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1.  Sexually transmitted diseases in tropical Africa. A review of the present situation. 
At present very little information is available on the prevalence and pattern of sexually transmitted diseases (STDs) in many countries of tropical Africa. The available evidence does, however, suggest that these diseases are highly prevalent and that a considerable reservoir of infection exists among the female population. Gonorrhoea is probably the most commonly recognised STD in tropical Africa, frequently causing epididymitis and urethral stricture in men and salpingitis and pelvic inflammatory disease in women. The prevalence of a infectious syphilis is still high, particularly the late manifestations of the disease. The prevalence of the other STDs is also high. Thus, the problem is clearly very serious and the need for improving facilities for diagnosis and treatment urgent; some attempt also must be made to initiate control measures.
PMCID: PMC1045881  PMID: 6894260
3.  Penicillinase-producing Neisseria gonorrhoeae in Riyadh, Saudi Arabia. 
Of 83 strains of Neisseria gonorrhoeae isolated in Riyadh, Saudi Arabia, between April 1979 and August 1980, 10 produced beta-lactamase and had minimum inhibitory concentrations (MICs) of penicillin between 1 and greater than or equal to 4 micrograms/ml. Of the 73 (88%) non-penicillinase-producing strains, 55% had diminished sensitivity to penicillin (MIC = 0.06 micrograms/ml) and 11 (15%) were highly resistant (MICs ranging from 0.5-2 micrograms/ml). This high incidence of resistance may be due to widespread abuse of antibiotics; it also confirms that two mechanisms of resistance to penicillin exist in this species.
PMCID: PMC1045936  PMID: 6791760
4.  Chlamydia trachomatis and Ureaplasma urealyticum in men attending a sexually transmitted diseases clinic. 
Urethral specimens from 480 heterosexual patients were examined for Chlamydia trachomatis. Chlamydia were isolated from 32.7% of men with non-specific urethritis (NSU), from 16.1% of men with gonorrhoea, and from 4.1% of men without urethritis. Chlamydial isolation was not related to duration of symptoms, presence of discharge, or past history of attendance at the clinic. Urine from 176 heterosexual patients was examined for Ureaplasma urealyticum. Ureaplasmas were present in 53.8% of men with NSU, in 28% of men with gonorrhoea, and in 32.9% of men with no urethritis. Detection rates for ureaplasmas in patients with chlamydia-negative and chlamydia-positive NSU were similar, but ureaplasmas were present in significantly greater numbers in patients with chlamydia-negative NSU than in those with chlamydia-positive NSU.
PMCID: PMC1045888  PMID: 7214120
5.  Gonorrhoea Study 1962 
PMCID: PMC1047557  PMID: 14066167
6.  Reiter haemagglutination test: a screening test for syphilis. 
Using an ultrasonicate of the Reiter treponeme as antigen the Reiter haemagglutination test (RHA) was evaluated as a serological test for syphilis. Comparison of the results of the cardiolipin Wassermann reaction, Reiter protein complement-fixation test, the fluorescent treponemal antibody-absorbed (FTA-ABS) test, the Treponema pallidum haemagglutination test (TPHA) (at dilutions of 1/16 and 1/80), and the Venereal Disease Research Laboratory test with those of the RHA showed that the RHA was sensitive (85.8%) and agreed well (85.8%) with the FTA-ABS test result. Simplicity, sensitivity, availability of the antigen, and the very low cost of this test support its use as a first-line screening test for syphilis.
PMCID: PMC1046075  PMID: 6751462
7.  Effect of epidemiological treatment of contacts in preventing recurrences of non-gonococcal urethritis. 
Clinical investigations of the usefulness of routine epidemiological treatment of sexual contacts of men with non-gonococcal urethritis (NGU) have produced conflicting results that could have been due to the selection of patients. In this study, which was undertaken in a provincial city, 100 men with untreated sexual partners and 100 demographically similar men with treated sexual partners were reviewed for recurrences of NGU over 12 months. Prolonged courses of tetracyclines were found to be beneficial particularly when the sexual partner gave positive results to tests for chlamydiae. There was, however, no clinical evidence that the men benefited from routine epidemiological treatment of their sexual partners.
PMCID: PMC1046346  PMID: 6487987
8.  The rectum as viewed by the venereologist. 
About 2-2 1/2 million people do, or will repeatedly, participate in ano-rectal sexual intercourse in Britain alone. The anus and the rectum of these individuals are thus vulnerable to all the sexually transmitted diseases (except trichomoniasis). Male homosexuals appear to be more prone to these conditions than female heterosexuals, possibly because a large minority is indiscriminately promiscuous. Over the last 20 years homosexually acquired infections--particularly syphilis--have increased in Britain; these are now more readily admitted to because of changes in the law and in public opinion. The frequent changes of sexual partner among male homosexuals is the most notable epidemiological factor in the spread of venereal disease.
