Active leprosy in Greece: a 20-year survey (1988-2007).

A retrospective study (1988-2007) of all newly detected (n = 26) and relapsed (n = 51) Greek cases of leprosy was carried out. Multibacillary types prevailed in both patient groups (n = 68, 88.3%). Seven immigrants from endemic areas were also referred with multibacillary leprosy. Newly detected Greek cases resided more frequently in rural areas. Incident and relapsed multibacillary disease cases did not differ by age. Diagnosis was mainly made on the basis of skin lesions rather than leprosy reactions. Leprosy in Greece (total population, ten million) has the epidemiological characteristics of a disease that is dying out, without gender inequalities.

Antimicrobial susceptibility of Neisseria gonorrhoeae in Greece: data for the years 1994-2004.

OBJECTIVES: Surveillance data concerning antimicrobial susceptibilities of Neisseria gonorrhoeae isolated in Greece during the 11 year period 1994-2004 are presented. METHODS: Antimicrobial susceptibilities of all gonococcal isolates received by the Greek National Reference Center for N. gonorrhoeae during the study period were determined in terms of MICs using Etest. Trends in yearly isolation frequencies by susceptibility category were estimated for defining significant changes in overall susceptibility figures. RESULTS: Cefotaxime and spectinomycin retained undiminished activity against all isolates throughout the study period. High rates of resistance and intermediate susceptibilities were noticed for penicillin, tetracycline and erythromycin, and even for norfloxacin and ciprofloxacin. A substantial portion (16.5%) of the gonococcal samples consisted of multiresistant strains exhibiting resistance to two or more agents of different antibiotic classes. Although annual rates of low-level chromosomal resistance decreased, high-level resistance owing to the presence of penicillin- and tetracycline-resistance plasmids increased. Fluoroquinolone resistance also showed a significant increasing trend after 1996, reaching a peak rate of 11.3% in 2004. CONCLUSION: Third-generation cephalosporins and spectinomycin should be considered as first-choice drugs for the empirical treatment of gonorrhoea in Greece.

Determinants of genital wart case detection rates among STD clinic attendees in Athens, Greece.

BACKGROUND AND OBJECTIVE: To report significant sociodemographic and behavioral outpatient characteristics associated with the diagnosis of genital warts. METHODS: Cross-sectional hospital-based study (1990-96). RESULTS: Genital warts (n = 2988, 51.2%) represent the leading sexually transmitted disease (STD) among 5831 consecutive symptomatic Greek and foreign immigrant STD outpatients. In Greek heterosexuals a low rate of partner change was the main patient characteristic at diagnosis (median: one partner in the past 6 months). Lower detection rate and riskier behavior characterized immigrants. Although associated with risky behavior, homo/bisexual orientation in males and injecting drug use were not significantly associated with condyloma diagnosis in the context of STDs. CONCLUSION: Broader health education and secondary prevention are needed to control this infection, whereas low-risk behavior in Greek heterosexuals with condylomata facilitates further preventive interventions.

Incidence determinants of gonorrhea, chlamydial genital infection, syphilis and chancroid in attendees at a sexually transmitted disease clinic in Athens, Greece.

OBJECTIVE: To determine the specific impact on the incidence rate of some demographic and behavioral characteristics in outpatients with four bacterial sexually transmitted diseases (STDs). STUDY DESIGN: A cross-sectional hospital outpatient-based study was conducted from 1990 to 1996 on 1064 consecutive symptomatic STD cases (Chlamydia trachomatis, n = 375; gonorrhea, n = 369; early symptomatic syphilis, n = 288, and chancroid, n = 32) using a standardized questionnaire. RESULTS: In a reference STD population of 5831 symptomatic outpatients, the relative incidence of gonorrhea, syphilis and chancroid was found to be increased among immigrants. Low educational/socioeconomic level was also a significant incidence predictor. Older age characterized homo/bisexuals. The chlamydial infection detection rate was not affected by nationality, injecting drug use history or sexual orientation in males. CONCLUSION: Innovative preventive and control strategies are needed among immigrants, older men having sex with men and injecting drug users, apart from those targeting the general population.

Epidemiologic determinants of herpes genitalis case detection rates among STD clinic attendees.

BACKGROUND AND OBJECTIVE: to report significant sociodemographic and behavioural outpatient characteristics in Greeks and foreign immigrants associated with the diagnosis of symptomatic herpes genitalis. METHODS: A cross sectional hospital-based study (1990-96). RESULTS: In the context of an STD reference population (n = 5,831), herpes genitalis (n = 831) represents the second leading sexually transmitted disease (14.2%), more often affecting Greek outpatients. Immigrant women were found five times more infected than Greek. In Greek heterosexuals low partner change rate was the main characteristic at the moment of health seeking behaviour (median: 1 partner in the past six months). Homo/bisexual orientation in males resulted in lower detection rate. Injecting drug use history was not associated with an increased relative incidence. CONCLUSIONS: low risk behaviour in heterosexuals constitutes a background for further preventive interventions to reduce complications.