NGHIEN CUtJ KHOA HOC
N H I I M LAU V A CHLAMYDIA d PHg NCf MAI DAM
TAI TRUNG TAM GlAO DUG DAY NGH& VA P H 6 N G KHAM
CQNG D 6 N G C U A THANH PHO H 6 CHf MINH, 2008 - 2009
Vu Hong Thai*, Le Thi Thanh Triic*, Phong Chi Dao TXiyen*
T6MTAT
Muc tieu nghien cdu. Chung tdi khao sat t i n h trang nhiem lau va Chlamydia d p h u n d m a i dam (PNMD) tai TTGDDN va p h d n g kham cong d d n g tai Tp. HCM.
PhUcfng phdp: Nghien cdu cat ngang tren 175 PNMD tai c i c TTGDDN va p h d n g kham cpng dong cua Tp.HCM tU 5/2008 den 5/2009. Benh nhan dupe kham, p h o n g van va xet n g h i e m mau va tiet chat t i m C.trachomatis (test nhanh), N.gonorrhoeae ( n h u p m Gram va cay), HIV, giang m a i . . .
/fe'tqud: 60%) PNMD cd t n e u chdng BLTQDTD v a 4 0 % khong trieu c h d n g va d a c d i e m hanhchanh cua hai nhdm PNMD khdng khac nhau cd y nghia, p > 0.05. N h d m PNMD cd trieu chdng nhiem chlamydia cao hon n h d m khdng trieu chdng (20%. so vdi 12.9%), p ^ 0,22). Ti ie n h i e m N.gonorrhea va HIV cua hai n h d m khdng khac nhau. PNMD ed trieu chdng BLTQDTD cd n g u y co viem c o t d c u n g (VCTC) gap 2.2 lan so vdi n h d m khdng trieu chdng (p = 0.03). PNMD cd VCTC cd nguy eo nhiem chlamydia cao gap 3,4 lan so vdi PNMD khac, (p = 0.002). PNMD hanh nghe nhieu noi hay khong quan he rinh due an toan thi de mac BLTQDTD.
Ketlugn:T\ le benh cua hai n h d m P N M D c d hay khdng cd trieu c h d n g BLTQDTD chua khac nhau cd y nghia, Dieu nay cho thay PNMD n h d m khong t n e u chdng co t h e la n g u y ca lay benh tiem tang cho cong d o n g .
Tir khoa: Phu n d mai d a m . Chlamydia trachomatis, N.gonorrhoeae.
I . D A T V A N D E h p p BLTQDTD, ke d e n l a u . Tl le n h i e m lau va Benh lay t r u y e n q u a d U d n g t i n h d y e C h l a m y d i a t h e o t h d t U d p h u nO mai dam (BLTQDTD) cd hay k h d n g cd loet e u n g lam (PNMD) t r o n g g i a m sat t r p n g d i e m 8.6%
gia t a n g kha n a n g lay lan HIV. Chlamydia va 2 . 6 % / 2 0 0 5 so v d i n a m 2 0 0 7 la 6.5%/lau trachomatis la tac n h a n gay b e n h t h u d n g [1]- N g h i e n c d u BLTQDTD t r e n PNMD tai g a p nhat va c h i e m k h o a n g 25 - 30 % t r d d n g 5dc T r a n g cua N g u y e n [5] c h o t h a y nhiem lau 14.9%> va C h l a m y d i a 4 8 . 4 % . T h e o Rou,
* Benh vien Da liiu TPHCM. nghien cdu tai 5 thanh pho Trung Quoc [7]
Phdn bien khoa hoc: PGS TS. Tran Lan Anh. ti le lau va Chlamydia tren PNMD la 26% va
1 4 D A L I E U H O C So 10 (Thang 03/2013)
NGHIEN CUtJ KHOA HQC
4 1 % ; n g h i e n c d u cua C o h a n t a i San Francisco [31 1 2 . 4 % v a 6 . 8 % .
