title: Pattern of sexually transmitted diseases in a Malagasy population.
abstract: BACKGROUND
  Data concerning the spectrum and antimicrobial susceptibility of STDs in Madagascar are scarce.
  
  
  OBJECTIVE
  Improvement of STD patient management in Madagascar.
  
  
  OBJECTIVE
  Assessment of the spectrum of STDs and improvement of therapy.
  
  
  METHODS
  Etiologic study of 400 patients (169 men, 231 women) under consultation at the major STD service in Antananarivo for one or more of the STD syndromes, urethral discharge, cervicovaginal discharge, genital ulcers, or condylomata according to a fixed diagnostic schedule.
  
  
  RESULTS
  Of genital ulcers, syphilis accounted for 46%, lymphogranuloma venereum for 24%, chancroid for 16%, and herpes for 1%. Of the syphilis cases, 51% presented as condyloma lata. Discharge was found in 124 men and 210 women. Counting concomitant infections separately, gonorrhea occurred in 69% of the men and 20% of the women with discharges, chlamydia infection in 42% and 52%, trichomoniasis in 9% and 31%, candidiasis in 12% and 30%. Bacterial vaginosis was found in 37% of the women with discharges. In 32% of male and 71% of female gonorrhea cases, there was concurrent chlamydia infection. Infection with HIV 1 or 2 was not detected. Determination of the antibiotic susceptibility of Neisseria gonorrhoea revealed high efficacy of ampicillin, ciprofloxacin, and spectinomycin; but frequent resistance to tetracycline and cotrimoxazole.
  
  
  CONCLUSIONS
  High priority should be given to the management of infections with chlamydia and with Treponema pallidum as well as to educational measures to increase awareness of genital ulcer disease.
authors.affiliation: Institut für Tropenmedizin Berlin, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Harms
authors.forename: R
authors.initials: R
authors.lastname: Matull
authors.forename: D
authors.initials: D
authors.lastname: Randrianasolo
authors.forename: J
authors.initials: J
authors.lastname: Andriamiadana
authors.forename: A
authors.initials: A
authors.lastname: Rasamindrakotroka
authors.forename: T
authors.initials: T
authors.lastname: Kirsch
authors.forename: U
authors.initials: U
authors.lastname: Hof
authors.forename: E
authors.initials: E
authors.lastname: Rarivoharilala
authors.forename: R
authors.initials: R
authors.lastname: Korte
mesh_terms: D000293:Adolescent; D000328:Adult; D004352:Drug Resistance, Microbial; D005260:Female; D006801:Humans; D008270:Madagascar / Q000453:epidemiology; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011159:Population Surveillance; D015995:Prevalence; D012749:Sexually Transmitted Diseases / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*