Hussain, Nik Hazlina Nik and Lah, Nik Ahmad Zuky Nik
(2004)
A study on common sexually transmitted disease infection in infertile
female attended to infertility clinic, HUSM, Kota Bharu, Kelantan.
Masters thesis, Universiti Sains Malaysia.
Abstract
Introduction: Sexually tramsmittcd disease (STDs), once call ed venereal disease, are
among the most common infectious diseases in the world. In Western countries, there has
been a dramatic increase in the reported incidence 0f sexually transmitted diseases (STD)
during the past 25 years. It is tragic irony that despite medical efforts against sexually
transmitted di seases and the existence, since the 1 9~0 s, of powerrul treatments for them,
!he~e di se~ses ~,,crs ist; eVC:il il11 ive in the twenty first century.
This trend was augmented by ea rlier sexual maturity in girls and earlier age of onset of
sexual activity in both sexes. Other sociological changes which contribute to the
increased incidence of STD include urbani7.ation, increased mobility among the young,
and the greater ease of world-wide tra vel. Sexual tourism is increasingly common. This
last factor has also promoted the importation of unusual tropical STDs and antibioticresistant
infections.
Traditionally, five diseases ha ve been class ified as sexually transmitted diseases which
are syphilis, gonorrhoea, lyphogranuloma venereum, chancroid, and granuloma
inguinale. Lyphogranuloma venereum is one of disease caused by Chlamydia
thrachomatis. To d~t e more than 20 distinct sex ually transmitted or transmissible
pathogens were identified which may have different clinical lllanifestations. Ilowever in
this study we are only concentrate on three common sexually tran smitted diseases which
are chlamydia! infection, gonorrhoea and syphilis.
Chlamydia! inti!ction and gonorrhoea are wdl known to cause pelvic inflammatory
disease (PID) and their sequelae; infertility, chronic pehic pain and ectopic pregnancy,
whereas syphilis affect the outco1ne of the baby before and after the pregnancy. Another
important issue is that, the genital chlarnydial int'tction is mcreasing in trend worldwide.
Objectives: To determine the local prevalence of common organism m Sexually
Traus1niued Diseases (STDs) infections (C 'hlun~vdia lracbrnuatis, gonorrhoea and
syphilis) in intertHe len1ales attended to Jntertihty Clinic Hospital Universiti Sains
Malaysia, Kubang Kerian, Kota Bhant, Kelantau. And to dctennine the clearance rate of
('h/anzydia trachoJJzalis and gonorrhoea infection after a course of azithromycin I gram
single dosage.
Methodology: This 1s a prospective study involving 150 intertile females under
fOllow up at infertility clinic Department of Obstetrics and Gynaecology, Hospital
Universiti Sa ins tvtalaysia between I st of March 2002 lill 281h of February 2003 .
Endocervical saruples were obtained to detect ( 'hla11~~·dia trachotnatis by direct
immunofluorescence, Nei.1·seria gonorrhoea by Gram smear and culture & sensitivity.
Blood sa1nples vverc also obtained tbr Venereal Disease Research Laboratory (VDRL)
testing and tor lg f\·1 antibody toward chla1nydia.
For VORL testing positive patient another blood san1plc tor 'lieponetna pallidun
Conclusion: The prevalence of sexually transtnitted diseases (Chlarnydia trachomatis,
gonorrhoea and syphilis) infection in infertile female is lo\v in our studied g~oup. The
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clearance rate of Chlanzydia trachrnnatis infection by azithrotnycin is good. There is
statistically significant correlation behveen the incidences of tubal factor causing
infertility \vith Chlamydia trachontatis infection arnong thern. The prevalence is not a true
representation of Malaysian populations as it is a hospital-based study. A larger scale
study involving a few centers i~ needed in order to obtain a better representation of
Malaysian populations.
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