Khoang 50% p h u n d n h i e m lau va 70 - 80%
phu n d nhiem clamydia la khong trieu chdng [2]. K h i nang lay nhiem Chlamydia n d sang nam cung n h u nam sang nCf k h 6 n g khae nhau 68%
so vdi 70% (PCR) va k h i nang lay cda lau t d n d sang nam 20-80% va nam sang n d 50-90%. Neu khong dieu trj lau va Chlamydia se de lai bien chdng rat nang ne c h o p h u n d n h u viem v u n g chau, gay thai ngoai t d cung, dau viJng chau man, v6 sinh, hoae v i e m ket mac tr^ so sinh...
PNMD la n h d m c6 hanh vi nguy co cao, quan the "bac eau" la ngudi bj BLTQDTD, va cac quan the nguy co "thap"- nghia v u quan s u (NVQS) va thai p h u (TP). PNMD la mae xich quan trpng trong viec lay truyen BLTQDTD cung nhuHIV.
De c d t h e giam t h i e u eae bien c h d n g nang ne cho p h u n d c u n g n h u g i l m di lay nhiem HIV t r o n g cpng d o n g , c h u n g t o i nghien cdu de tai nay vdi m y c tieu: Khdo sat tinh trang nhiem lau cau va Chlamydia trachomatis dphu ndmai ddm tgi TTGDDN va phong khdm cgng dong cua Tp. HCM.
II. DOI liSCKG VA PHI/ONG PHAP NGHIEN CCfU 2 . 1 . D o i tuong nghien cu'u
Tat c l eae PNMD m d i d e n TTGDDN t r o n g vdng 2 thang va PNMD den kham tai cac phdng kham cpng d d n g tai Tp.HCM t d t h i n g 5/2008 - 5/2009.
2.1.1. Tieuchuan chgn benh
Tat e l eae PNMD mdi d e n TTGDDN t r o n g vong 2 t h i n g va d e n kham tai p h d n g kham cdng d o n g tai Tp. HCM t d t h i n g 5/2008 - 5/2009 va dong y t h a m gia nghien cdu.
2.1.2. Tieu chuan logi triT: cd m p t t r o n g cac tieu chuan sau
- Doi t u p n g c d c l e benh t a m t h a n , cac b e n h /
chdng khdng kiem s o l t duoc hanh vi hoac - Khong d o n g y t h a m gia nghien cdu.
- PNMD den TTGDDN tren 2 t h i n g 2.2. Phuong phap nghien cUu
2.2.7. Thiet ke nghien cift/.-nghien cdu cat ngang
2.2.2. Cdmau: Udc lupng theo cdng thdc Z\i-a/2)XP{\-P)
n>-
ri'
P: so Udc doan t i le benh can nghien cdu d = 0.06 (sai so t o i da cua k h o i n g tin cay 95%)
L/dctinh ti le nhiem Chlamydia d p h u n d m a i d a m la 20% va lau 15%.
Vay c d mau can eho nghien cdu t d i thieu la 171 ngudi.
2.2.3. Cdc bien so nghien cCtu
' Cdc thong tin cd nhan: tuoi, noi sinh sdng, dan tdc, trinh d o hpc van, nghe nghiep, tinh trang hdn nhan va t h u nhap.
- Cac ddc diem lam sang vd can lam sang:
trieu chdng eO nang, tien sd BLTQDTD, 4 hdi chdng BLTQDTD, C.trachomatis, N. gonorrhoeae.
Trichomonas vaginalis. Candida...
Trieu chdng cO nang cua BLTQDTD nhd tieu rat, tieu buot, tiet djch a m dao, ngda, dau vCing bung d u d i . . . PNMD cd m o t trong nhdng trieu chdng nay ddpc xep vao nhdm cd trieu chdng.
PNMD khdng cd trieu chdng nao ddpc xep vao n h d m khdng trieu chdng.
- Cdc dgc diem hdnh vi tinh due, hanh nghemgi dam, mo tuy: quan he tinh due lan dau, noi tiep xuc t i n h due, d u n g bao cao su (BCS) khi quan he rinh due, d u n g ma tuy, noi hanh nghe, sd lUpng khich...
2.2.4. Cdc budc tien hdnh
Chpn cac hoc vien tai TTGDDN va eae phdng kham edng d o n g tai Tp.HCM thda man cac tieu
So 10 (Thang 03/2013) D A L I ^ U H O C I 1 5
NGHIEN CLTU KHOA HQC
chuan tren den khi d u so luong toi thieu can cho nghien cdu.
