Epidemiology of non-ulcerative sexually transmitted diseases in a high risk population in Jamaica

The role of ulcerative STDs such as syphilis in facilitating the transmission and acquisition of HIV is well established. Non-ulcerative STDs such as gonorrhoea and Chlamydia infection are considered facilitators of HIV transmission. This study was designed to determine the types of non-ulcerative sexually transmitted diseases and associated risk factors among high-risk Jamaican men and women. A cross-sectional survey was conducted including 510 clients attending an STD clinic in Kingston. A standardised questionnaire was administered and microbiological investigations performed on urethral or cervical swab specimens obtained from each participant. All the subjects were symptomatic; 377 (74 percent) had genital discharge and 197 (39 percent) had dysuria with or without discharge. There were 309 cases of NGU; 115 cases of Candidiasis, 275 confirmed gonococcal infections and 226 cases of Trichomoniasis. Men were two times more likely to have gonococcal infection than women (69 percent vs. 50 percent; p<0.01). History of smoking marijuana was significantly associated with a positive test for gonorrhoea (69 percent vs. 52 percent; p<0.01). Forty one percent of women reported that their partners never used condoms (41 percent vs. 19 percent; p<0.01). Only nine men acknowledged consistent condom use. Those who were first time attendees at the STD clinic (n=263) were more likely to report never using condoms (38 percent vs. 27 percent; p<0.01). These data highlight the need for priority targetting in this high-risk group for counselling and health education in controlling, STD and HIV infection in Jamaica.(AU)

Pruritus ani: common infection and treatment

Pruritus ani is a manifestation of a wide spectrum of disease conditions. Infections form a minor aetiological fraction but include organisms from the various microbiological subdisciplines. Fungal causes of pruritus ani usually come from the normal flora, and can be diagnosed in the office, by microscopy using a mixture of potassium hydroxide and dimethyl sulfoxide. Parasites causing pruritus ani may be transmitted by direct contact, the faeco-oral or sexually. Treatment of scabies and enterobiasis should involve simultaneous treatment of family members. Articles of clothing and bed sheets must be exposed to heat. Lindane (gamma benzene hexachloride) should not be used in pregnant women and children under the age of two years to avoid potential neurotoxicity. Irrespective of the aetiology, severe pruritus ani predisposes to secondary bacterial infection (AU)

The incidence of mycoses in the Eastern Caribbean area: Guyana, Trinidad and Barbados

This report details the distribution and importance of fungal disease in Barbados, Trinidad and Guyana. Detailed statistics are not available largely because of the absence of specialised mycological diagnostic facilities. However, there is sufficient data to establish that mycoses particularly superficial infections, are very prevalent and to justify the establishment of diagnostic facilities for mycoses and following this a more detailed analysis of the problem. (AU)

VDRL tests in representative communities of Guyanese adults

VDRL tests were carried out on 774 adults aged 35-54 years in two typical African and East Indian communities in Guyana. Results were weakly reactive in 11.2 per cent. at reactive in 6.9 per cent., the reactivity rate being higher in Africans than in East Indians. Reactivity was not due to previous infection with yaws which has been absent from most of Guyana for many years in contrast to some parts of the West Indies. Clinical evidence of syphilis in Guyana is surprisingly infrequent in view of the high reactivity rates. (AU)

Clinicopathological observations on systemic moniliasis

A case of generalized moniliasis which occurred in a 48-year-old man after operation for carcinoma of the esophagus is reported. A histopathologic description of lesions in the heart, kidney, diaphragm and liver is given. The roles of antibiotics, intravenous glucose and vitamins are discussed as possible precipitating factors in this condition (Summary)

Infections of the lower genital tract

The main symptoms of vaginitis is discharge, which is usually irritating and frequently odorous. The common causes of vaginitis in adults are fungi or protozoa (bacterial vaginitis occurs mainly in children and women who have passed the menopause). The cause can usually be determined quite easily from the clinical appearance of the vagina and from the findings on microscopic examination of a fresh sample of the vaginal secretion. Most vaginal infections respond well to the appropriate treatment, but the diagnosis must be accurate. Numerous proprietary preparations have been advocated for the treatment of vaginitis, have had their brief flurry of popularity, and are now forgotten. Pessaries containing various combinations of antibiotics are seldom effective and-because the vagina depends on a normal bacterial flora for its well-being-often do positive harm (AU)