Changing trends of sexually transmitted diseases at Kakinada

Sexually transmitted diseases (STDs) is a global health problem. In the past, tropical infections like chancroid, gonorrhea and syphilis were considered as most important STDs in developing countries. Donovanosis has been largely prevalent in only some tropical countries. Now scenario is changing very rapidly with effective management of bacterial STDs.

Epidemiological factors influencing STDs - like social, cultural and environmental factors; sexual practices; moral outlook; sex education; incidence of human immunodeficiency virus (HIV) infection; facilities for early diagnosis and treatment - vary from region to region. The available data in India is limited due to lack of compulsory 'reporting system and registry' and presence of asymptomatic persons with STDs in society.

The present study was conducted to understand the pattern and any change in the trend of STDs, epidemiological factors and behavior of individual diseases.

Materials and Methods

All new clinic attendees of the exclusive STD Department constituted the material of this study. This study was conducted at the STD Department, Government General Hospital attached to Rangaraya Medical College, Kakinada, Andhra Pradesh. The period of study was 6 years (Jan. 2000-Dec. 2005), which was further divided into two spells of 3 years each, viz., 1 st spell from Jan. 2000 to Dec. 2002 and the 2 nd spell from Jan. 2003 to Dec. 2005 respectively.

A thorough history and clinical examination was done on every patient, supported with relevant laboratory investigations like Venereal Disease Research Laboratory (VDRL), Dark Ground Illumination (DGI), enzyme-linked immunosorbent assay for HIV, urethral smear, tissue smear, serology, X-ray chest, Fine Needle Aspiration Cytology (FNAC), biopsy, potassium hydroxide and normal saline mount, depending on the case. Pre- and post-test counseling was done for patients who needed HIV test. All the data were recorded. Every patient was treated accordingly and kept under follow-up.

Discussion

When the pattern and behavior of STDs were analyzed over a 6-year period in two equally divided spells, out of a total of 12,071 patients, the significant increase in the number of clinic attendees by 1.5 times in the 2 nd spell was due to increased awareness, decreased stigma in the public and efficient services and facilities provided by the department.

Majority of people were male patients, married and in the third decade of their life, which is consistent with the studies done by Agarwal et al . at Rohtak, Chopra et al . at Patiala, Parmar et al . at Ahmedabad. Since the majority of the patients belong to the married group, it can reasonably be deduced that extramarital relations were more prevalent, under the guise of marriage. Thus, marriage conferred unauthorized license to such people.