zithromax and Trichomonas-Vaginitis

Hotel-based sex workers in Bangladesh have high rates of sexually transmissible infections (STIs), high client turnover and low condom use. Two monthly clinic-based strategies were compared: periodic presumptive treatment (PPT) and enhanced syndromic management (ESM) - one round of presumptive treatment followed by treatment based on assessment and laboratory tests.. A randomised controlled trial compared PPT and ESM by prevalence and incidence, behaviour, retention, cost and STI incidence and prevalence. Demographic, behavioural and clinical data were collected from women at two clinics in Dhaka. All women received presumptive treatment and were randomised to receive PPT or ESM at nine monthly visits.. In total, 549 women (median age: <20 years) were enrolled. At baseline, the prevalence of chlamydia (Chlamydia trachomatis) and gonorrhoea (Neisseria gonorrhoeae) was 41% (ESM: 41%; PPT: 42%). After 9 months, chlamydia and gonorrhoea decreased to 7% overall, (ESM: 7.4%; PPT: 6.8%). At each visit, 98% of women receiving ESM met the therapy criteria and were treated. Retention was low (50%). Total costs were 50% lower per visit for each woman for PPT (ESM: $11.62 v. PPT: $5.80). The number of sex work sessions was reduced from 3.3 to 2.5 (P<0.001), but income did not change. Coercion was reduced but condom use at last sex did not change significantly.. Monthly PPT and ESM were effective approaches for STI control. PPT offered a feasible, low-cost alternative to ESM. Educational aspects led to a reduction in coercion and fewer sessions. Implementation studies are needed to improve condom use and retention.

Topics: Adolescent; Anti-Bacterial Agents; Azithromycin; Bangladesh; Candidiasis, Vulvovaginal; Cefixime; Chlamydia Infections; Chlamydia trachomatis; Combined Modality Therapy; Condoms; Cross-Sectional Studies; Developing Countries; Drug Therapy, Combination; Female; Gonorrhea; Health Education; Humans; Incidence; Mass Screening; Metronidazole; Occupational Diseases; Sex Workers; Sexually Transmitted Diseases; Trichomonas Vaginitis; Uterine Cervicitis; Utilization Review; Vaginitis; Vaginosis, Bacterial; Workplace; Young Adult

The aim of this paper is to describe the prevalence of

Topics: Anti-Bacterial Agents; Azithromycin; Chlamydia trachomatis; Coinfection; Drug Resistance, Bacterial; Female; Humans; Macrolides; Male; Mycoplasma genitalium; Mycoplasma Infections; Neisseria gonorrhoeae; Netherlands; Prevalence; Primary Health Care; Sexually Transmitted Diseases; Trichomonas vaginalis; Trichomonas Vaginitis

Topics: Adult; Anti-Bacterial Agents; Azithromycin; Chlamydia Infections; Chlamydia trachomatis; Cross-Sectional Studies; Democratic Republic of the Congo; Feasibility Studies; Female; Gonorrhea; Humans; Infectious Disease Transmission, Vertical; Mass Screening; Metronidazole; Neisseria gonorrhoeae; Patient Acceptance of Health Care; Pregnancy; Pregnancy Complications, Infectious; Prenatal Care; Tinidazole; Treatment Outcome; Trichomonas vaginalis; Trichomonas Vaginitis