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STUDIES
Year : 1994  |  Volume : 60  |  Issue : 6  |  Page : 323-326

A ten year study of STD Cases in an urban clinic in Calcutta


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Correspondence Address:
Kumar Sadhana Ghosh


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  Abstract 

Total 16440 patients attended the STD clinic during the 10 years period of study from 1984 to 1993. From 1988 number of STD caes were gradually decreasing probably due to less promiscuity in fear of AIDS and different measures taken to prevent transmission of HIV infection. But it does not lessen the importance of STD control, because syphilis is still prevalent (8%) with congenital syphilis. Peak in the incidence of chancroid (15%) is alarming as this may lead to increased transmission of HIV infection in near future. Male unmarried constituted the bulk of STD sufferers (44%) and married males (34%), while female unmarried and married patients were 1% and 20% respectively, 5.7% of antenatal mothers were strongly seroreactive for syphilis. Therefore all antenatal mothers should be screened for STD and routine serological test for syphilis should be done.


Keywords: Sexually transmitted diseases, Urban clinic


How to cite this article:
Ghosh KS, Roy KA. A ten year study of STD Cases in an urban clinic in Calcutta. Indian J Dermatol Venereol Leprol 1994;60:323-6

How to cite this URL:
Ghosh KS, Roy KA. A ten year study of STD Cases in an urban clinic in Calcutta. Indian J Dermatol Venereol Leprol [serial online] 1994 [cited 2014 Apr 24];60:323-6. Available from: http://www.ijdvl.com/text.asp?1994/60/6/323/4094



  Introduction Top


Syphilis, gonorrhoea, chancroid, lymphogranuloma venereum and granuloma inguinale were considered the five venereal diseases. Though after the invent of modern antibiotics, the treatment of venereal diseases has been easy and satisfactory with less morbidity and social and congenital stigma, but that does not diminish their importance as infectious diseases of general concern, but it does point out that the spectrum of this type of communicable disorder is broad and the number of people affected by more common sexually transmitted disorders (STDs) is high. [1] After the advent of human immunodeficiency virus (HIV) and AIDS, the impact and importance of STDs have again come to the fore-front. Sexual transmission is one of the modes of transmission of HIV infection, Mucosal trauma as is more likely in anal intercourse and the presence of other anogenital infections, especially if eroded or ulcerated - typically herpes simples, syphilis or

chanroid - facilitato viral trancfer [2]

Therefore, control of STDs is a primary necessity for the prevention of HIV infection and development of AIDS. Though AIDS is not a major problem at the present moment in India in comparison to the Western and African countries, but it is the high time to take measures for control of HIV infection and STDs in our country. 221 AIDS cases including 14 foreigners and seropositivity rate per thousand 5.50 were reported by the National AIDS Control Organization, Ministry of Health and Family Welfare, Govt. of India during the period from 1st October, 1985 to 31st July 1992. More than 70% of these AIDS cases acquired the infection through hetero-sexual route.

Besides the above diseases, there are .numerous disorders that can be transmitted through sexual contact, namely, genital herpes, genital warts, molluscum contagiosum, hepatitis virus, chlamydia infections and non­gonococcal urethritis (NGU), genital candidiasis, trichomoniasis, amoebiasis, giardiasis, cryptosporidiosis, enterobiasis, strongyloidiasis, shigellosis, salmonallosis, campylobacter enteritis, pediculosis and scabies . [3]

Prostitution is very important in developing countries, where the large majority of STD episodes are contracted through them. In some urban and tropical areas, over half of the prostitutes were found to be infected with gonorrhoea, syphilis or HIV infection. [4],[5] Prostitutes and promiscuous individuals especially form a reservoir. Homo-sexuals because of multiplicity of partners and less recognition of the pattern of oral and ano­rectal diseases are an increasing reservoir. High prevalence of STD, as a result of changing socio-economic factors has been reported from the rapidly developing oil rich middle-eastern countries . [6] The present study has been undertaken to have a view of the trend of STDs in a cosmopolitan city like Calcutta.


  Materials and Methods Top


Data were collected from the out-patient attendence register of STD clinic from the year 1984 to 1993. Demographic figures, clinical diagnosis and blood VDRL test of STD

patients and antenatal mothers were studied. Clinical diagnosis was confirmed by gram staining of smears of urethral and vaginal discharges and routine examination of blood for serological test of syphilis.




