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Bacterial vaginosis:a synthesis of the literature on etiology,prevalence,risk factors,and relationship with chlamydia and gonorrhea infections

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Journal of Medical Colleges of PLA(China) 2016年第2期31卷 93-103页

作者： Christian T.Bautista Eyako Wurapa Warren B.Sateren Sara Morris Bruce Hollingsworth Jose L.Sanchez Division of Health Research Lancaster University Lancaster UK. Walter Reed Army Institute of Research Maryland USA Armed Forces Health Surveillance Center and Cherokee Nation Technology Solutions Maryland USA

Bacterial vaginosis(BV) is a common vaginal disorder in women of reproductive age. Since the initial work of Leopoldo in 1953 and Gardner and Dukes in 1955, researchers have not been able to identify the causative etiologic agent of BV. There is increasing evidence, however, that BV occurs when Lactobacillus spp., the predominant species in healthy vaginal flora, are replaced by anaerobic bacteria, such as Gardenella vaginalis, Mobiluncus curtisii, M. mulieris, other anaerobic bacteria and/or Mycoplasma hominis. Worldwide, it estimated that 20%–30% of women of reproductive age attending sexually transmitted infection(STI) clinics suffer from BV, and that its prevalence can be as high as 50%–60% in high-risk populations(e.g., those who practice commercial sex work(CSW). Epidemiological data show that women are more likely to report BV if they: 1) have had a higher number of lifetime sexual partners; 2) are unmarried; 3) have engaged in their first intercourse at a younger age; 4) have engaged in CSW, and 5) practice regular douching. In the past decade, several studies have provided evidence on the contribution of sexual activity to BV. However, it is difficult to state that BV is a STI without being able to identify the etiologic agent. BV has also emerged as a public health problem due to its association with other STIs, including: human immunodeficiency virus(HIV), herpes simplex virus type 2(HSV-2), Chlamydia trachomatis(CT) and Neisseria gonorrhoeae(NG). The most recent evidence on the association between BV and CT/NG infection comes from two secondary analyses of cohort data conducted among women attending STI clinics. Based on these studies, women with BV had a 1.8 and 1.9-fold increased risk for NG and CT infection, respectively. Taken together, BV is likely a risk factor or at least an important contributor to subsequent NG or CT infection in high-risk women. Additional research is required to determine whether this association is also present in other low-risk sexually active populations, such as among w

关键词： Bacterial vaginosis Chlamydia gonorrhea Military Epidemiology STI

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On the Stability of the Solution to a gonorrhea Diserete Mathematical Model

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Applied Mathematics and Mechanics(English Edition) 1994年第6期15卷 545-550页

作者：金均 Shanghai Teachers University Shanghai

In this paper, the author studies the stability of the solution to a three-dimension-al gonorrhea discrete mathematical model by Liapunoy method. The parameter es-timator of the slability domain is obtained and the ra... 详细信息

关键词： gonorrhea discrete mathematical model. parameter estimator.stability domain

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gonorrhea in China, 2018

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International Journal of Dermatology and Venereology 2019年第2期2卷 65-69页

作者： Xiao-Li Yue Xiang-Dong Gong Jing Li Ya-Jie Wang Heng Gu National Center for STD Control of Chinese Center for Disease Control and Prevention Hospital for Skin Diseases(Institute of Dermatology)Chinese Academy of Medical Sciences and Peking Union Medical CollegeNanjingJiangsu 210042China Department of STD Control Dermatology Hospital of Southern Medical UniversityGuangdong Center for Skin Diseases and STI ControlGuangzhouGuangdong 510091China

Objective:gonorrhea is a globally widespread sexually transmitted infection caused by Neisseria gonorrhoeae.This study is aimed to analyze the epidemiological characteristics of gonorrhea cases reported in China in 2018 and provide evidence for strategies making in the gonorrhea prevention and control programme.Methods:gonorrhea cases were extracted from National Notifiable Disease Report System (NNDRS) covering 31 provinces,autonomous regions,arnd municipalities in the mainland of China.The overall incidence rate was calculated,as were rate per province,sex,age group,and occupation group.ResultS:in 2018,133,156 new cases of gonorrhea were reported in China,corresponding to an incidence rate of 9.59 cases per 100,000 population and having a 36.03% increase from 2014 (7.05 cases per 100,000 population).Zhejiang,Hainan,Guangdong,Fujian provinces,and Shanghai city had a higher reported rate (14.05-28.00 per 100,000 population).Hebei,Tianjin,Tibet,Heilongjiang,and Jilin provinces had a lower rerted rate (1.56-5.19 per 100,000 population).The males had a much higher incidence than the females (15.81 per 100,000 vs.3.08 per 100,000) and a faster rising rate (38.32% vs.27.27%).The highest rate was detected in the aged 25-29 years both of male and female (46.37 and 6.60 per 100,000,respectively),followed by those aged 30-34 years (41.12 and 6.39 per 100,000,respectively).The largest proportion of gonorrhea cases was among the farmers accounting for 27.74%,followed by the unemployed persons (24.67%),business persons (17.02%) and industrial workers (9.50%).Conclusion:In general,gonorrhea has an increasing trend from 2014 and remains a common notifiable disease in China in 2018.Young males who are sexually active are high risk populations for gonococ~ infection.The southeast coastal areas with developed economy have a higher rate of gonorrhea reported.Corresponding strategies on disease prevention and control should be performed on the high risk populations and regions.

