exudates and Gonorrhea

Sex workers face a disproportionate burden of human immunodeficiency virus (HIV) and sexually transmitted infections (STI) worldwide. For cisgender women sex workers (CWSW), global HIV prevalence is over 10%, whereas transgender women sex workers (TWSW) face an HIV burden of 19% to 27%.. We used respondent-driven sampling to recruit 492 sex workers, including CWSW (n = 299) and TWSW (n = 193) in Greater Kuala Lumpur, Malaysia. Participants completed an in-depth survey and were screened for HIV, syphilis, Chlamydia trachomatis, and Neisseria gonorrhoeae. Sample characteristics stratified by gender identity and interview site are presented. Bivariate analyses comparing CWSW and TWSW were conducted using independent samples t tests for continuous variables and χ tests for categorical variables.. Pooled HIV prevalence was high (11.7%; 95% confidence interval [CI], 8.8-14.5), and was similar for CWSW (11.1%) and TWSW (12.4%). Rates of syphilis 25.5% (95% CI, 21.6-29.5), C. trachomatis (14.8%; 95% CI, 11.6-18.0) and N. gonorrhoeae (5.8%; 95% CI, 3.7-7.9) were also concerning. Both groups reported lifetime HIV testing (62.4%), but CWSW were less likely to have ever been HIV tested (54.5%) than TWSW (74.6%). Median time since last HIV test was 24 months. Previous screening for STI was low. Inconsistent condom use and drug use during sex work were not uncommon.. High HIV and STI prevalence, coupled with infrequent HIV and STI screening, inconsistent condom use, and occupational drug use, underscore the need for expanded HIV and STI prevention, screening, and treatment efforts among CWSW and TWSW in Malaysia.

Topics: Adult; Aged; Chlamydia Infections; Condoms; Female; Gonorrhea; Health Knowledge, Attitudes, Practice; HIV Infections; Humans; Malaysia; Male; Mass Screening; Middle Aged; Prevalence; Sampling Studies; Sex Workers; Sexual Partners; Substance-Related Disorders; Syphilis; Transgender Persons; Unsafe Sex; Young Adult

Topics: Academic Medical Centers; Anti-Bacterial Agents; Anti-Infective Agents; Ciprofloxacin; Drug Resistance, Multiple, Bacterial; Gonorrhea; Humans; Malaysia; Neisseria gonorrhoeae; Penicillins

The World Health Organization Western Pacific Region Gonococcal Antimicrobial Surveillance Programme examined about 8,700 isolates of Neisseria gonorrhoeae from 15 countries for resistance to antibiotics in 2005. High to very high rates of resistance to penicillins and quinolones persisted in most centres. Increasing numbers of gonococci with decreased susceptibility to third generation cephalosporins were found in several countries. There were infrequent instances of spectinomycin resistance.

Topics: Anti-Bacterial Agents; Australia; Brunei; China; Drug Resistance, Multiple, Bacterial; Gonorrhea; Hong Kong; Humans; Japan; Malaysia; Neisseria gonorrhoeae; New Caledonia; New Zealand; Pacific Ocean; Philippines; Singapore; Vietnam; World Health Organization

Between 1992 and 1994, 253 tetracycline-resistant Neisseria gonorrhoeae (TRNG) strains were isolated and characterized by auxotype and serogroup (A/S) classes to study TRNG prevalence in different years. TRNG accounted for 28.1, 42.5, and 51.9% of the strains isolated in 1992, 1993, and 1994, respectively, showing a significant increase in each successive year (chi square = 26.7, P < 0.001). There was no significant increase in penicillinase-producing TRNG, which accounted for 53.1, 53.8, and 63.2% of the TRNG isolates. The 253 TRNG isolates belonged to 53 A/S classes. Eighteen A/S classes not observed in 1992 were detected in 1993, and 11 A/S classes not observed in 1992 and 1993 were isolated in 1994, indicating dissemination of the tetracycline resistance gene among the N. gonorrhoeae strains in Malaysia. Its emergence and subsequent rapid spread are alarming. The plasmid is capable of self-transfer (S.A. Morse, S.R. Johnson, J.W. Biddle, and M.C. Roberts, J. Infect. Dis. 155:819-822, 1987), allowing further dissemination of tetracycline resistance.