PMCID: PMC1045856  PMID: 6894100
9.  Chlamydial screening of pregnant women in a sexually transmitted diseases clinic. 
Fifty-three consecutive pregnant women seen over six months were screened for chlamydial infection, syphilis, gonorrhoea, trichomoniasis, and candidosis. Chlamydia trachomatis was isolated in 20 (37.7%) patients, of whom six were sexual partners of known cases of non-gonococcal urethritis (NGU) (two had associated gonorrhoea or candidosis) and six had gonorrhoea (three had associated trichomoniasis and candidosis). If treatment is given to contacts of NGU 14 patients with other presenting conditions would not have been treated unless chlamydial cultures had been performed. This may lead to potentially serious complications of chlamydial infection in both mothers and neonates.
PMCID: PMC1046086  PMID: 6897007
10.  Social and psychological factors in the distribution of STD in male clinic attenders. I Demographic and social factors. 
We describe three related studies of possible aetiological risk factors for sexually transmitted diseases (STDs) in men attending an STD clinic. In this paper we present the results for a variety of social and demographic variables traditionally associated with STD. In contrast to the results in the next two papers, these were largely negative. Occurrence rates of overall STD or of hepatitis, syphilis, gonorrhoea, or non-specific urethritis (NSU) had no aetiologically relevant association with age, nationality, marital status, social class, occupation, non-sexual social contact, drug abuse, or aggressive attitudes and behaviour. Gonorrhoea, however, was the only STD which correlated with alcohol abuse and with eating out rather than at home. We conclude that, with the possible exception of gonorrhoea, social factors contribute little to the distribution of STD risk within the study population.
PMCID: PMC1046241  PMID: 6688959
11.  Treatment of uncomplicated gonorrhoea in women with talampicillin in a single oral 1.5 g dose. 
Four hundred and sixty women with uncomplicated gonorrhea were treated with a single oral dose of 1.5 g talampicillin. The success rate among those who attended for at least one follow-up examination after treatment was 99.14%. The antibiotic was well tolerated and no side effects were reported. Talampicillin given under supervision has proved to be the most effective and safest treatment in this area. A smaller dosage of talampicillin than ampicillin is required, the drug is better tolerated by the patient, and the time of nursing staff is saved.
PMCID: PMC1046040  PMID: 7082979
12.  Study of STD clinic attenders in England and Wales, 1978. 2. Patterns of diagnosis. 
A study of diagnostic patterns in patients attending sexually transmitted disease clinics in England and Wales during 1978 showed that homosexuals contributed 10% of all male cases but 15% of gonococcal infections. In heterosexual and homosexual men only 6% of disease episodes included more than one positive diagnosis compared with 16% in women. One or more diseases occurred concurrently in over 30% of cases of gonorrhoea, trichomoniasis, candidosis, genital herpes, and genital warts in women. Men with multiple episodes of disease contributed a disproportionate number of gonococcal infections but were less likely to have candidosis or genital herpes than patients with only one disease episode. Thus, counting cases treated appears to be an inadequate way of measuring the problems caused by STDS. To enable more rapid identification of the diseases which are the most difficult to control, STD statistics should include the sexual orientation of male patients and differentiate between genuine "new" attenders at clinics and those previously seen.
PMCID: PMC1045950  PMID: 6895342
13.  Recent observations on the serology of syphilis. 
Routine screening of 404 742 sera by the automated micro-haemagglutination assay (AMHA-TP) and the Venereal Disease Research Laboratory (VDRL) test showed that 9848 specimens gave a reactive result to one of the three assays. Reactive results were confirmed by the fluorescent treponemal antibody absorption (FTA-ABS) test. The possibility of false-positive results varied from 0.04-0.38% of all specimens or from 1.7-15.7% of reactive sera. The VDRL test failed to detect reactivity in 56.54% of sera from patients who had previously been infected with Treponema pallidum. The importance of routine testing by the AMHA-TP is illustrated by the detection of four patients with mesaortitis and two with active neurosyphilis among a selected group of 54 patients who had non-reactive results to the VDRL test. Testing of cerebrospinal fluid specimens by the AMHA-TP test produced more specific results than by the other two tests.