关键词： gonorrhea incidence rate China high risk occupation

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National Guidelines on Diagnosis and Treatment of gonorrhea in China (2020)

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International Journal of Dermatology and Venereology 2020年第3期3卷 129-134页

作者： Qian-Qiu Wang Rui-Li Zhang Quan-Zhong Liu Jin-Hua Xu Xiao-Hong Su Yue-Ping Yin Shu-Zhen Qi Dong-Mei Xu Ping-Yu Zhou Yu-Ye Li Xiao-Fang Li Min-Zhi Wu Xian-Biao Zou Li-Gang Yang Xiang-Sheng Chen Xiang-Dong Gong Guo-Jun Liang Juan Jiang Hao Cheng Feng-Qin Ge National Center for STD Control,Chinese Centers for Disease Control and Prevention Committee of STD,Branch of Dermatovenereology,Chinese Medical Association Committee of STD,Chinese Dermatologist Association Hospital for Skin Diseases(Institute of Dermatology) Chinese Academy of Medical Sciences and Peking Union Medical College and National Center for STD ControlChinese Centers for Disease Control and PreventionNanjingJiangsu 210042China Department of Dermatology Affiliated Wuxi No.2 People’s Hospital of Nanjing Medical UniversityWuxiJiangsu 214002China Department of Dermatology General Hospital of Tianjing Medical UniversityTianjing 300052China Department of Dermatology Huashan HospitalFudan UniversityShanghai 200040China Department of Neurology Ditan Hospital of Capital Medical UniversityBeijing 100050China Department of Dermatology Shanghai Hospital for Skin Disease and STD of Tongji UniversityShanghai 200050China Department of Dermatology The First Affiliated Hospital of Kunming Medical UniversityKunmingYunnan 650032China Department of Dermatology The 5th People’s Hospital of SuzhouSuzhouJiangsu 215007 China Department of Dermatology The First Affiliated Hospital of General Hospital of PLABeijing 100048China Department of Dermatology The Skin Disease Hospital of Southern Medical UniversityGuangzhouGuangdong 510091 China Department of Dermatology Sir Run Run Shaw Hospital of Zhejiang UniversityHangzhouZhejiang 310020China 不详

gonorrhea is one of the main sexually transmitted diseases in China.It mainly affects the genitourinary tract,and its clinical manifestations vary from asymptomatic to complicated types.The diagnosis of gonorrhea should be based on the patient's epidemiologicai history,clinical manifestations,and laboratory examination results.Treatment should be prompt and standardized and should involve the recommended treatment regimens.Patients should be appropriately followed up after treatment.The antimicrobial resistance of gonococcal isolates has become a severe problem of clinical concern.In order to provide technical guidance of the diagnosis and treatment of gonorrhea for health care workers,the authors developed the guidelines based on the version of 2014,which will be of important in the standardizing medical care of gonorrhea,and further facilitating control and prevention of the disease.

关键词： gonorrhea diagnosis treatment guidelines

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Modeling the impact of changing sexual behaviors with opposite-sex partners and STI testing among women and men ages 15-44 on STI diagnosis rates in the United States 2012-2019

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Infectious Disease Modelling 2023年第4期8卷 1169-1176页

作者： Deven T.Hamilton David A.Katz Laura T.Haderxhanaj Casey E.Copen Ian H.Spicknall Matthew Hogben Center for Studies in Demography and Ecology University of WashingtonSeattleWAUSA Department of Global Health University of WashingtonSeattleWAUSA Division of STD Prevention National Center for HIV/AIDSHepatitisSexually Transmitted DiseaseTuberculosis PreventionCenters for Disease Control and PreventionAtlantaGAUSA

Objective:To estimate the potential contributions of reported changes in frequency of penile-vaginal sex(PVS),condom use and STI screening to changes in gonorrhea and chlamydial diagnoses from 2012 to 2019.Methods:An agent-based model of the heterosexual population in the U.S.simulated the STI epidemics.Baseline was calibrated to 2012 diagnosis rates,testing,condom use,and frequency of PVS.Counterfactuals used behaviors from the 2017-2019 NSFG,and we evaluated changes in diagnosis and incidence rates in 2019.Results:Higher testing rates increased gonorrhea and chlamydia diagnosis by 14%and 13%,respectively,but did not reduce incidence.Declining frequency of PVS reduced the diagnosis rate for gonorrhea and chlamydia 6%and 3%respectively while reducing incidence by 10%and 9%respectively.Declining condom use had negligible impact on diagnosis and incidence.Conclusion:Understanding how changing behavior drives STI incidence is essential to addressing the growing epidemics.Changes in testing and frequency of PVS likely contributed to some,but not all,of the changes in diagnoses.More research is needed to understand the context within which changing sexual behavior and testing are occurring.

