Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound   Target Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound

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Query: UMLS:C0021051 (immunodeficiency)
71,517 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A survey of commercial sex workers in Fukuoka City, Japan, during 1990-93 revealed significant declines in the prevalence of chlamydia, gonorrhea, and syphilis during the study period, presumably as a result of increased condom use. The study group consisted of 824 commercial sex workers who attended a sexually transmitted disease (STD) clinic in Fukuoka from 1990 to 1993 for voluntary STD check-ups. The annual Chlamydia trachomatis detection rate declined from 16.3% in 1990 to 12.2% in 1993; the annual detection rate for Neisseria gonorrhoeae fell from 1.5% to 0.8%, while that for syphilis dropped from 7.5% to 0.5%. None of the 791 women screened for human immunodeficiency virus was seropositive. In addition, a subsample of 79 commercial sex workers were interviewed about their condom use. The proportion of sex workers always using condoms rose from 6.3% in 1990 to 25.3% in 1993; in this period, never use of condoms decreased from 45.6% to 5.1%.
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PMID:Trends in sexually transmitted diseases and condom use patterns among commercial sex workers in Fukuoka City, Japan 1990-93. 897 54

Epidemiologic trends in sexually transmitted diseases strongly vary in the world. The situation is worrying in the developing countries. Both the incidences and prevalences are very high antibiotic resistance is expanding and interactions between sexually transmitted diseases and human immunodeficiency virus contribute to AIDS epidemic. In western Europe, the decline of some sexually transmitted diseases is likely to be linked with successful control programmes and gonorrhea and syphilis now are rare diseases. The USA situation is contrasted. Some inner-city minority population still have high level of gonorrhea and are concerned with resurgence of syphilis and chancroid. Chlamydia trachomatis infections, which are a major, cause of infertility and ectopic pregnancy, have become the most prevalent sexually transmitted disease in industrialized world.
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PMID:[Epidemiology of sexually transmitted diseases, with the exception of AIDS]. 897

A survey of 777 randomly selected pregnant women attending an antenatal clinic in Dar es Salaam, Tanzania, in 1993 revealed a high prevalence of sexually transmitted diseases (STDs), particularly among teenagers. The median age of survey respondents was 23.6 years (range, 14-40 years); 170 women (22%) were teenagers and 439 (56.7%) were married. 320 women (41.2%) had 1 or more STDs (excluding human immunodeficiency virus (HIV) infection); in 32.7%, there was active infection. STD prevalence was 45.3% in teenagers compared with 29.2% in adults. In the overall sample, the prevalences of syphilis, trichomoniasis, gonorrhea, and HIV were 4.0%, 22.7%, 3.6%, and 15.2%, respectively. 80 women (10.3%) showed serologic evidence of past syphilis infection and 4% had active syphilis. Syphilis was most prevalent in pregnant women aged 35 years and above (13.8%), while trichomoniasis was most common in teenagers (34.3%). Of the 732 pregnant women with genital infections, 63 (8.6%) were asymptomatic; when symptoms did exist, they were generally not disease-specific. The most significant risk factor for STDs, including HIV, was single marital status. These findings suggest a need for the introduction of essential clinical and laboratory facilities for STD detection to antenatal clinics in Tanzania.
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PMID:High frequency of sexually transmitted diseases among pregnant women in Dar es Salaam, Tanzania: need for intervention. 899 49

Core population groups play an important role in the spread of sexually transmitted diseases. Subjects in a core group may change their behavior over time and "migrate" to the noncore. The authors examined the effects of such migration on the prevalence of gonorrhea, chlamydia, and human immunodeficiency virus (HIV) using a mathematical model. The size of the core and the migration rate from the core to the noncore were estimated from population-based sexual survey data on 8,445 Norwegians collected in 1987 and 1992. Sixty-four percent of the sample was considered without risk of contracting a sexually transmitted disease. The core group made up 2.5% of the remaining sample. The migration rate from the core was estimated at 12% per year. The three types of infections analyzed exemplify three different patterns of the effect of migration on infection prevalence in the core/noncore groups: gonorrhea = no effect/no effect, Chlamydia = no effect/increase, and HIV = decrease/increase. Migration affects the basic reproductive ratio of diseases with a long infectious period more than that of diseases with a short infectious period. For HIV, this means that the later stages of infection contribute less to the basic reproductive ratio in the presence of migration. The results are qualitative and show that detailed knowledge about mixing, migration, transmission rates, and duration of infectiousness is necessary to make accurate predictions.
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PMID:Effect of changing partnership formation rates on the spread of sexually transmitted diseases and human immunodeficiency virus. 909 82