PMCID: PMC1045718  PMID: 6989443
14.  Chlamydia trachomatis in women attending a gynaecological outpatient clinic with lower genital tract infection. 
In a study of 3794 consecutive women attending a gynaecological outpatient clinic with symptoms of lower genital tract infection (LGTI) 350 (9.2%) harboured Chlamydia trachomatis and 83 (2.2%) Neisseria gonorrhoeae. One hundred and ninety-five patients who were later found to have acute salpingitis and 109 other women in whom the chlamydial cultures were spoiled were excluded from the series. Of the remaining 3490 women, 281 were infected with C trachomatis, 42 with N gonorrhoeae, and 17 with both. Of the 3150 women who were infected with neither organism, 146 were randomly selected as controls. The chlamydia-positive patients were younger (P less than 0.001), did not complain of pelvic discomfort or pain (P less than 0.01), and used oral contraceptives (P less than 0.001) more frequently than did the controls; intrauterine devices were used more often (P less than 0.01) by the controls. Increased vaginal discharge was reported significantly more often in chlamydia-positive patients than in the controls (P less than 0.05). Of 266 women harbouring C trachomatis the organism was still present in 22 (8.3%) when they were followed up from two to more than eight weeks after finishing treatment with doxycycline. Of 91 male consorts of chlamydia-positive women, 53 (58.2%) were infected with C trachomatis.
PMCID: PMC1045937  PMID: 6791761
15.  Susceptibility to antimicrobials of Neisseria gonorrhoeae isolated in Singapore: implications on the need for more effective treatment regimens and control strategies. 
The antimicrobial susceptibility of gonococci isolated in Singapore has been studied over several years. In 1983, the prevalence of penicillinase producing Neisseria gonorrhoeae (PPNG) was 33.5% and 64% of non-PPNG isolates had minimum inhibitory concentrations (MICs) of penicillin of greater than or equal to 0.5 mg/l. After a control programme, the isolation of the gonococcus from prostitutes was reduced and there was improvement in its susceptibility to antimicrobials. The incidence of PPNG strains was stabilised with a change in the treatment regimen. An influx of foreign prostitutes, however, had an unfavourable impact on these variables. Countries in South East Asia have a high prevalence of PPNG and non-PPNG strains that have reduced susceptibility to antimicrobials. In view of increased air travel the problem should be seen from a global perspective. Better treatment regimens and control strategies are urgently needed.
PMCID: PMC1046384  PMID: 6240311
16.  Neisserial colonisation of the pharynx. 
The spectrum of neisserial colonisation of the pharynx was determined from 3557 throat exudates cultured on modified New York City (MNYC) medium. Oxidase positive Gram-negative diplococci (GNDC) were isolated from 1204 (33.8%) of the throat cultures. Neisseria gonorrhoeae, N meningitidis, and N lactamica accounted for 20.3%, 74.2%, and 3.7% of the oxidase positive GNDC respectively. The observed coexistence of gonococci and meningococci in the pharynx (0.39%) was significantly different (p less than 0.001) from the theoretical expected value (1.7%). The prevalence of pharyngeal infection in patients with gonorrhoea was 4.3% for all men, 11% for homosexual men, and 7.9% for women. Despite the risks of disseminated infection and spread to sexual partners, the detection of pharyngeal gonorrhoea is less important than that of endocervical infection in women, urethral infection in heterosexual men, and anorectal infection in homosexual men.
PMCID: PMC1046189  PMID: 6409342
17.  Prevalence of chlamydial infection in promiscuous women. 
Chlamydia trachomatis was isolated from the cervix of 18 (33%) of 55 women who admitted to two or more casual sexual contacts to one (3%) of 32 women who admitted to one casual contact in the preceding month. The chlamydial infections did not produce characteristic clinical features. Since promiscuous women are at high risk of acquiring chlamydial infection, they should be regarded as a priority group when resources for chlamydial isolation are limited.
PMCID: PMC1046148  PMID: 6831188
18.  Antibiotic sensitivity patterns of penicillinase-positive and penicillinase-negative strains of Neisseria gonorrhoeae isolated in Fukuoka, Japan. 
Penicillinase production and minimum inhibitory concentrations (MICs) of penicillin G, amoxycillin, doxycycline, and spectinomycin were studied for 155 gonococcal strains isolated in Fukuoka, Japan, between April and December 1981. Of 155 isolates, 25 (16.1%) strains were identified as penicillinase-producing Neisseria gonorrhoeae (PPNG) by a rapid iodometric test. The antibiotic sensitivity of 130 penicillinase-negative (non-PPNG) and 25 PPNG strains was compared. The mean MIC of penicillin G for non-PPNG strains was 0.65 microgram/ml. Twenty-five PPNG strains had MICs of penicillin G between 6.25 and greater than 100 micrograms/ml. The susceptibility to amoxycillin and doxycycline of PPNG strains was significantly lower than that of non-PPNG strains. All the strains proved to be sensitive to spectinomycin. The MICs of four antibiotics for non-PPNG strains were significantly correlated.