CIc ddi t u p n g duoc chpn se dUpc k h i m va phdng van theo mau nghien cdu da de ra.
Tat c l doi t u p n g nghien cdu dupc xet nghiem mau t a m s o l t giang mai va HIV (theo chien luoe hai), Tiet chat n h u p m gram va cay de x i c dinh nhiem lau va test nhanh de chan d o i n Chlamydia. Soi tUOi tiet ehat de t i m Trichomonas vaginalis, Candida va clue cells.
2.2.5. XCfly vdphdn tich so lieu So lieu nhap va x d ly bang phan m e m SPSS 15.0
Thong ke m d ta dugc t i n h tan so, ti le %.
Tim mdi lien he gida cac yeu to bang Chi binh p h u o n g Test va Independent Samples T Test. Khac biet cd y nghTa vdi p < 0.05 va khoang tin cay 95%.
III. K e i Q U A NGHIEN c a u
Qua khao sat 175 PNMD tai cac TTGDDN Phu Nghia, BlnhTrieu va cac p h o n g kham cpng d o n g
tai q u a n 3 , 4 , 8 , 1 0 cda Tp.HCM t d t h i n g 5/2008 den t h i n g 5/2009, n g h i e n cdu cho thay 60%
PNMD cd trieu c h d n g BLTQDTD va 4 0 % khong trieu c h d n g . Dac d i e m hanh chanh cua nhom PNMD cd va k h d n g cd trieu c h d n g BLTQDTD k h d n g khac nhau cd y nghTa, p>0.05.
Tuoi PNMD cua hai n h o m k h d n g k h i c nhau va CO n h d n g ngUdi rat tre 6 Ida t u o i thanh thieu nien. Trong c l hai n h o m h o n 5 0 % PNMD t d eae t i n h den Tp.HCM sinh sdng va da so trinh do hpc van t h a p t d biet dpc cho den cap 11, 80%
t r o n g n h d m c6 trieu c h d n g va n h d m khong trieu c h d n g 74.3%. 71.4% PNMD nhdm trieu chdng la lao d p n g ehan tay phan edn lai that nghiep 20.2% va mai d a m 7 . 1 % , tUOng tU nhU vay d n h d m k h o n g trieu c h d n g theo t h d tU la 78%, 10.2% va 8.5%. Ngoai ra eo t i le nhd PNMD la hpe sinh. Khoang 2/5 PNMD e l hai nhdm co gia d m h hoac song c h u n g k h d n g hon nhanva k h o i n g 9 5 % PNMD la n g d d i kinh. 50% PNMD ca hai n h d m t h u nhap t r u n g b i n h t h a n g dudi ba trieu d o n g .
Bdng 1. BLTQDTD chung ciia PNMD va giCta 2 nhom co va khong co trieu chd^g BLTQDTD
Benh Loet sinh due Viem CO tCr cung Chlamydia Gonorrhea Trichomonas vaginalis Candida albicans Mongga Giang mai HIV
Chung (n=105) N
1 48 30 3 13 20 6 3 13
%
0.6 27,4 171 1.7 7.4 11.4 3.4 1.7 7.4
Trieu chuTng (n=105) N 1 35 21 2 9 15 3 3 3
%
1 33.3
20 1.9 8.6 14.3 2.9 2.9 7.6
Khong trieu chufng (n= 70)
N 0 13
9 1 4 5 3 0 5
%
0 18.6 12.9 1.4 5.7 7.1 4.3 0 7.1
P value;
OR(95%CI) (giijra 2 nhom)
0.03;
2.2(1.1-4.5) 0.22 0.81 0.48 0.15 0.61 0.15 0.91
16
D A L I E U H O C So 10 (Thang 03/2013)NGHIEN CUtJ KHOA HOC
P N M D n h d m c d t r i e u c h d n g nhiem chlamydia (20%) cao hon n h d m k h d n g trieu chdng (12.9%), nhdng chda k h i c biet eo y nghTa. Tl le nhiem N.gonorrhoeae va HIV cda hai n h d m khdng khac nhau. PNMD n h d m cd trieu chdng BLTQDTD eo nguy eO viem eo t d eung (VCTC) gap 2.2 lan so vdi n h d m khdng trieu chdng (p=0.03).
