Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:2.7.10.2 (focal adhesion kinase)
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Qualitative research was conducted with traditional healers in Manica Province, Mozambique to develop an empirical, culturally-appropriate strategy for communication between government and traditional healers related to the prevention of STDs including AIDS. Most Manica healers regard AIDS as a new disease for which they lack medicines. However, when questioned on other sexually transmitted diseases, as defined by healers themselves, relatively complex disease taxonomies based on fine distinctions between symptoms emerged. Manica healers recognize two broad categories of STDs: siki and nyoka-related. The former seems to correspond with the more serious common STDs of Western biomedicine--syphilis, gonorrhea, chlamydia and chancroid--and is believed to be caused by a common invisible, microscopic agent, khoma. Nyoka-related illnesses are understood in terms of traditional ideas of pollution, and denote less serious, self-limiting genito-urinary conditions. Healers express great faith in the efficacy of traditional medicines. Based on the ethnomedical research findings, a culturally-sensitive and -specific AIDS/STD health education strategy for Manica indigenous healers was developed and began operating in a week-long workshop held in Chimoio, Mozambique in November 1991.
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PMID:Sexually-transmitted diseases, AIDS and traditional healers in Mozambique. 811 22

Genital ulcer disease as a risk factor for HIV transmission has become apparent in the fight against AIDS. In poor communities in developing countries with people living under low hygienic conditions chancroid is often reported to be the most common form of genital ulcer. It is caused by Haemophilus ducreyi; a fastidious bacterium, notoriously difficult to grow in the laboratory. Apart from a few small micro-epidemics from time to time the disease, which has interesting immunological aspects, is now rare and almost forgotten in most industrialized countries. This may be part of the reason why there is no simple and inexpensive diagnostic test available yet that would be useful in the low-resource settings where chancroid is prevalent. The present review focuses on the diagnosis and pathogenesis of chancroid.
Int J STD AIDS
PMID:Haemophilus ducreyi. 830 70

Plasma samples from patients with chancroid diagnosed both on clinical and microbiological grounds were assessed for their ability to inhibit mitogen-induced proliferation of human lymphocytes from healthy donors. All serum samples analysed suppressed phytohaemagglutinin A (PHA) blastogenic response. A significant difference in the observed extent was seen when serum samples from patients with and without associated lymphadenopathy were compared (P < 0.05). Using an interleukin-2 (IL-2)-dependent cell line it could be demonstrated that the addition of patients' plasma to cultured cells markedly depressed mitogen-induced IL-2 synthesis. Results presented suggest that cell-mediated mechanisms play a role in the pathogenesis of infection due to Haemophilus ducreyi.
Int J STD AIDS
PMID:The suppressive effect of serum samples from patients with chancroid on human mononuclear cells correlates with the clinical picture and is interleukin-2-dependent. 832 45

Travel to tropical countries is an important factor in the spread of sexually transmitted diseases. In spite of intensive anti-AIDS campaigns, some 30% of Swiss tourists have casual sexual contacts abroad. The prevalence of sexually transmitted diseases is higher in tropical countries than in western industrialized countries. More than 25% of cases of gonorrhea treated in Switzerland from 1989-1991 were imported from abroad. The penicillin producing Neisseria gonorrhoeae strains (PPNG) isolated in Switzerland from 1989-1991 are mainly imported from abroad (60%). The typical "imported sexually transmitted diseases" in Switzerland are chancroid, lymphogranuloma venereum and donovanosis. The clinical manifestations, laboratory and special examinations, and treatment of these diseases are described. The most frequent sexually transmitted disease from the so-called "imported tropical STD's" is chancroid. Chancroid is also a major risk factor for HIV infection.
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PMID:[Sexually transmissible diseases following travel in tropical countries]. 832 73

Data derived from laboratory and activity statistics of the Venereal Disease" department of the Public Health Office in Bremen were analysed between 1961 and 1991. The traditional concept to fight venereal diseases" aimed at controlling persons "at risk" for syphilis, gonorrhoea, chancroid or lymphogranuloma. This "high-risk" approach of STD prevention stressed the compulsory, at least twice monthly screening of female prostitutes and neglected other population groups like clients of prostitutes and young people, who might have an elevated risk in acquiring STD. The spread of STD like chlamydia, HPV, herpes and even HIV in considerable parts of the general population underlines the need for developing a more effective STD prevention, based on scientific diagnosis and treatment. Intervention programmes in STD control must be performed in full partnership with the targeted population; this can require great effort and time. But STD control certainly cannot be achieved under the threat of punishment or proscription.
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PMID:[Prevention of sexually transmitted diseases or control of prostitutes and patients with venereal diseases? An exemplary, epicritical study in Bremen]. 850 94

A randomized, comparative study undertaken in Nairobi, Kenya and a non-comparative evaluation undertaken in Carletonville, South Africa have both shown that a single oral dose of azithromycin 1 g is effective in the treatment of the genital ulcer disease (GUD), chancroid, with cure rates of 89% and 92% recorded respectively. While treatment failure was associated with human immunodeficiency virus seropositivity and lack of circumcision in Kenya, no such association could be found in the South African study. In both series, azithromycin treatment resulted in cure of both Haemophilus ducreyi culture-positive and culture-negative cases of GUD, including two cases subsequently diagnosed as lymphogranuloma venereum. A combination of single-dose azithromycin with single-dose benzathine penicillin may provide effective 'single-visit' syndromic treatment for GUD in many developing countries.
Int J STD AIDS 1996
PMID:Treatment of chancroid with azithromycin. 865 28