PMCID: PMC1046080  PMID: 6215085
19.  Current routine statistics in the United Kingdom room for improvement? 
A substantial number of problems are associated with the present notification system on sexually transmitted diseases. Since a comprehensive and uniform system is vitally important to all clinicians in indicating changes in disease incidence and patterns, some modifications are proposed to make the system of more direct clinical relevance.
PMCID: PMC1045880  PMID: 6894259
20.  Epidemiology of infection by serotypes D to K of chlamydia trachomatis. 
Non-specific urethritis (NSU) is a sexually transmitted disease; 50% of cases are due to Chlamydia trachomatis, so that this is the commonest sexually transmitted infection in the developed world. Chlamydial infection is now readily diagnosable and the evidence increasingly suggests that it is underdiagnosed. Chlamydial conjunctivitis (in the newborn baby or the adult) in the developed world is a complication of sexually transmitted genital infection by C trachomatis and it indicates a large reservoir of such infections. Because of the association of sexually transmitted diseases, systemic treatment for such chlamydial conjunctivitis should not be given until full genital and serological investigators have been carried out. Chlamydial infection causes serious complications (that were formerly often thought to be gonococcal), such as epididymitis in young men and salpingitis on young women. It may cause local complications in the eye of the newborn baby and even pneumonia in babies and fatal endocarditis in adults. The diagnosis of NSU should lead to the correct treatment of the male patient and of his sexual partners. It is the promiscuous woman, who does not have a regular sexual partner to report back to her that he has NSU, who is at particular risk of undiagnosed chlamydial infection. Routine genital investigations for chlamydia are particularly indicated in her case. Following the parallel of gonorrhoea, it seems that the use of contact tracers may be an effective method for controlling chlamydial infection.
PMCID: PMC1045760  PMID: 7427689
21.  Role of the medical auxiliary in the control of sexually transmitted disease in a developing country. 
Venereal diseases are becoming a major health problem in many developing countries where the greater part of primary medical care is undertaken by medical auxiliaries. Under these circumstances, the medical auxiliary has an important role to play in the control of these diseases but he can only do this with adequate training, support, and supervision from the professional doctors and specialists. In this paper, the role of the medical auxiliary is outlined and a case is also made for a specially-trained cadre for venereal disease work in busy urban clinics in developing countries.
PMCID: PMC1045235  PMID: 946783
22.  Gonorrhoea Study 1963 
PMCID: PMC1047694  PMID: 14275956
23.  Quantitative microhaemagglutination assay for Treponema pallidum antibodies in experimental syphilis. 
The quantitative microhaemagglutination assay for Treponema pallidum antibodies (MHA-TP) was studies in 52 untreated and treated rabbits with experimental syphilis. Rabbits with incubating experimental syphilis were cured or inadequately treated with penicillin G and some cured rabbits were later reinfected. MHA-TP conversion occurred within 45 days in untreated rabbits. Titres reached peak levels about four months after inoculation and remained relatively high for up to two years. The quantitative MHA-TP test differentiated between rabbits cured of experimental incubating syphilis and those untreated and inadequately treated. MHA-TP titres decreased after treatment given six or 12 months after inoculation but reversion did not occur. MHA-TP conversion or significant increases in titre occurred as soon as seven days after reinfection and preceded corresponding changes in a quantitative non-treponemal test. The MHA-TP is useful as a screening test for treponemal antibodies in rabbits. The quantitative MHA-TP in humans after treatment for syphilis and reinfection deserves further study.
PMCID: PMC1045808  PMID: 7000307
24.  Health advisers (contact tracers) in sexually transmitted disease. 
Contact tracing has always been a vital element in the control of sexually transmitted disease (STD), and the early full time contact tracers were more effective than doctors in this work. Those appointed to the early posts had to train themselves and they concentrated on contact tracing. Training has now improved, and most contact tracers in Britain, now called Health Advisers in STD, have attended a full time five day residential training course, and it is hoped that better courses may be developed. A handbook has been produced and widely circulated. The Society of Health Advisers in STD holds regular regional meetings and an annual conference. Health advisers may discover personal problems and have an important role in education, both of which activities are covered in their role specification. Health advisers in STD have developed from contact tracers to undertake a broad range of functions, but the question is asked whether they could contribute to other aspects of health care within the clinic.
PMCID: PMC1046324  PMID: 6547628
25.  A reappraisal of non-specific genital infection with reference to the work of the late Dr E. Weston Hurst. 
It is easy to overlook work that is before its time, especially if it has been done in the recent past. In his animal experimental work with Chlamydia spp, the late Dr E. Weston Hurst found that although he was able to effect a clinical cure in his intraperitoneally infected mice, he was unable to eradicate their infections. As his work appears to have relevance to today's growing problems concerning genital infections associated with chlamydiae, it should not fall into obscurity.
PMCID: PMC1046244  PMID: 6357349

Results 1-25 (3936)