Sexually transmitted infections associated syndromes assisted in the primary health care in Northeast, Brazil

Abstract

BackgroundThe lack of information on the care for sexually transmitted infections (STI) associated syndromes may contribute for its non-inclusion as prevention and control strategy for STI in Brazil. This study aims to analyze the cases of STI – Associated Syndromes assisted in primary health care center in a city in Northeast Brazil associating them with socio-demographic and behavioral variables.MethodsThis is a retrospective study that analyzed 5148 consultation forms and medical records of patients assisted in a primary health care center who presented at least one genital syndrome from 1999 to 2008. Was considered as dependent variables the genital syndromes and serologies for syphilis and HIV and as independent variables the socio-demographic and behavioral aspects. It was used Pearson’s chi-square test to analyze the differences between the categorical variables, with a significance level of 5%. It was performed a multivariate analysis through the multivariate logistic regression model with the variables with p <0.05. We used odds ratio with a confidence interval of 95%.ResultsThe most frequent syndromes were vaginal discharge and/or cervicitis (44%) and genital wart (42.2%). Most people were between 20 and 39 years old (70%) and women (74.2%). Genital ulcer was most prevalent among men (OR = 2.67; CI 95% 1.99-3.58) and people who studied more than eight years (OR = 1.33; CI 95% 1.00-1.75) and wart prevailed among men (OR = 3.92; IC 95% 3.36-4.57), people under 29 years old (OR = 1.81; CI 95% 1.59-2.07) and who studied more than eight years (OR = 1.75; CI 95% 1.54-1.99). The Venereal Disease Research Laboratory (VDRL) was positive in 7.3% of men and in 7.1% of women and the Anti-HIV in 3.1% of men and 0.7% of women.ConclusionVaginal discharge was the most frequent syndrome assisted in primary health care, followed by genital wart. The high prevalence of genital wart justifies the greater effort for the proper follow-up of these cases. Men presented more genital wart and ulcer and reported having more sexual partners, showing their need for a greater access and inclusion in health activities developed in primary health care in Brazil.

Partner notification for sexually transmitted infections and perception of notified partners

“…In different regions of the world, contact from sexual partners with healthcare centers is affected not only by sociocultural obstacles, but also by inadequate infrastructure offering a limited number of STI centers, short time dedicated to this health service, lack of trained staff and reliable diagnostic methods, and absence of partner notification guidelines (12) . At national level, an important structural obstacle is the syndromic management of patients with STIs, an alternative to compensate the lack of laboratory diagnostic methods (3) , and which may be one important reason why partner notification is not integrated into the care of health professionals (12,19) . In this study, it may be associated with the predominance of reasons for partner notification having resulted from HIV and syphilis diagnosis, which may indicate failure in the control of other STIs in the country, due to the syndromic management of cases (19) .…”

“…At national level, an important structural obstacle is the syndromic management of patients with STIs, an alternative to compensate the lack of laboratory diagnostic methods (3) , and which may be one important reason why partner notification is not integrated into the care of health professionals (12,19) . In this study, it may be associated with the predominance of reasons for partner notification having resulted from HIV and syphilis diagnosis, which may indicate failure in the control of other STIs in the country, due to the syndromic management of cases (19) . On the other hand, HIV infection is still characterized by stigma and fear of transmission.…”

Síndromes Infecciosas Sexualmente Transmissíveis Em Homens: Prevalência E Fatores De Risco

“…Mesmo considerando essa limitação, esse achado é corroborado por outros trabalhos científicos (MAKASA et al, 2012;CAVALCANTI et al, 2012;GOMES et al, 2013).…”

“…A síndrome mais frequente foi verruga genital (42,2%). Úlceras e verrugas genitais foram mais prevalentes em homens, que também relataram ter mais parceiros sexuais do que as mulheres (CAVALCANTI et al, 2012). No presente manuscrito, a síndrome com maior prevalência foi também a verrucosa, o que justifica a implementação de esforços para um acompanhamento adequado desses casos.…”

“…Essa é uma observação diferente em comparação aos dados literários encontrados, que apontaram idade, escolaridade e situação financeira como fatores sociodemográficos de risco para alguma DST (GUO et al, 2011;SEN, 2013). Essa disparidade pode ser parcialmente explicada por tratar-se de amostra exclusiva de homens atendidos em ambulatório especializado, além do desfecho pesquisado ser definido como síndrome infecciosa e não como diagnóstico etiológico (MAKASA et al, 2012;CAVALCANTI et al, 2012;GOMES et al, 2013).…”