Topics: Female; Gonorrhea; Humans; Malaysia; Male; Neisseria gonorrhoeae; Plasmids; Serotyping; Tetracycline Resistance; Time Factors

The microbial aetiology of genital ulcers was studied in 249 patients (241 men and 8 women) attending a Sexually Transmitted Disease Clinic in Kuala Lumpur, Malaysia. Herpes simplex virus type 2 was isolated in 48 (19.2%) patients, Haemophilus ducreyi from 22 (8.8%), Neisseria gonorrhoeae from seven (2.8%) and Chlamydia trachomatis from four (1.6%). Syphilis was diagnosed in 18 (7.2%) patients on the basis of dark field microscopy. Two (0.8%) patients were found to have both chancroid and syphilis and one (0.5%) had both gonorrhoea and syphilis. No organism was isolated in the remaining 151 (61.5%) patients. Overall, the accuracy of clinical diagnosis was 58% for single infection, 67% for herpes, 63% for syphilis, 47% for chancroid and 0% for lymphogranuloma venereum. Therefore, our study confirms the need for laboratory tests to diagnose accurately the aetiology of genital ulcer disease.

Topics: Adolescent; Adult; Chlamydia Infections; Chlamydia trachomatis; Female; Genital Diseases, Female; Genital Diseases, Male; Gonorrhea; Haemophilus Infections; Herpes Genitalis; Humans; Malaysia; Male; Middle Aged; Ulcer

The prevalence of sexually transmitted diseases was determined among 370 prostitutes in Kuala Lumpur, Malaysia. Chlamydial cervicitis (26.5%) was detected more frequently than gonorrhoea (14.25%) and was associated more often with pelvic inflammatory disease. Concurrent infections and asymptomatic infections were common. Seropositivity to hepatitis B and syphilis were 66.3% and 13.6% respectively. Women under 20 years of age had significantly higher rates of infection with Chlamydia trachomatis and hepatitis B virus than older women.

Topics: Adolescent; Adult; Chlamydia Infections; Female; Gonorrhea; Hepatitis B; Humans; Malaysia; Middle Aged; Pelvic Inflammatory Disease; Prevalence; Sex Work; Sexually Transmitted Diseases; Syphilis

The plasmid profiles of 160 strains of Neisseria gonorrhoeae isolated in Peninsular Malaysia, comprising 80 penicillinase-producing (PPNG) and 80 non-penicillinase-producing (non-PPNG) isolates, were determined. The 80 PPNG isolates were divided into two plasmid groups. All of them harbored two common plasmid species, a 4.4 megadalton (Md) R plasmid previously associated with beta-lactamase production in PPNG strains from the Far East and a 2.6 Md multicopy plasmid of unknown function. In addition to these two plasmids, 60 (75%) PPNG isolates also carried a large 24.5 Md conjugative plasmid. In contrast, the 80 non-PPNG strains were divided into three plasmid groups. All of them possessed the 2.6 Md cryptic plasmid, and 35 (44%) isolates also harbored the 24.5 Md transfer plasmid. Besides these two plasmids, one non-PPNG isolate carried an additional 7.8 Md cryptic plasmid.

Topics: Epidemiologic Methods; Female; Gonorrhea; Humans; Malaysia; Male; Neisseria gonorrhoeae; Penicillinase; Plasmids

Topics: Adolescent; Adult; Aged; Gonorrhea; Humans; Malaysia; Male; Middle Aged; Neisseria gonorrhoeae; Urethritis

Despite being part of one of the few remaining primitive areas of the world, both Sabah and Sarawak are provided with adequate, though simple, urban and rural general medical services. At present no reliable data on the incidence of sexually transmitted diseases in these areas have been collected and no organised treatment services are available. Gonorrhoea appears to be the commonest notifiable infectious disease in Sarawak, and beta-lactamase-producing strains have been isolated. Because of the rapidly expanding economy and the encouragement of the tourist trade, sexually transmitted disease is likely to prove an increasing problem, for which a specialised service for diagnosis and treatment is badly needed.

Topics: Adult; Developing Countries; Gonorrhea; Health Services; Humans; Infant, Newborn; Malaysia; Male; Sexually Transmitted Diseases; Social Change; Urethritis

Topics: Administration, Oral; Adult; Aged; Ampicillin; Drug Evaluation; Gonorrhea; Humans; Malaysia; Male; Middle Aged; Prospective Studies; Urethritis

Topics: Adolescent; Adult; Child; Child, Preschool; Female; Gonorrhea; Humans; Infant; Malaysia; Male; Microbial Sensitivity Tests; Middle Aged; Neisseria gonorrhoeae; Penicillin Resistance; Penicillins