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      Pattern and clinico-epidemiological profile of female patients of RTI/STIs attending an STI clinic in Uttarakhand, India

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          A BSTRACT

          Context:

          Reproductive tract infections/sexual tract infections (RTI/STIs) have a huge economic impact in terms of costs of healthcare, loss of productivity and the long-term sequelae.

          Aims:

          This study was aimed at documenting the pattern of RTI/STIs and clinico-epidemiological profiles of patients attending an STI clinic.

          Settings and Design:

          Seventy-six female patients attending the STI clinic at the Department of Obstetrics and Gynaecology, AIIMS Rishikesh between November 2017 and March 2018 were recruited after taking informed verbal consent in this cross-sectional study.

          Methods and Materials:

          All patients were evaluated and managed according to the syndromic approach (NACO). Patients were interviewed and data were entered into a semi-structured questionnaire.

          Statistical Analysis Used:

          The data were analysed using Microsoft Excel 2016 (Microsoft Corporation, released September 22, 2015).

          Results:

          The average age of the patients was 34.46 ± 8.77 years, with a maximum of patients (41%) in the age group 25–35 years. The majority of patients were from an urban background (62%), Hindu (91%), married (95%) and housewives (74%). Most had some level of formal education (97%) and belonged to the lower middle class (43%). The most common diagnosis was lower abdominal pain (LAP) (68%) followed by vaginal/cervical discharge (VD/CD) (30%). Only one patient out of 76 had genital ulcer disease - herpetic (GUD-H).

          Conclusions:

          There is a need for focussed community-based interventions targeting the young, urban, lower-middle-class population to reduce the burden of STIs, particularly LAP.

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          Most cited references25

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          Impact of improved treatment of sexually transmitted diseases on HIV infection in rural Tanzania: randomised controlled trial.

          A randomised trial was done to evaluate the impact of improved sexually transmitted disease (STD) case management at primary health care level on the incidence of HIV infection in the rural Mwanza region of Tanzania. HIV incidence was compared in six intervention communities and six pair-matched comparison communities. A random cohort of about 1000 adults aged 15-54 years from each community was surveyed at baseline and at follow-up 2 years later. Intervention consisted of establishment of an STD reference clinic, staff training, regular supply of drugs, regular supervisory visits to health facilities, and health education about STDs. 12,537 individuals were recruited. Baseline HIV prevalences were 3.8% and 4.4% in the intervention and comparison communities, respectively. At follow-up, 8845 (71%) of the cohort were seen. Of those initially seronegative, the proportions seroconverting over 2 years were 48 of 4149 (1.2%) in the intervention communities and 82 of 4400 (1.9%) in the comparison communities. HIV incidence was consistently lower in the intervention communities in all six matched pairs. Allowing for the community-randomised design and the effects of confounding factors, the estimated risk ratio was 0.58 (95% CI 0.42-0.79, p = 0.007). No change in reported sexual behaviour was observed in either group. We conclude that improved STD treatment reduced HIV incidence by about 40% in this rural population. This is the first randomised trial to demonstrate an impact of a preventive intervention on HIV incidence in a general population.
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            Socio-economic status scales updated for 2017

            The health status of any country depends on the socio-economic status (SES) and the per capita income of its citizens. The SES also decides the affordability and utilization of the health facilities. Constant changes in the price of goods in the country due to inflation make it mandatory to constantly update the income-based socioeconomic scales. This paper attempts to provide updates in Kuppuswamy, B.G. Prasad and udai pareek socioeconomic scales for 2017.
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              Approaches to the control of sexually transmitted infections in developing countries: old problems and modern challenges.

              Sexually transmitted infections (STIs) constitute a huge health and economic burden for developing countries: 75-85% of the estimated 340 million annual new cases of curable STIs occur in these countries, and STIs account for 17% economic losses because of ill health. The importance of STIs has been more widely recognised since the advent of the HIV/AIDS epidemic, and there is good evidence that the control of STIs can reduce HIV transmission. The main interventions which could reduce the incidence and prevalence of STIs include primary prevention (information, education and communication campaigns, condom promotion, use of safe microbicides, and vaccines), screening and case finding among vulnerable groups (for example, pregnant women), STI case management using the syndromic approach, targeted interventions for populations at high risk (for example, sex workers), and in some circumstances (targeted) periodic mass treatment. The challenge is not just to develop new interventions, but to identify barriers to the implementation of existing tools, and to devise strategies for ensuring that effective STI control programmes are implemented in the future.
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                Author and article information

                Journal
                J Family Med Prim Care
                J Family Med Prim Care
                JFMPC
                J Family Med Prim Care
                Journal of Family Medicine and Primary Care
                Wolters Kluwer - Medknow (India )
                2249-4863
                2278-7135
                November 2022
                16 December 2022
                : 11
                : 11
                : 7357-7361
                Affiliations
                [1] Department of Community and Family Medicine, Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
                Author notes
                Address for correspondence: Dr. Anupama Bahadur, Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Rishikesh, Virbhadra Marg - 249 203, Uttarakhand, India. E-mail: anupama.bahadur@ 123456gmail.com
                Article
                JFMPC-11-7357
                10.4103/jfmpc.jfmpc_1397_22
                10041268
                5e683e2d-5438-4689-9b5e-5a5197dca788
                Copyright: © 2022 Journal of Family Medicine and Primary Care

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 10 July 2022
                : 31 July 2022
                : 18 August 2022
                Categories
                Original Article

                clinical epidemiology,female patients,pattern,profile,rti/stis,sti clinic,uttarakhand

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