An integrated STD (sexually transmitted disease) and HIV control program is vital to tackling the major public health problem of STDs and HIV/AIDS. The World Health Organization estimates that there are 333 million new STD infections and 15-20 million new HIV infections each year. The two basic principles common to all STD control programs worldwide include prevention of STDs, their complications, and sequelae and the interruption and reduction of their transmission. These principles also apply to bringing about the reduction of the incidence of HIV infection. Primary prevention strategies, which should be accessible to all sexually active adults and youth, include health education and information, education, and communication (IEC). Secondary prevention strategies include promotion of health care seeking behavior, case management of people with an STD, and early detection and treatment of asymptomatic infections through case finding and screening. In developing countries especially, the most realistic and cost effective way to treat STD patients is the syndromic approach. This approach uses algorithms based on common signs and symptoms (e.g., genital ulcer, urethral and vaginal discharge). It can be used either with or in the absence of laboratory support. The two most common causes for genital discharge are syphilis and chancroid, so, given no laboratory support, the health provider would provide treatment for both STDs. The algorithm for urethral discharge is similarly clear cut. That for vaginal discharge is not so discriminating, since this symptom is very common and non-specific with multiple non-sexually acquired etiologies possible. Since most chlamydial and gonococcal infections in women are asymptomatic, active case finding, screening, and partner notification are very important in women-focused STD control programs.
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PMID:Sexually transmitted diseases control in developing countries. 869 72

Clinical diagnosis of STDs is unreliable and therefore constitutes a poor basis for choice of treatment. A syndromic approach has been suggested to increase effectiveness of treatment in resource poor settings. Algorithms for the treatment of STD syndromes were evaluated. A total of 436 patients were followed; cure rates were defined and estimated for genital ulcer disease (GUD), urethral and vaginal discharge. Cure rates for the discharge syndromes were high, 97-98%, for both sexes. The cure rate for GUD was 83% for female and 69% for male patients. A higher prevalence of syphilis in the female study population probably contributed to this. It is likely that a large proportion of the treatment failures were due to decreased susceptibility of Haemophilus ducreyi to trimethoprim-sulpha. The determination of cure rates met with a number of methodological problems. This makes it difficult to evaluate the algorithms as part of routine activities, as suggested earlier by WHO.
Int J STD AIDS
PMID:STD care in Zambia: an evaluation of the guidelines for case management through a syndromic approach. 889 21

Of 22,274 patients > or = 12 years old attending a Nairobi primary health care (PHC) clinic, 1076 (4.8%) had STD-related complaints, of whom 980 underwent assessment of risk factors for human immunodeficiency virus (HIV) infection and infrequent condom use. Gonorrhoea, chancroid, syphilis seroactivity, trichomoniasis, or objective signs of STD were found in 78%, and HIV seropositivity in 15% of men and 19% of women. Most women were married, living with a spouse; while most men were single, or married, but living separated from a spouse. Among married men, last sex was with a female sex worker (FSW) or casual partner for 60% not living with a spouse and 26% living with a spouse (P<0.005). Two or more partners during the past year were reported by 82% of men and 25% of women (P <0.001), and 55% of men and 11% of women reported the last partner was high risk. HIV seropositivity among both genders was associated with numbers of partners, and among women, with being widowed or divorced. Only 3% reported use of a condom with the last partner. Among men whose last sex was with a FSW, 74% said the reason for not using a condom was not having one. Thus, infrequent condom use, low condom availability, and gender differences in behaviour necessitate modifying development policies that separate families; and better coordination between family planning, PHC, and AIDS/STD programmes, with improved supply, social marketing and community-based distribution of condoms in high-risk settings for STD/HIV prevention.
Int J STD AIDS 1997 Aug
PMID:High HIV prevalence, low condom use and gender differences in sexual behaviour among patients with STD-related complaints at a Nairobi primary health care clinic. 925 99

Absent for several decades, the chancroid reappeared in Algeria in 1988. In the unique department of Dermatology and Venereology of the University Hospital of the country of Tlemcen (more than 700,000 inhabitants), we wanted to know the state of this STD seven years after the report of the first cases. The file of the consulting patients were examined. We looked for the principal characteristics of this STD: age, sex, incubation period, place infection contact, type of relation, clinical presentation, evolution without and with treatment, other associated STD (syphilis, HIV). From August 1988 (1st case) to December 1995, 144 cases of chancroid were collected = 1988: 6, 1989: 5, 1990: 7, 1991: 18, 1992: 11, 1993: 33, 1994: 48, 1995: 16. The presentation is quite stereotyped; it concerns males only, singles in must cases, having had sexual relations with prostitutes. The incubation period is short (less than 10 days), the characteristic ulceration presents, very often, some adenopathies. The treatment by cotrimoxazole is efficient. They are no concomitant syphilis or HIV infection. The chancroid is the first cause of genital ulceration in the world. Since 1991, it is the principal STD in our department. It spreads within a male population, young singles associated with prostitutes. It is well installed in Algeria, and its role, although minor, in the transmission of the HIV infection, should not be neglected.
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PMID:[Chancroid in Algeria: the status of this sexually transmitted disease in 1995]. 928 57


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