Characterization of sexually transmitted infections, their pharmacological treatment, and recurrence in a Colombian population
Abstract
Introduction: Sexually transmitted infections are a public health problem worldwide. Their inadequate antimicrobial management has been associated with a higher risk of recurrence.
Objective: To characterize the main sexually transmitted infections, the adherence to clinical practice guidelines, and the factors associated with recurrence in Colombia.
Materials and methods: We conducted an observational study to identify the main sexually transmitted infections, the sociodemographic variables, and the pharmacological management in a patient cohort from a population database of 6.5 million people affiliated with the Colombian health system. We made a multivariate analysis to identify the variables associated with recurrence.
Results: We detected 3,158 patients with a mean age of 41.8 ± 14.5 years, of whom 63.1% were men. We found 4.030 episodes of sexually transmitted infections, predominantly urethral syndrome (27.5%). Only 13.6% of patients with urethral syndrome, ulcerative syndrome, or genital warts were managed in compliance with clinical practice guidelines and 20.6% were dispensed condoms; 16.7% of patients had recurrences and being male (OR=1.32; 95%CI 1.08-1.63), <30 years old (OR=1.72; 95%CI 1.40-2.13), being treated in municipalities other than capital cities (OR=1.43; 95%CI 1.06-1.94), and having received inadequate treatment for the first episode (OR=1.93; 95%CI 1.52-2.39) were associated with recurrence.
Conclusions: The majority of patients with sexually transmitted infections were not treated in compliance with clinical practice guidelines and those who did not have adequate management had a higher risk of recurrence.
Downloads
References
Sexually Transmitted Diseases. Summary of 2015 CDC Treatment Guidelines. J Miss State Med Assoc. 2015;56:372-5.
American Sexual Health Association. STDs/STIs. Accessed on: June 1, 2020. Available from: http://www.ashasexualhealth.org/stdsstis/
Buder S, Schöfer H, Meyer T, Bremer V, Kohl PK, Skaletz-Rorowski A, et al. Bacterial sexually transmitted infections. J Dtsch Dermatol Ges. 2019;17:287-315. https://doi.org/10.1111/ddg.13804
Rowley J, Vander Hoorn S, Korenromp E, Low N, Unemo M, Abu-Raddad LJ, et al. Chlamydia, gonorrhoea, trichomoniasis and syphilis: Global prevalence and incidence estimates, 2016. Bull World Health Organ. 2019;97:548-62. https://doi.org/10.2471/BLT.18.228486
de Amorim TF, Teles SA, Moraes LC, de Matos MA, Carneiro M, Nogueira DJ, et al. Symptomatic sexually transmitted infections in Brazil’s emerging rural populations. J Assoc Nurses AIDS Care. 2018;29:942-8. https://doi.org/10.1016/j.jana.2018.05.004
World Health Organization. Report on global sexually transmitted infection surveillance, 2018. Accessed on: June 1, 2020. Available from: https://www.who.int/reproductivehealth/publications/stis-surveillance-2018/en/
Korenromp EL, Ríos C, Apolinar ALS, Caicedo S, Cuéllar D, Cárdenas I, et al. Prevalence and incidence estimates for syphilis, chlamydia, gonorrhea, and congenital syphilis in Colombia, 1995-2016. Rev Panam Salud Pública. 2018;42:e118. https://doi.org/10.26633/RPSP.2018.118
Sieving RE, Gewirtz O’Brien JR, Saftner MA, Argo TA. Sexually transmitted diseases among us adolescents and young adults: Patterns, clinical considerations, and prevention. Nurs Clin North Am. 2019;54:207-25. https://doi.org/10.1016/j.cnur.2019.02.002
Tisler-Sala A, Ojavee SE, Uusküla A. Treatment of chlamydia and gonorrhoea, compliance with treatment guidelines and factors associated with non-compliant prescribing: Findings form a cross-sectional study. Sex Transm Infect. 2018;94:298-303. https://doi.org/10.1136/sextrans-2017-053247
Ministerio de Salud y Protección Social - Colciencias. Guía de práctica clínica para el abordaje sindrómico del diagnóstico y tratamiento de los pacientes con infecciones de transmisión sexual y otras infecciones del tracto genital, 2013. Accessed on: June 1, 2020. Available from: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/INEC/IETS/profesionales%20salud.pdf
Moreno-Ribera N, Fuertes-de Vega I, Blanco-Arévalo JL, Bosch-Mestres J, González-Cordón A, Estrach-Panella T, et al. Sexually transmitted infections: Experience in a multidisciplinary clinic in a tertiary hospital (2010-2013). Actas Dermosifiliogr. 2016;107:235-41. https://doi.org/10.1016/j.ad.2015.10.007
Jacob L, Duse DA, Kostev K. Prevalence and treatment of sexually transmitted infections in men followed by urologists in Germany - a cross sectional study with 347,090 men. Ger Med Sci. 2018;16:1-7. https://doi.org/10.3205/000265
Boffin N, Moreels S, Deblonde J, van Casteren V. Four sexually transmitted infections (STIs) in Belgian general practice: First results (2013-2014) of a nationwide continuing surveillance study. BMJ Open. 2017;7:e012118. https://doi.org/10.1136/bmjopen-2016-012118
