Trends of gonorrhoea and early syphilis in Belgrade, 1985-99.
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Biomedical subjects
Publications and source records attributed to M Bjekić.
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The incidence of gonorrhea in Belgrade decreased 55.5% from 1988 to 1994, but a decreasing trend of gonorrhea incidence actually started many years before. In all age groups gonorrhea incidence was higher in men than women, and the male/female ratio increased with age. The incidence was highest in men and women 20-29 years old. In both sexes the lowest incidence was below 15 years of age and in persons 50 or more years of age. In men, service and industrial workers were the most frequently affected by gonorrhea. In women the disease was commonest among unemployed persons and among workers of the service and industrial sectors. In both sexes gonorrhea infection was commonest in populations who had never married, and in the divorced population.
OBJECTIVE: To define risk factors for gonococcal infection. METHODS: A case-control study comparing 200 gonorrhoea cases with 400 patients with non-gonococcal genitourinary infections and 400 patients with various skin diseases, all of them attending City Department for Skin and Venereal Diseases In Belgrade (Yugoslavia) from October 1993 to December 1994. RESULTS: According to multivariate logistic regression analysis the following factors were significantly related to gonorrhoea in men: education level, sexual contact same day as meeting, condom use, history of prior gonorrhoea, and casual and/or new sex partner in the past month. Age, sexual contact same day as meeting, number of partners in the past year, and frequency of sexual intercourse in the past month were independently, significantly related to gonorrhoea in women. Also, in females, gonorrhoea was significantly more frequent in industrial workers and supported people. CONCLUSION: Since sexual behaviour, low education level, younger ages, and low socioeconomic status were found to be related to gonococcal infection, health education at early age seems to be the most appropriate means of altering high risk behaviour.
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INTRODUCTION: The sexually transmitted diseases (STDs) comprise a large group of infections produced by different microorganisms including spirochetes, bacteria, chlamydia, mycoplasme, protozoa, fungi, parasites, and viruses. A considerable number of sexually transmitted diseases patients are STD repeaters. As reported by Marjanovitsh and Laloshevitsh [2], in Belgrade, among patients who during the years 1985 and 1986 visited the City Department for Skin and Veneral Diseases, because of syphilis or gonorrhea, 22.8% had these diseases two or more times during their lives (male/female ratio 10:1). In Richert et al. [6] study over 30% of all patients who in one year visited sexually transmitted diseases clinic in Dade County, Florida, returned with a new infection within 3 years of their index visit. The aim of this study was to test the hypothesis that there is a relationship between antisocial behaviour and repeated STD. MATERIAL AND METHODS: Case-control study was performed in the population of Belgrade, from June 1997 to April 1998. Participants were recruited among patients attending the City Department for Skin and Venereal Diseases of Belgrade because of sexually transmitted diseases (syphilis, gonorrhea, nongonoccocal urethritis and genital warts). The group comprised 101 patients who in their personal histories already had STD two or more times. The control group consisted of 210 patients treated at the same institution for micotic diseases, patients who in their personal histories have never had STD or had it only once (13% of controls). All participants were men aged 20 to 50 years and all were from Belgrade. Data on demographic characteristics, sexual history and sexual behaviour, as well as data on use of sedatives, smoking habit and sport activity, and data on antisocial behaviour (alcohol abuse, prostitution, drug abuse, prosecution for minor and criminal offences) were collected from all participants by an anonymous questionnaire. In the present paper only data on antisocial behaviour are presented. In the analysis of data chi 2 was used. RESULTS: According to the results obtained, STD repeaters in comparison to their controls used more frequently alcohol (17.8%:0.9%) and drug 18.8%:3.8%), had more frequently sex for money (17.8%:2.8%), and were more frequently prosecuted for minor offences (58.4%:24.8%) and criminal offences (24.8%:4.3%). All these differences were statistically significant (p < 0.01). DISCUSSION: In the present study STD repeaters consumed alcohol more frequently than their controls, especially hard liquors, and 55.5% of them had used alcohol at the time of STD infection. In the study of Myliueva et al. [4], 50% of venereal disease patients consumed alcohol now and then and 10% consumed alcohol frequently. Scheidt and Windle [5] found that 60% of alcoholics had at least one sexually transmitted disease as the result of a high number of sexual partners, low use of condoms and practicing sex for drugs or money. Alcohol has