关键词： gonorrhea Chlamydia Agent-based modeling Simulation

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Longitudinal association of gonorrhea and bacterial vaginosis with repeat chlamydia diagnoses among U.S. Army women: A retrospective cohort analysis

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Military Medical Research 2019年第2期6卷 128-134页

作者： Christian TBautista Eyako KWurapa Warren BSateren Bruce PHollingsworth Jose LSanchez Division of Health Research Lancaster UniversityLancasterUK Walter Reed Army Institute of Research Silver SpringMDUSA Senior Research Consultant WashingtonDCUSA Armed ForcesHealth Surveillance Branch Public Health DivisionDefense HealthAgencySilver SpringMDUSA.

Background: Historically, sexually transmitted infections have affected the health of the U.S. military. To determine whether gonorrhea, bacterial vaginosis, genital herpes, and trichomoniasis are predictors of repeat chlamydia diagnoses among U.S. Army women, medical data reported into the Defense Medical Surveillance System during the 2006–2012 period were analyzed.Methods: For all inpatient and outpatient medical records, the first and second International Classification of Diseases,version 9(ICD-9) diagnostic positions were reviewed for each chlamydia case to determine the occurrence of repeat diagnoses. The Andersen-Gill regression model, an extension of the Cox model for multiple failure-time data, was used to study associations between predictors and repeat chlamydia diagnoses.Results: Among 28,201 women with a first chlamydia diagnosis, 5145(18.2%), 1163(4.1%), 267(0.9%), and 88(0.3%)had one, two, three, and four or more repeat diagnoses, respectively. Overall, the incidence of repeat chlamydia was8.31 cases per 100 person-years, with a median follow-up time of 3.39 years. gonorrhea(hazard ratio(HR)=1.58, 95%CI: 1.44–1.73) and bacterial vaginosis(HR=1.40, 95% CI: 1.09–1.79) were significant predictors for repeat chlamydia.These estimated hazard ratios were attenuated, but remained significant, after controlling for age, race/ethnicity,marital status, and military rank. No significant association was found for genital herpes(HR=1.13, 95% CI: 0.55–2.29)and trichomoniasis(HR=1.43, 95% CI: 0.43–4.68).Conclusions: This large cohort study suggests that gonorrhea and bacterial vaginosis were associated with repeat chlamydia diagnoses among U.S. Army women. These findings can be used in formulating new interventions to prevent repeat chlamydia diagnoses.

关键词： gonorrhea Bacterial vaginosis Chlamydia Sexually transmitted infection Military

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A generalized ODE susceptible-infectious-susceptible compartmental model with potentially periodic behavior

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Infectious Disease Modelling 2023年第4期8卷 1190-1202页

作者： Scott Greenhalgh Anna Dumas Department of Mathematics Siena College515 Loudon RoadLoudonvilleNY12211USA

Differential equation compartmental models are crucial tools for forecasting and analyzing disease trajectories.Among these models,those dealing with only susceptible and infectious individuals are particularly useful as they offer closed-form expressions for solutions,namely the logistic equation.However,the logistic equation has limited ability to describe disease trajectories since its solutions must converge monotonically to either the diseasefree or endemic equilibrium,depending on the parameters.Unfortunately,many diseases exhibit periodic cycles,and thus,do not converge to equilibria.To address this limitation,we developed a generalized susceptible-infectious-susceptible compartmental model capable of accurately incorporating the duration of infection distribution and describing both periodic and non-periodic disease trajectories.We characterized how our model's parameters influence its behavior and applied the model to predict gonorrhea incidence in the US,using Akaike Information Criteria to inform on its merit relative to the traditional SIS model.The significance of our work lies in providing a novel susceptible-infectedsusceptible model whose solutions can have closed-form expressions that may be periodic or non-periodic depending on the parameterization.Our work thus provides disease modelers with a straightforward way to investigate the potential periodic behavior of many diseases and thereby may aid ongoing efforts to prevent recurrent outbreaks.