  Comments Top


From the year 1988 the number of STD cases were gradually decreasing with slight increase in 1990 may be due to less promiscuity in fear of AIDS and different measures taken to prevent transmission of HIV infection. In this study the greatest number of cases occurred in the age group 15-35 years. Male patients were found to be nearly four times of female patients. This could be explained because of demographic factors such as more young male being in urban centres and resorting to small pool of prostitutes. Secondly, men recognize the lesions more easily and present early for treatment. Moreover some societies do not facilitate women coming to a clinic for genital complaints, perhaps to be examined by a man. Male married patients were 34% and male unmarried 44% whereas female married 20% and female unmarried only 1%. The increased number of unmarried male patient is probably because a stable marriage with both partners living together protects the couple from STD. Female married patients were 20 times more than the unmarried, probably due to social stigma of attending STD clinic, but married females usually attend the clinic with their diseased husband. Less than 1% of total patients was child, because child sexual abuse is much less in our country than in western countries because of stable family . [7]

In this study the commonest STD was found to be chancroid (15%) and in 1990 peak incidence occurred (31%). In industrialized western countries, chancroid is the cause of 1-2% of cases of genital ulceration. These observations are similar to previous reports. [7],[8],[9] Syphilis was found in 8% of patients and it was fairly steady during the study period and 6 cases of congenital syphilis were detected.

In our country, pregnant mothers do not always attend the antenatal clinics and take adequate treatment. Further resort to traditional remedies or purchased antibotics can lead to increased opportunity of transmission and delay in cure.

Gonorrhoea was found in 2% and NGU in 5% of total patients. A steady decline in the incidence of gonorrhoea is likely to be due to advent of quinolone derivatives and early self­medication. L.G.V. was detected in 1% of total STD clinic attendents and only 1 case of granuloma inguinale was found during the last 10 years. It is similar to the previous observation. [9] In the present study 5.7% of antenatal mothers were VDRL test strongly reactive, which is a significant finding and indicates the need of regular check-up for syphilis and also other STDs. [10]

 
  References Top

1.Kenneth A Arndt. Manual of Dermatologic therapeutic, 4th Edn. Boston : Little, Brown & Co., 1989; 135-46.  Back to cited text no. 1    
2.Piot P, Laga M. Genital ulcers, other sexually transmitted diseases and the sexual transmission of HIV. Br Med J 1989, 298 623-4.  Back to cited text no. 2    
3.Arya O P, Osoba AO and Benne,tt. Tropical Venereology, 2nd Edn ISE. Edinburgh Churchill Livingstone, 1984; 4.  Back to cited text no. 3    
4.Khoo R, Sng EH, Goh AJ. Incidence of sexually transmitted diseases in prostitutes in Singapore. Asian J Infectious disease 1977; 1: 77-9.  Back to cited text no. 4    
5.Lahiri VL, Jain NK, Elhence BR, Dhir GG, Lahiri B. Study of sexually transmitted diseases in 50 prostitutes of Agra (India). Asian J Infectious diseases 1978; 2 : 221-2.  Back to cited text no. 5    
6.Farid M, Sallam, TH, El Shiemy S. Sexually transmitted diseases in Abu Dhabi : Epidemiological features of a consecutive series of 1780 cases. Emirates Medical Journal 1981; 2 : 84-6.  Back to cited text no. 6    
7.Csonka GW, Dates JK. Sexually transmitted diseases. A text book of genito-urinary medicine, 1st edn. Bailliere Tindall 1990; 352­89.  Back to cited text no. 7    
8.King A, Nicol C, Rodin P. Venereal Diseases, 4th edn. ELBS 1980; 251.  Back to cited text no. 8    
9.Kapur TR. Pattern of Sexually transmitted diseases in India. Ind J Dermatol Venereol 1982; 48 : 23-4.  Back to cited text no. 9    
10.Mabey DCW, Lioyd-Evans NE, Conteh S, Forsey T. Sexually transmitted diseases among randomly selected attenders at an antenatal chlinic in the Jambia. Br J Ven Dis 1984; 60 : 331-6.  Back to cited text no. 10    


    Tables

[Table - 1], [Table - 2], [Table - 3]

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3 A study on the present scenario of STD management in an urban clinic in Kolkata
Ghosh, S.K.
Indian Journal of Dermatology, Venereology and Leprology. 2002; 68(2): 82-83
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