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  • Title: The epidemiology of sexually transmitted diseases in Southeast Asia and the western Pacific.
    Author: Thirumoorthy T.
    Journal: Semin Dermatol; 1990 Jun; 9(2):102-4. PubMed ID: 2117964.
    Abstract:
    Sexually transmitted diseases (STDs) and their complications are common in Southeast Asia (SEA) and the Western Pacific region. Gonorrhea, chancroid, nongonococcal urethritis, and syphilis are still the major STDs. However, the clinical incidence of genital herpes and genital warts show a definite increase. The gonococcal infections in SEA show high levels of antimicrobial resistance. There is a high level of chromosomal-mediated and plasmid-mediated penicillinase resistance. The sex industry, strongly fueled by local consumption, travel, and tourism, continues to play an important focal role in maintaining the high level of transmission of STDs in SEA and the Western Pacific region. In incidence and epidemiology of sexually transmitted disease (STD)s in Southeast Asia and the Western Pacific, with gonorrhea, chancroid, nongonococcal urethritis, syphilis, genital herpes and genital warts at the forefront, are reviewed. The bacterial STDs gonorrhea, chancroid and syphilis are the major problems. Gonorrhea is the most prevalent STD in the region, with a high incidence of chromosomally-mediated resistant and penicillinase-producing strains comprising 35-53% of isolates. Clinical treatment failures due to spectinomycin-resistant gonococci are reported as increasing. Uncontrolled antibiotic sales are blamed for these resistant strains. Syphilis has declined in the 1950s, but has re-emerged. Chancroid is declining, while herpes is making up a greater share of ulcer disease. nongonococcal genital infection and chlamydia are thought to be the 2nd most common infection, however most centers do not have the facilities to isolate chlamydia. Genital warts are becoming a common cause for attendance at STD clinics and are a concern for cervical cancer. Prostitutes are most often cited as the source of male STD infection. The anonymity and large number of contacts of the sex industry, and high mobility of the indigenous population and of tourists are considered central in STD transmission. The high incidence of STDs in this area is a harbinger of future trends of HIV/AIDS in Asia.
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