关键词： Infectious period Duration of infection gonorrhea Integral equations Differential equations

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Screening for asymptomatic chlamydia and gonorrhea in adolescent males in an urban pediatric emergency department

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World Journal of Clinical Pediatrics 2017年第3期6卷 154-160页

作者： Megan E Maraynes Jennifer H Chao Konstantinos Agoritsas Richard Sinert Shahriar Zehtabchi Ochsner Medical Center University of Queensland SUNY Downstate Medical Center and the Kings County Hospital Center

AIM To determine the prevalence of Chlamydia trachomatis(CT) and Neisseria gonorrhea(GC) in young men seeking care in the emergency department(ED) for non-sexually transmitted infection(STI) related symptoms.METHODS This was a prospective, cross-sectional study in an urban ED. The main outcome was the rate of positive CT and GC on urine nucleic acid amplification testing in males aged 16-21 presenting with non-STI related complaints. RESULTS Two hundred and eighty-four patients were enrolled, 271 were included in the final data analysis [age range 16-21, median: 18(quartiles 16-18, 19-21)]. Overall, 17(6.3%, 95%CI: 4%-10%) tested positive for CT and 0%(95%CI: 0%-2%) were found to have GC. The proportion of sexually active subjects was 71%(95%CI: 65%-76%) and 2%(95%CI: 0.6%-4%) reported sex with men. Previous STI testing was reported in 46%(95%CI: 43%-54%) and 13%(95%CI: 8%-20%) of those patients previously tested had a history of STI. Of the patients who tested positive for CT in the ED, 88%(95%CI: 64%-98%) were successfully followed up. CONCLUSION The prevalence of CT infection found by screening was 6.3%. Screening and follow-up from the ED was successful. The findings justify routine STI screening in male adolescents presenting to the ED with non-STI related complaints.

关键词： Chlamydia gonorrhea Adolescent Public health Emergency department Pediatric

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Incidence of gonorrhea and Chlamydia in Urban Settings: The Case for Neighborhood Level Analysis in Boston

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Advances in Infectious Diseases 2015年第4期5卷 162-166页

作者： Catherine Cattley Paola Massari Caroline A. Genco Department of Medicine Section of Infectious Diseases Boston University School of Medicine Boston USA Department of Microbiology Boston University School of Medicine Boston USA

The sexually transmitted infections (STIs) gonorrhea and chlamydia are known to disproportionately affect impoverished communities and communities of color, especially in urban areas. Moreover, socioeconomic and demographic factors such as poverty and race/ethnicity may contribute to a difference in treatment setting choice as well as a delay in care seeking. In an urban metropolitan area such as Boston, the overall gonorrhea and chlamydia rates are higher than national rates, and such differences are even more marked in certain neighborhoods with greater proportions of individuals who are impoverished, young, and of color. Using a retrospective analysis of city wide data, we highlight the effects of socioeconomic and demographic variables on urban STI prevalence. High poverty rates, race/ethnicity and younger adult populations are linked to disproportionately high STI rates. Interestingly, STI rates do not appear to be influenced by the universal health care coverage offered to the whole Massachusetts’ resident populations. We examine the effects of these variables in Boston neighborhoods in conjunction to STI rates and hypothesize that the observed rates are underestimates of the true prevalence of infection. Future studies will investigate how these same socioeconomic and demographic factors influence which treatment settings are chosen and subsequently lead to a delay in treatment.

关键词： gonorrhea Chlamydia Social Determinants of Health Poverty Boston

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A reliable numerical analysis for stochastic gonorrhea epidemic model with treatment effect

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International Journal of Biomathematics 2019年第6期12卷 221-246页

作者： Ali Raza Muhammad Shoaib Arif Muhammad Ualiq Department of Mathematics Stochastic Analysis and Optimization Research Group Air University PAF Complex E-9 Islamabad 44000PedralPakistan Faculty of Engineering.University of Central PunjabLahore 54000 PunjabPakistan

The phenomena of disease spread are unpredictable in nature due to random mixing of individuals in a population.It is of more significance to include this randomness while modeling infectious diseases.Modeling epidemics including tlieir stochastic behavior could be a more realistic approach in many situations.In thus paper,a stochastic gon orrhea epidemic model with treatment effect has been analyzed numerically.Numerical solution of stochastic model is presented in comparison with its deterministic part.The dynamics of the gonorrhea disease is governed by a threshold quantity Ai called basic reproductive number.If.A11 shows the persistence of disease in population.The standard numerical schemes like Euler Maruyaina.stochastic Euler and stochastic Rurige Kutta are highly dependent on step size and do not behave well in certain scenarios.A competitive non-standard finite dif ference numerical scheme in stochastic setting is proposed,which is independent of step size and remains consistent with the corresponding deterministic model.

关键词： gonorrhea disease stochastic differential equations stochastic numerical schemes

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