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  • Title: Can "mass treatment" work with STDs?
    Author: Herndon N.
    Journal: Netw Res Triangle Park N C; 1992 Apr; 12(4):12-3. PubMed ID: 12343655.
    Abstract:
    Health workers in several areas of the world have tried to reduce the spread of sexually transmitted diseases by treating everyone in the targeted group even if they do not exhibit symptoms. In 1981-1982, health workers treated prostitutes regularly in Nairobi, Kenya to curtail gonorrhea. Some researchers believe that mass treatment to control chancroid is more viable since the genital ulcers grant HIV a pathway. In fact, an epidemiologist with AIDSTECH believes chancroid and syphilis are the most promising diseases for testing and evaluating selective mass treatment. Between 1952-1969, health workers administered single doses of penicillin to 50 million people infected with yaws in 45 countries. These WHO and UNICEF sponsored global campaigns almost eradicated it, but it reappeared recently. Further health workers regularly treat prostitutes in some areas of Indonesia with penicillin. In 1976-1977, health workers treated several hundred migrant farm workers and prostitutes in California to prevent the spread of syphilis. In 1 year, syphilis fell 27% among the migrants and 51% among the prostitutes. Further, the 2nd year of the campaign, health workers tried more diligently to find cases, yet there were fewer reported syphilis cases. In Greenland, during the 1960s, the results of small scale mass treatment for gonorrhea (penicillin and probenecid) were not as promising as the California results, however. Gonorrhea prevalence fell from 10-1% in 6 months, but it climbed again after mass treatment ended. 1 problem with mass treatment is cost. For example, 1 injection of ceftriaxone to treat chancroid costs US$7. Other problems include side effects, drug resistance, and increased susceptibility to other infections. Issues to consider for mass treatment are the degree of a disease's infectiousness and the ability to control it with a single dose.
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