Mat khae nghien cdu cho thay nhiem Chlamydia va VCTC d PNMD ed m d i lien he cd y nghia vdi p = 0.002, OR = 3.4,95% Cl (1.5 ^ 7 7) Ngoai ra, t i le nhiem HIV d n h d m PNMD cd bat kl BLTQDTD (12.7%.) cao hon so vdi nhdm khdng cd BLTQDTD (4.5%i), nhung sU k h i c biet nay chua thay co y nghTa t h d n g ke, p=0.069.
Bdng 2. Ddc diem hanh vi tinh due, ma tuy cda PNMD CO va khong co trieu chCdig BLTQDTD
Dac diem
Tuoi quan he tinh duclan dau Mean
Min - max Nai tiep xuc llnh due
Sinh dye - Sinh due va cac dudng khac Sinh dye - Sinh due
Ngira thai
Khong dung bao cao su Co dung bao cao su Diing BCS khi quan he tinh dye vcri ngUdi yeu*
Luonluon Thinh thoang Khong bao gid Tien sir eo BLTQDTD Dijng matijy
Trieu chijrng (n=105)
N 1 %
18±3.2 10-30
10 95
22 83
14 46 34
32 12
9.5 90.5
21 79
14.9 48.9 36.2
30.5 11.4
Khong trieu chuTng (n=70)
N 1 %
18.4 ±2.7 13-26
3 67
14 56
15 8 36
6 8
4.3 95.7
20 80
25.4 13.6 61
8.6 11.4
P value; OR 95% Ci
0.467
0 195
0.88
0.000
0.001 ; 4.7 (1.8-11.9)
1
* fl nhom trieu chirng = 94; n nhdm Ithong tri^u chiing = 59 C l hai n h d m PNMD quan he rinh due sdm, t r u n g binh t u o i quan he rinh due lan dau 18, da sd PNMD quan he rinh due t h e o d u d n g sinh due - sinh dye va gan 80% PNMD c l hai n h d m ngda thai bang diJng bao cao su.
Dung bao cao su (BCS) khi quan he rinh due vdi ngudi yeu gida hai n h d m PNMD khae nhau cd y nghTa (p - 0.000) va PNMD ed trieu chdng cd tien sd BLTQDTD cao 4.7 lan so vol nhom khdng trieu chdng, (p - 0.001).
So 10 (Thang 03/2013) D A L I E U H O C 1 7
NGHIEN citu KHOA HpC
Bang 3. Bgc diem hanh nghe mgl dam cOa nhom PNMD CO va khong co trieu chdng BLTQDTD
Dac diem
Thdi gian hanh nghe mai dam (thang) 25 % PNMD
50 % PNMD 75 % PNMD Min - max Noi hanh nghe
Dich vu (massage, quan bia caffe, nha hang...) Dudng phd
NhachCra
Hanh nghe mai dam nhieu nai 56 khach trung binh/1 tuan
Mean Mm -max
Gia trung binh moi landi khach (x 1000 VND)
<150 150-200 201 - 3 0 0
>300
Diing BCS khi quan he tinh due vdi khach quen*
Luon luon Thinh thoang Khong bao gid
Diing BCS khi quan he tinh dye vdi khach la£
Ludn luon Thinh thoang Khong bao gid
Tridu chtjmg (n=105)
N 1 %
1 3.5 12.2 0.1 -182.5 73 30 6 11
73 28.6
5.7 10.5
7.3 ± 6.6 1-35 18 58 17 12 35 47 6 58 43 2
17.1 55.2 16.1 11.4 39.8 53.4 6.8 563 41.7 1.9
Khong triSu chOng (n= 70)
N 1 %
1 2 12.2 1 ngay-243.3
43 23 4 1
65.2 32.9 5.7 1.4
6.7 ± 6.2 1 -28
9 38 14 9 33 9 3 58 8 2
12.9 54.3 20 12.9 73.3 20 6.7 85.3 11.8 2.9
P value; OR 95% Ci
0.28 0.02; 8.1 (1.02-64.03)
0.56
0.82
0.001
O.OOO
" f? nhom tneu chiing = 88; n nhom I<h6ng Irieu chitng = 45 'nnhom tneu chiing = 103; n nhom khong tneu chifng = 6 3/4 PNMD c l hai n h d m hanh nghe mai dam khoang 1 nam t r d lai va hanh nghe chu yeu tai nha hang, quan bia, massage... PNMD n h d m trieu chdng hanh nghe nhieu noi (10.5%) cao hdn so vdl n h d m khong trieu chdng (1.4%), p=G.02. PNMD n h o m khong trieu chdng ludn ludn d u n g BCS khi quan he rinh due vdi khach quen va khach la cao hon so vdi n h d m cd trieu chdng va sd khac biet co y nghTa, p < 0,001.
