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Epidemiology of STD
Epidemiology of STD
• Change in incidence (simple access to
antibiotic, change to sexual behavior, multiple
partner, low age of sexual contact, addiction,
hemoseuality )
• Epidemiology in developed and undeveloped
area
Trichomoniasis
• There are >170 million cases of trichomoniasis
annually worldwide, including >7.4 million
new cases annually in North America.
• Trichomoniasis vaginalis is the protozoan that
causes trichomoniasis.
• Men who are infected may be asymptomatic
or may have nongonococcal urethritis.
• Women who are infected may have no or
minimal symptoms.
Epidemiology of STD
• The Centers for Disease Control and Prevention (CDC)
estimated that 20 million new sexually transmitted
diseases (STDs) occur each year in USA.
• Of the new cases, half occur in patients aged 15 to 24
years.
• Although there have been significant advances in
prevention, diagnosis, treatment, and education, the
occurrence of STDs continues to increase.
• Diagnosis and treatment continue to be major public
health challenges because of the asymptomatic nature
of many of these infections
Epidemiology of STD
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The most common STDs include:
Chlamydia
Herpes simplex virus types 1 and 2
Human papillomavirus (HPV)
Syphilis
Gonorrhea
Bacterial vaginosis
Trichomoniasis
and pelvic inflammatory disease (PID)
Epidemiology of STD
• STDs have not only physical but also emotional
and psychological consequences for infected
patients.
• STDs also have a direct and indirect economic
effect; costs associated with STDs were estimated
to be approximately $14.7 billion in 2006.
• Many attempts have therefore been made to
increase prevention, proper diagnosis, and early
treatment of STDs.
•
Epidemiology of STD
• In the general population, patients are
considered to be at high risk for contracting an
STD:
• Multiple sex partners
• Used intravenous (IV) drugs, have been
• Men who have sex with men (MSM)
• Contact withprostitutes
• Unprotected intercourse
• and are not in a monogamous relationship.
Epidemiology of STD
• Special populations to consider when
assessing a patient's risk for STDs include:
• Pregnant women
• Adolescents
• MSM
• Women who have sex with women (WSW)
• and older patients.
Chlamydia
• Chlamydia trachomatis infection is the most frequently
reported sexually transmitted infectious disease in the
United States and continues to be an important risk factor
for pelvic inflammatory disease (PID), ectopic pregnancies,
urethritis, cervicitis, chronic pelvic pain, and infertility.
• In 2007, there were 1,108,374 cases of chlamydia reported
to the CDC.
• In women, the highest age-specific rates were among
patients aged 15 to 19 years (3,004.7 cases per 100,000)
and those aged 20 to 24 years (2,948.8 cases per 100,000).
• Typically, patients are asymptomatic and are unaware of an
infection with C trachomatis.7
Genital herpes
• Herpes simplex virus type 1 (HSV-1) and type 2
(HSV-2) infections are both chronic, lifelong viral
infections.
• Approximately 50Epidemiology
million ofpeople
in the United
STD
States are infected with HSV.
• Historically, HSV-2 has been the causative agent
in the majority of genital herpes cases, but HSV-1
has become more prevalent, causing
approximately half of first episode outbreaks.
Genital herpes
• 15-fold increase during 1966 to 1984.
• 724000 new cases annually in USA.
Genital warts
• Human papillomavirus (HPV), which is
responsible for cervical cancer and genital warts.
• In most studies HPV is the most common STD.
• Although there are >100 genotypes of HPV, the 4
genotypes targeted by the vaccine cause the
majority of cervical cancers and genital warts.
HPV types 6 and 11 cause 90% of genital warts,
and types 16 and 18 cause 70% of cervical
cancers.
• Vaccination ???
Genital warts
• Similar to HSV.
• Magnitude 3-4 greater to HSV.
• Eradication ???
Gonorrhea
• Neisseria gonorrhoeae infection has been
increasing over the past few years, causing a
growing public health concern in the United
States.
Gonorrhea
• After outbreak during second world war,
decrease incidence were seen.
• Between 1964 to 1975 increase were seen.
• There is resistant species of NG to antibiotics.
Syphilis
• Syphilis is caused by the bacterium Treponema
pallidum.
• Although syphilis incidence had decreased by
2000, the incidence of the disease has since
increased; in 2007, a total of 11,466 cases
were reported, an increase of 15% from 2006.
• The population most affected is MSM.
Syphilis
• After large outbreak of syphilis during second
world war , dropped low level of syphilis.
• Between 1985-89 high incidence were seen.
Bacterial vaginosis
• Bacterial vaginosis (BV) is a polymicrobial
syndrome that causes 10% to 30% of infectious
vaginitis cases in women of childbearing age.
• Bacterial vaginosis is the result of an overgrowth
of Gardnerella vaginalis, Mycoplasma
hominis, Mobiluncusspecies, Bacteroides species
(excluding Bacteroides fragilis),
and Peptostreptococcusspecies.
• 50% of women with BV are asymptomatic.
‫گزارش موارد چند بیماری آمیزشی در ایران در سال ‪1385‬‬
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‫تریكومونیازیس‬
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