性）。在研究人群中，对RTIs症状和体征的知晓度和认知度较低。仅提供针对RTIs的充分治疗不太可能对疾病的总体负担产生重大影响，因为最大的疾病负担存在于那些有隐匿性感染的患者（主要是女性）中。迫切需要开展关于RTIs（包括性传播疾病及其引起的症状）的健康教育，以及强调早期前往医疗机构就诊和改善治疗可及性的重要性。