depressive effect on the central nervous system, reduces anxiety and increases libido. In this study STD repeaters in comparison with their controls were significantly more frequently drug users (the majority of them inhaled drugs). In several studies conducted in the USA [7, 8] the increase of gonorrhea and syphilis was related to drug use. Upchurch et al. [9] reported that individuals with repeated episodes of gonorrhea were frequently intravenous drug abusers. Drugs are most frequently used by young people, at ages of the highest sexual activity. While most of the subjects developed sexual disinterest and dysfunction with prolonged crack cocaine use, some of them become more sexually promiscuous and consequently contracted sexually transmitted diseases more often. Inciardi /10/ found that 1/3 of men who had exchanged sex for crack (or for money needed to by crack) had 100 or more sex partners during a 30-day period prior to study recruitment. Cleghorn et al. (ABSTRACT TRUNCAT
A case-control study was performed in order to assess risk factors for repeated sexually transmitted diseases. The study comprised 101 patients who had had sexually transmitted diseases 3 or more times during their lives and 182 controls who had no history of sexually transmitted disease. The subjects all attended the City Department for Skin and Venereal Diseases in Belgrade, Yugoslavia, from June 1997 to April 1998. According to multivariate logistic regression analysis, sexually transmitted diseases repeaters, in comparison with the controls, were older, more frequently divorced and widowed and without a regular partner, had more sexual partners and more sexual intercourse, and had more frequent sexual contact with people on the same day as meeting them. They also consumed alcohol, used sedatives and were prosecuted for criminal offences more frequently than the controls. The results of this study support the hypothesis that sexually transmitted diseases repeaters are different from their controls in terms of their behavioural and social characteristics.
INTRODUCTION: Sexually transmitted diseases (STDs) comprise a large group of infections caused by different microorganisms including spirochetes, bacteria, chlamydia, mycoplasma, protozoa, fungi, parasites, and viruses. A considerable number of patients with sexually transmitted diseases are STD recurrences. As reported by Marijanović and Lalosević, in Belgrade, among patients who visited the City Department of Skin and Venereal Diseases, during 1985 and 1986 because of syphilis or gonorrhea, 22.8% had these diseases two or more times during their lives (male/female ratio 10:1). The aim of this study was to test the hypothesis that there is a relationship between alcohol use and recurrence of STD. MATERIAL AND METHODS: A case-control study was performed in Belgrade population, from June, 1997 to April, 1998. Participants were recruited among patients attending the City Department of Skin and venereal Diseases of Belgrade because of sexually transmitted diseases (syphilis, gonorrhea, nongonoccocal urethritis and genital warts). The case group comprised 101 patients who already had STD two or more times in their personal histories. The control group consisted of 210 patients treated at the same institution for micotic diseases, patients who either never had STD or had it only once (13% of controls) in their personal histories. All participants were men aged 20 to 50 years and all were from Belgrade. Data on demographic characteristics, sexual history and sexual behavior, and data on antisocial behavior were collected from all participants using an anonymous questionnaire. In the present paper only data on alcohol use are presented. In the analysis of data chi 2-test was used. RESULTS: STD recurrence patients in comparison to their controls used alcohol more frequently (56.3%:16.1%), especially hard liquors, and 55.5% of them used alcohol at the time of STD infection. DISCUSSION: In the present study STD recurrence patients consumed alcohol more frequently than their controls, especially hard liquors. In the study of Myliueva et al, 50% of venereal disease patients consumed alcohol now and then and 10% consumed alcohol frequently. Scheidt and Windle found that 60% of alcoholics had at least one sexually transmitted disease as the result of a high number of sexual partners, low use of condoms and practicing sex for drugs or money. Alcohol has a depressive effect on central nervous system, reduces anxiety and increases libido. CONCLUSION: The obtained results support the hypothesis that alcohol use is related to recurrence of STDs.
The basic demographic characteristics of the patients with gonorrhea in Belgrade population in the period 1988-1994 were analysed on the basis of the reports of gonorrhea newly diseased to the City Institute for Skin and Venereal Diseases. The decrease of gonorrhea incidence was observed in the period 1988-1992, and the lowest value of 21.2 cases per 100,000 inhabitants was noted in 1992. Gonorrhea incidence increased for 23.8% compared to 1992. The disease is more frequently found in males, aged 20-29, industrial and service workers and unemployed. Unmarried persons had the highest incidence rate of gonorrhea.