IV. B A N L U A N
Qua khao s i t 175 PNMD cua hai nhdm co trieu chdng va k h o n g trieu c h d n g BLTQDTD nghien cdu cho thay t u o i eua PNMD tUong doi tre, mac d u t u o i eCia hai n h o m khdng khac nhau cd y nghia n h d n g t r o n g n h o m c6 trieu chdng khoang 1/3 PNMD la Ida t u o i t h a n h thieu nien.
Tudi nay ca t h e va t a m ly chua phat trien hoan
18
D A L I § U H p C S6 10 (Thang 03/2013)NGHIEN CUU KHOA HOC
thien nen khi bj viem nhiem cd t h e de lai n h d n g di chdng nang ne sau nay. Hon 1/2 PNMD den t d c i c t i n h va hau het PNMD cd trinh do van hda thap co the vl vay ma 3/4 hp la lao d o n g chan tay va gan 1/4 that nghiep hay chpn mai dam n h u m d t nghe. Day cung la van de chung eua PNMD khdng ehl cd d t r o n g nghien edu nay ma gap d nghien cdu cua c l e t i c gia khac [4], [5], [8], [9]. De PNMD cd t h e chuyen doi nghe nghiep eua ho khdng p h l i la van de de ma can su h6 trp eua toan xa hdi de giup hp.
Nghien cdu cho thay 17.1%. PNMD nhiem Chlamydia ket qua nay gan gidng vdl nghien edu Sopheab, H tai Cambodia [9] va Patterson, T. L tai 2 thanh phd bien gidi Mexico-US [6] va thap hon nhieu so vdi ket qua nghien cdu tai China eua tac gia Wang, H.[10] va tai Bangladesh cua Mondal, N.I [4]. Nguoc lai, chi cd 1.7% PNMD nhiem lau
vise (bang 4), co the do t i le nhiem lau trong cdng dong dang giam dan. Theo so lieu thong ke cua b§nh vien Da lieu (BVDL) t i le nhiem lau t d BVDL va 24 phong kham da lieu quan huyen trong Tp.HCM g i l m dan 6.1 %/2003 xuong 1.1 %/2007 vl the ma t l le nhiem lau cda PNMD cung giam theo.
Nghien cdu nay eho thay Chlamydia tac nhan gay benh pho bien nhat, ke den Trichomonas, mong ga va giang mai.Ti le nhiem HIV cung thap hon rat nhieu so vdi cac nghien cdu cua cac nddc trong khu vdc [8], [10], Ket qua tren phan nao cung eho thay hieu qua cua cac chuong trinh giao due sdc khde cho PNMD ndi rieng va cpng ddng ndi chung. Ngoai ra trong nghien cdu nay ta thay t d 3/5 den 3/4 PNMD ludn ludn dung BCS khi quan he rinh dye vdi khach va 80% PNMD ngda thai bang d u n g BCS dieu nay phan nao cung giup cho PNMD giam nguon lay benh cho ban than va cho cpng ddng.
rat thap so vdi c l e nghien cdu khac trong khu
Bang 4: Mgt so kit qud nghien cuTu HIV/BLTQDTD tren PNMD cfmgtsontfdc
Tac gid/ Nam
Nghien eiiu hien tai (Shahmanesh, Covtfan et al. 2009) (Wang,Wang etal.