To investigate the role of sexual transmission of hepatitis B virus (HBV) in East Africa, a cross-sectional serosurvey was conducted in 3 populations with potentially divergent exposure to sexually acquired pathogens. Included were 253 voluntary blood donors (predominantly secondary school students), 952 relative blood donors, and 1025 patients with sexually transmitted diseases (STDs) from Mwanza, Tanzania. The overall prevalence of hepatitis B surface antigen (HBsAg)--a measure of current infection--was 9.9% in voluntary donors, 11.2% in relative donors, and 8.1% in STD patients, with a 2.2:1 carrier ratio of men to women. The prevalences of human immunodeficiency virus (HIV), anti-hepatitis B core antigen (anti-HBc), and past or recent syphilis were significantly lower among voluntary donors than in the other 2 groups. Evidence of past infection with HBV (anti-HBc) was associated with recent syphilis in both men and women (odds ratios (ORs), 1.91 and 2.34, respectively) and with HIV in men (OR, 1.93). Current infection with HBV (HBsAg) was associated with recent syphilis in men (OR, 2.13). In STD patients, current HBV was associated with Trichomonas vaginalis in women (OR, 3.57) and recent syphilis in men (OR, 3.46). There was no significant association between HBV and gonorrhea. Based on the association between syphilis and HBV, the population attributable fraction for sexual acquisition of HBV is estimated at 7.2% in men and 3.0% in women. Overall, these findings suggest that the sexual acquisition of HBV occurs at low levels in Mwanza. Improved vaccination strategies, early detection and treatment of syphilis, and programs aimed at reducing HIV transmission should enhance the control of HBV.
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PMID:Sexual transmission of hepatitis B in Mwanza, Tanzania. 913 77

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.
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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

Among men who have sex with men (MSM), gonorrhea trends may reflect changes in sexual behaviors that also influence risk for human immunodeficiency virus (HIV) infection. Data from the Gonococcal Isolate Surveillance Project (GISP) were used to assess trends in gonococcal infection (GC) among MSM. For the subset of GISP sites where a substantial proportion of GC cases were in MSM, a special survey of the local areas was conducted to describe factors associated with GC in MSM. This report summarizes the results of that survey, which indicate that the number and proportion of MSM diagnosed with GC has increased in the sexually transmitted diseases (STD) clinics of several large cities in the United States.
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PMID:Gonorrhea among men who have sex with men--selected sexually transmitted diseases clinics, 1993-1996. 931 79

To assess associations of nonulcerative sexually transmitted diseases (STDs) with human immunodeficiency virus (HIV)-susceptible leukocytes on female genital mucosa, cervicovaginal specimens from 32 HIV-negative STD clinic patients with gonorrhea, chlamydial infection, or trichomoniasis were compared with specimens from 32 clinic patients without these infections. Twenty-eight patients had single infections (15 gonorrhea, 10 chlamydial infection, 3 trichomoniasis), and 4 had dual infections. A saline vaginal wash and saline suspensions of vaginal wall scrapings, ectocervical scrapings, and endocervical brushings were analyzed by flow cytometry. Specimens from the endocervix had the highest proportions of lymphocytes, monocytes, and Langerhans' cells. The median number of endocervical CD4 lymphocytes/10,000 cells was greater among patients with STDs than among those without (476 vs. 245; P < .001). These data suggest that the endocervix may have a particularly important role in heterosexual HIV transmission and that nonulcerative STDs may facilitate HIV transmission by increasing the presence of CD4 lymphocytes at this site.
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PMID:Increase in endocervical CD4 lymphocytes among women with nonulcerative sexually transmitted diseases. 941 84

The efficacy of a behavioral intervention to reduce human immunodeficiency virus (HIV) risk behaviors was tested in a randomized, controlled trial with three high-risk populations at 37 clinics from seven sites across the United States. Compared with the 1855 individuals in the control condition, the 1851 participants assigned to a small-group, seven-session HIV risk reduction program reported fewer unprotected sexual acts, had higher levels of condom use, and were more likely to use condoms consistently over a 12-month follow-up period. On the basis of clinical record review, no difference in overall sexually transmitted disease (STD) reinfection rate was found between intervention and control condition participants. However, among men recruited from STD clinics, those assigned to the intervention condition had a gonorrhea incidence rate one-half that of those in the control condition. Intervention condition participants also reported fewer STD symptoms over the 12-month follow-up period. Study outcomes suggest that behavioral interventions can reduce HIV-related sexual risk behavior among low-income women and men served in public health settings. Studies that test strategies for reducing sexual risk behavior over longer periods of time are needed, especially with populations that remain most vulnerable to HIV infection.
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PMID:The NIMH Multisite HIV Prevention Trial: reducing HIV sexual risk behavior. The National Institute of Mental Health (NIMH) Multisite HIV Prevention Trial Group. 966 48

Reports pertinent to bacterial arthritis in 1997 included two large, multi-year surveys of joint infection in patients from defined European health districts, noting trends including the declining incidence of gonococcal arthritis and an increasing number of prosthetic joint infections. Children with infected joints generally fare better than adults despite having proportionately more infections due to gram-negative organisms, of which Hemophilus influenzae comprises an ever smaller portion as the fastidious Kingella kingea is emerging. Joint infections remain an uncommon complication of immunodeficiency due to HIV, with responsible agents, affected sites, and clinical course also influenced by certain HIV comorbidities such as intravenous drug user and hemophilia. The rare immunodeficient patient with hypogammaglobulinemia retains a nearly unique susceptibility to joint infection with mycoplasmas, which can cause considerable morbidity if not promptly recognized and treated. Polymerase chain reaction can detect remnants of bacteria in the face of negative conventional cultures, but inoculation of synovial fluid into blood cultures bottles may be a more immediate and practical method to increase the yield in suspected septic arthritis.
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PMID:Bacterial arthritis. 972 94


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