Epidemiology of gonorrhoea
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A sexually transmitted infection caused by a Gram-negative diplococcus. Infects mucous membranes of the genital tract, rectum, pharynx and eyes
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Epidemiology of gonorrhoea
- 1. Epidemiology of gonorrhoea Josep Vidal Alaball, Anne Marie Cunningham, David Tucker, Suzanne Mckeown, Karen Gully and Paul Scott 23 March 2004
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- 17. Table 3. Estimated new cases of gonorrhoea infections (in million) in adults, 1995 and 1999 Region 1995 1999 Female Male Total Female Male Total Trend North America 0.92 0.83 1.75 0.84 0.72 1.56 F M P Western Europe 0.63 0.6 1.23 0.63 0.49 1.11 F M P North Africa & Middle East 0.77 0.77 1.54 0.68 0.79 1.47 F M P Eastern Europe & Central Asia 1.16 1.17 2.32 1.81 1.5 3.31 F M P Sub Saharan Africa 8.38 7.3 15.67 8.84 8.19 17.03 F M P South and South East Asia 14.55 14.56 29.11 15.09 12.12 27.2 F M P East Asia & Pacific 1.47 1.8 3.27 1.68 1.59 3.27 F M P Australia & New Zealand 0.07 0.06 0.13 0.06 0.06 0.12 F M P Latin America & Caribbean 3.67 3.045 7.12 4.01 3.26 7.27 F M P Total 31.61 30.54 62.15 33.65 28.7 62.35 F M P
- 21. STI Surveillance Population Demographic Behavioural
- 29. Culture diagnosis (presumptive) Typical colonial morphology on selective culture medium, typical Gram stain morphology, positive oxidase reaction, positive superoxol reaction. Culture diagnosis (‘Gold standard’) Typical colonial morphology on selective culture medium, typical Gram stain morphology, positive oxidase reaction confirmed with sugar utilisation, coagglutination or anti-gonococcal fluorescent antibody testing .
Notas do Editor
- Neisser was an undistinguished student who had to repeat his chemistry exams Followed by the discovery of treponema pallidum (cause of syphillis in 1905) There was no treatment of gonorrhoea until the discovery of penicillin, however ophthmalmia neonatorum, a conjunctivitis affecting the new born could be treated easily by the application of silver nitrate thus preventing a common cause of blindness. In 1943 penicillin was being tried in a British field hospital in North Africa. It was in desperately short supply. The urine from patients was collected and the penicillin extracted so that more people could be treated. There were two main groups of patients in the hospital. Patients with extensive infected war wounds and patients with gonorrhoea. The MRC had sent the drug for trial in patients with war wounds but it was noticed that the drug was effective in gonorrhoea. You do not have enough penicillin for everybody, who would you treat? Option 1. The men with war wounds who might die if not treated. Option 2. The men who had ignored orders and gone to the local brothels. War wounds versus self inflicted disease. Life threatening infected war wounds versus crippling chronic gonorrhoea. The fact that there is a war on and penicillin cures gonorrhoea - you can rapidly send men back to their units. War wounds have a prolonged convalescence and the patient may never be fit again for military service. The decision went as far as the War Cabinet. Churchill chose to treat the men with gonorrhoea.
- 1864- Contagious Disease Act- This legislation allowed policeman to arrest prostitutes in ports and army towns and bring them in to have compulsory checks for venereal disease. If the women were suffering from sexually transmitted diseases they were placed in a locked hospital until cured. It was claimed that this was the best way to protect men from infected women. Many of the women arrested were not prostitutes but they still were forced to go to the police station to undergo a humiliating medical examination. Repealed in 1886. The biggest initiative came with the appointment in 1913 of a Royal Commission on Venereal Diseases which submitted its final report in 1916 – mid-way through the First World War and at a time of increased incidence of the very diseases it had been formed to consider. The report estimated that at least a tenth of the urban population in Britain was infected with syphilis, and many more infected with gonorrhoea The Commission shied away from advocating a system of compulsory notification, but recommended free examination and treatment, and the Local Government Board implemented this through the provision of grant to local authorities to open free clinics. Following on from the report, the 1917 Venereal Diseases Act made it illegal for anyone other than legally qualified medical practitioners to give advice or medication for venereal diseases. At the turn of the century charlatans commonly advertised treatment of STD but were using laudanum(mixture of gin and opium). The act also protects the patient’s confidentiality.
- Since the beginning of the 20th century, peaks of reported cases of gonorrhea in developed countries occurred during World Wars 1 and 2, and following the "sexual liberation" of the late 1960s and early 1970s. Thereafter, there has been a sharp decline in the incidence of this disease in almost all western countries. This decline occurred first in countries of Northern Europe. For instance, in Sweden, gonorrhea incidence (reported cases) decreased from 487 per 100,000 in 1970 to 31 per 100,000 in 1987, and was below 10 per 100,000 in 1994. In parallel with this decline, there has been a steady reduction in the male:female ratio of reported cases. This early decline in incidence, as well as the reduction in the male:female ratio, can be attributed, at least in part, to improved screening programs for women and enhanced partner notification of STD cases.
- Gonorrhoea has been a notifiable disease in Sweden since 1925. The incidence of gonorrhoea peaked in Sweden in 1970 with an annual incidence of almost 500 per 100 000 population. Levels of gonorrhoea reached an all-time low in 1996 with 2.4 cases per 100,000. In the early 1990s it was thought that the disease would be completely eradicated. However incidence has risen since 1996. Initially this was thought to be die to imported cases, but studies have shown there to be a rise in domestic cases also.