2009) (Sopheab, Morineau
et al. 2008) (Mondal, Hossain et
al. 2008) (Patterson, Sempie
et al. 2008)
N0i nghien cuTu
Tp.HCM, Vietnam Goa, India Kaiyuan city, Yunnan
province, China Cambodia Rajshahi City,
Bangladesh Tijuana and Ciudad
Juarez, fvlexico-US border cities
n FSWs
175 326 737 1079
150
924
%
G 1.7 8.9 8.3 13 23.3
6.4 CT 17.1 7.3 25.9 14.4 27.3
13 TV 7.4 9.4 10.6
20 Syphi
1.7
7.5 23 173
14.2 HiV 7.4 25.7 10.3 26
6
Mac d u t i le benh gida hai n h d m cd va khdng cd trieu chdng BLTQDTD khac nhau, nhUng sd khae b i M nay ehUa co y nghTa t h o n g ke. Dieu nay eho thay nguy eo lay benh cho cpng d o n g d PNMD nhom khdng trieu chdng Idn vl khdng
CO tneu chdng nhdng ngUdi nay cang chu quan nen It chii y d e p h d n g tranh benh cho b i n than va khaehvl vay ma benh c d e o hpi de lay truyen.
Dieu nay dat ra eho cac nha lam chuong trinh cung n h u c i c chUOng trinh giao due sdc khde
So 10 (Thang 03/2013) D A L l £ U H Q C | 1 9
J
NGHIEN CUU KHOA HOC
(GDSK) t r o n g viec q u I n ly BLTQDTD dat biet tren doi t u p n g PNMD.
Hanh vi rinh due, ma tuy va hanh nghe mai dam cua hai n h d m PNMD kha gidng nhau. Tuy nhien, cd mdt sd khae biet cd y nghTa n h d n h o m CO trieu chdng ed tien sd BLTQDTD cao gap 4.7 lan va hanh nghe mai dam nhieu noi cao gap 8.1 so vdi nhdm khdng trieu chdng, vl cang hanh nghe nhieu nai PNMD cang nhieu c d hpi riep xuc vdi nhdng nhdm khach hang khac nhau do d d cang nhieu nguy cd nhiem benh. Dung BCS khi quan he tinh due vdi khach la, khach quen va ngUdi yeu cung khac nhau cd y nghTa gida 2 n h d m . Nhdm khdng trieu chdng bao gid cung ludn dung BCS nhieu hon vdi cac ddi t d p n g tren so vdi nhdm khong trieu chdng. Dieu nay cho thay nhdm cang khdng quan he rinh due an toan thi cang de mac benh, do do chung ta can day manh GDSK ve quan he tinh due an toan cho PNMD ndi rieng va cdng dong ndi chung de tranh lay benh.
Nghien cdu co han che nhU PNMD thu nhan vao nghien cdu t d m p t sd phdng kham cong d o n g va trung tam giao due day nghe nen mau nghien cdu CO the chUa dai dien cho PNMD tai Tp.HCM.
V. KET LUAN
Qua khao sat 175 PNMD tai cac TTGDDN va phong kham cpng d o n g cua Tp.HCM t d t h i n g 5/2008 den t h i n g 5/2009 cho thay:
- H a n mdt nda PNMD den t d cac rinh va hau het PNMD CO trinh dp van hoa thap, hau het la lao d d n g chan tay va that nghiep.
Ti le nhiem N.gonorrhoeae va chlamyife cua hai n h d m PNMD n h o m co va khong cd trieu chdng BLTQDTD chua khac biet co y nghTa. Dieu nay cho thay PNMD n h o m k h o n g trieu chdngg t h e la nguy eo lay b e n h t i e m t a n g cho cpng ddfto - PNMD cd trieu c h d n g BLTQDTD co nguyca viem CO t d eung g a p 2.2 lan so vdi n h d m khong trieu c h d n g . PNMD cd VCTC ed n g u y co nhiem chlamydia cao g a p 3,4 lan so vdi PNMD khac.
- PNMD hanh n g h e mai d a m cang nhieu ndi cung n h u k h d n g q u a n he t i n h due an toan thi de mac BLTQDTD.
V I . K I ^ N N G H I
Td ket q u i cua nghien cdu chung tdl kien nghj:
- Nen dieu tri d i n h kl eho PNMD cd hay khong CO t n e u c h d n g BLTQDTD.
