Genital ulcer disease in women in Durban, South Africa.
OBJECTIVE
To study the microbial aetiology of genital ulcer disease (GUD) in women.


METHODS
Microbial and clinical assessment of genital ulcers in women.


METHODS
City Health sexually transmitted diseases clinic, King Edward VIII Hospital, Durban, South Africa.


METHODS
100 Zulu women with genital ulceration who had not received antibiotics in the previous two weeks.


RESULTS
Syphilis was diagnosed in 40%, genital herpes in 18%, donovanosis (granuloma inguinale) in 16%, chancroid in 14%, lymphogranuloma venereum in 7% and scabies in 2%. No recognised cause was detected in 18%. Secondary syphilis was diagnosed in 21%, primary syphilis in 16% and mixed primary and secondary syphilis in 3%. Multiple infections were detected in 13 women, of whom 12 had syphilis. Bleeding was observed from the ulcers of 59 during swab collection. Three women had HIV-1 antibodies. Neisseria gonorrhoeae was isolated from the ulcers and endocervix of two women and from the endocervix alone in nine. Generalised scabies was diagnosed in 14.


CONCLUSIONS
All the major causes of GUD are prevalent in Zulu women in Durban: secondary syphilis was the commonest diagnosis. Donovanosis, which often presents late with large ulcers, and genital herpes are now significant problems. Mixed infections with coexisting syphilis are common. All women in this population with GUD should be treated for syphilis and receive oral antibiotics effective for chancroid and donovanosis.
O'Farrell
N
N
City Health STD Department, King Edward VIII Hospital, Durban, South Africa.
Hoosen
A A
AA
Coetzee
K D
KD
van den Ende
J
J
D000293:Adolescent; D000328:Adult; D000818:Animals; D002157:Calymmatobacterium / Q000302:isolation & purification*; D005260:Female; D005831:Genital Diseases, Female / Q000453:epidemiology / Q000382:microbiology*; D006678:HIV / Q000302:isolation & purification; D006191:Haemophilus ducreyi / Q000302:isolation & purification*; D006801:Humans; D008875:Middle Aged; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification; D015995:Prevalence; D012520:Sarcoptes scabiei / Q000302:isolation & purification; D018139:Simplexvirus / Q000302:isolation & purification*; D013019:South Africa / Q000453:epidemiology; D014210:Treponema pallidum / Q000302:isolation & purification*; D014456:Ulcer / Q000453:epidemiology / Q000382:microbiology*