Wetten S, Mohammed H, Yung M, Mercer CH, Cassell JA, Hughes G. Diagnosis and treatment of chlamydia and gonorrhoea in general practice in England 2000-2011: A population-based study using data from the UK Clinical Practice Research Datalink. BMJ Open. 2015;5:e007776. https://doi.org/10.1136/bmjopen-2015-007776
Forster R, Ng D, Upton A, Franklin R, Thomas M. Treatment of gonorrhoea in Auckland, New Zealand: Marked variation in prescriber adherence to treatment guidelines. Intern Med J. 2017;47:640-8. https://doi.org/10.1111/imj.13433
Mohammed H, Sile B, Furegato M, Fifer H, Hughes G. Poor adherence to gonorrhoea treatment guidelines in general practice in England. Br J Gen Pract. 2016;66:352. https://doi.org/10.3399/bjgp16X686077
van Amerongen R, Gazendam RP, van Bergen JEAM. Trends in antimicrobial management of gonorrhoea by general practitioners in Amsterdam, the Netherlands, between 2010 and 2016: A cross-sectional study. BMC Fam Pract. 2019;20:12. https://doi.org/10.1186/s12875-018-0900-9
Almeida VC, Donalisio MR, Cordeiro R. Factors associated with reinfection of syphilis in reference centers for sexually transmitted infections. Rev Saúde Pública. 2017;51:64. https://doi.org/10.1590/S1518-8787.2017051006432
Généeux M, Leclerc P, Bédard L, Allard R. Upsurge of chlamydial reinfection in a large Canadian city: An indication of suboptimal Chlamydia screening practices? Can J Public Health. 2010;101:420-4. https://doi.org/10.1007/BF03404865
Amiri S, Pham CD, Amram O, Alcover KC, Oluwoye O, Bravo L, et al. Proximity to screening site, rurality, and neighborhood disadvantage: Treatment status among individuals with sexually transmitted infections in Yakima County, Washington. Int J Environ Res Public Health. 2020;17:2679. https://doi.org/10.3390/ijerph17082679
Panchanadeswaran S, Johnson SC, Mayer KH, Srikrishnan AK, Sivaran S, Zelaya CE, et al. Gender differences in the prevalence of sexually transmitted infections and genital symptoms in an urban setting in southern India. Sex Transm Infect. 2006;82:491-5. https://doi.org/10.1136/sti.2006.020768
Satterwhite CL, Torrone E, Meites E, Dunne EF, Mahajan R, Ocfemia MC, et al. Sexually transmitted infections among US women and men: Prevalence and incidence estimates, 2008. Sex Transm Dis. 2013;40:187-93. https://doi.org/10.1097/OLQ.0b013e318286bb53
Sonnenberg P, Clifton S, Beddows S, Field N, Soldan K, Tanton C, et al. Prevalence, risk factors, and uptake of interventions for sexually transmitted infections in Britain: Findings from the National Surveys of Sexual Attitudes and Lifestyles (Natsal). Lancet. 2013;382:1795-806. https://doi.org/10.1016/S0140-6736(13)61947-9
Dolan G, Chauhan M, Foster K, Basta M, Bushby S, White C, et al. Factors associated with repeat diagnosis of syphilis in genitourinary medicine (GUM) clinic attendees in the North East of England, 2002-2014. Int J STD AIDS. 2018;29:790-99. https://doi.org/10.1177/0956462418757554
López-de-Munain J, Cámara-Pérez MD, Imaz-Pérez M, Pereda-Berroeta J, López-Azcarreta I, Muñoz-Sánchez J, et al. Chlamydia trachomatis re-infection in Spain: A STI clinic-based cohort study. Enferm Infecc Microbiol Clin. 2017;35:165-73. https://doi.org/10.1016/j.eimc.2016.08.011
Some similar items:
- Luz Elena Velásquez, Catalina Gómez, Erika Valencia, Laura Salazar, Eudoro Casas, Paragonimosis in the peri-urban zone of Medellín, Antioquia , Biomedica: Vol. 28 No. 3 (2008)
- Sandra Milena Arias, Lina Marcela Salazar, Eudoro Casas, Alexandra Henao, Luz Elena Velásquez, Paragonimus sp. in crabs and awareness of the educational community to aquatic ecosystems in La Miel and La Clara, Caldas, Antioquia , Biomedica: Vol. 31 No. 2 (2011)
- Jaiberth Cardona-Arias, Luz Peláez-Vanegas, Juan López-Saldarriaga, Marcela Duque-Molina, Oscar Leal-Álvarez, Health related quality of life in adults with HIV/AIDS in Colombia , Biomedica: Vol. 31 No. 4 (2011)
- Oscar Eugenio Sierra, María Antonia Gaona de Hernández, Gloria Janneth Rey, Permeability to phi chi 174 bacteriophages in polyolephin membrane condoms. , Biomedica: Vol. 25 No. 4 (2005)
- Lilliana María Giraldo, Camilo Duque, Carlos Santiago Uribe, Olga Helena Hernández, Symptoms of myasthenia gravis in a patient with a history of thymectomy for invasive thymoma , Biomedica: Vol. 35 No. 4 (2015)
- Germán Briceño, Jaime Céspedes, Martha Leal, Sarha Vargas, Prevalence of cardiovascular risk factors in schoolchildren from a rural and urban area in Colombia , Biomedica: Vol. 38 No. 4 (2018)
- Cindy Córdoba , Paola A. Buriticá , Robinson Pacheco , Anyela Mancilla , Augusto Valderrama-Aguirre, Gustavo Bergonzoli , Risk factors associated with pulmonary tuberculosis relapses in Cali, Colombia , Biomedica: Vol. 40 No. Supl. 1 (2020): Mayo, Infecciones en el trópico
- Ana Yibby Forero Torres, Luis Carlos Forero, Comparison between anthropometric measurements and indices to evaluate general and abdominal obesity, Colombia ENSIN 2015 , Biomedica: Vol. 43 No. Sp. 3 (2023): Enfermedades crónicas no transmisibles

Article metrics | |
---|---|
Abstract views | |
Galley vies | |
PDF Views | |
HTML views | |
Other views |