- Day m a n h g i l o due sdc khde ve quan he rinh due an t o a n eho PNMD noi rieng va cong d o n g ndi c h u n g .
C S m O n
CIc t i e g i l chan t h a n h c l m d n c i c PNMD da t h a m gia t r o n g n g h i e n cdu. CIc t i c gia chan thanh cam on t a t c l c i c baesTvaean bpytecCia Phdng Chi Dao Tuyen, khoa Xet Nghiem, Benh vien Da lieu Tp. HCM, can bp y te cua TTGDDN Phu NghTa, Binh Trieu va eae p h d n g kham cpng d o n g tai q u a n 3, 4, 8, 10 cda Tp.HCM da tham gia nghien cdu. Cac tae gia chan t h a n h cam m p h d n g Nghiep vu Y,Sd Y te Tp. HCM va Ban Giam Doc Benh Vien Da Lieu Tp. HCM da h6 trdde thuc hien n g h i e n cdu nay.
T A I LIEU T H A M KHAO
/. Bdo eao tong ket hogt dong cua Benh vien Da lieu Tp. HCM nam 2007
2. Tdi lieu tap huan qudn I'y benh Idy truyen qua dudng tinh due ndm 2004 tgi Tp.HCM cua National network of STD-HIV Prevention Training
Center va California STD/HIV Prevention Training Center.
3. Cohan, D., A. Lutnick, et al. (2006). "Sex worker health: San Francisco style." Sex Transtti Infect 82(5): 418-22.
20 DA LIEU HOC
So 10 (Thang 03/2013)NGHlfiN COU mQ^0^'
4. Mondal, N. I., K. Hossain, etal. (2008). "Sexual behavior and sexually transmitted diseases in street-based female sex workers in Rajshahi City, Bangladesh." Braz J Infect Dis 12(4): 287-92.
5. Nguyen, T. V., N. Van Khuu, et al. (2008).
"Sexually transmitted infections and risk factors for gonorrhea and chlamydia in female sex workers in Soc Trang, Vietnam." Sex Transm Dis 35(11): 935-40
6. Patterson, T. L, S. J. Sempie. et al. (2008).
"Prevalence and correlates of HIV infection among female sex workers in 2 Mexico-US border cities." J Infect Dis 197(5): 728-32.
7. Rou, K., Z. Wu, et al. (2007). "A five-city trial of a behavioural intervention to reduce sexually transmitted disease/HIV risk among sex workers in China." Aids 21 SuppI 8:595-101.
8. Shahmanesh, M., F. Cowan, et al. (2009).
"Theburden and determinants of HIV and sexually transmitted infections in „ population-based sample of female sex workers in Goa, India." Sex Transm Infect 85(1): 50-9.
9. Sopheab, H., G. Morineau. et ai (2008).
"Sustained high prevalence of sexually transmitted infections among female sex workers in Cambodia: high turnover seriously challenges the 100% Condom Use Programme." BMC Infect Dis 8:167
W. Wang, H., N. Wang, et ai (2009).
"Application of cumulative odds logistic model on risk factors analysis for sexually transmitted infections among female sex workers in Kaiyuan city, Yunnan province. China." Sex Transm Infect 85(4): 290-5.
GONORRHEA AND CHLAMYDIA IN FEMALE SEX W/ORKERS ATTHE VOCATIONAL EDUCATION CENTERS AND COMMUNITY CLINICS IN HO CHI MINH CITY, 2008 - 2009 Objective: We studied Gonorrhea and Chlamydia in the female sex workers (FSWs) with and w i t h o u t sexually transmitted disease (STD) symptoms at Vocarional Education Centers and Community Clinics in Ho Chi Minh City.
Methods: A cross-sectional study was performed among 175 FSWs recruited in vocational educarion centers and c o m m u n i t y clinics in Ho Chi Minh City from 5/2008 to 5/2009. They were examined, interviewed and tested for HIV and other sexually transmitted infections (STIs), [N.gonorrhoeae, C.trachomatis...).
Results: 60% FSWs had STD symptoms and 40% FSWs w i t h o u t STD symptoms. The following characteristics (age, education, residential areas and marital status) of t w o FSWs groups were not staristieally significant different (p > 0.05). FSWs w i t h STD symptoms had Chlamydia higher than FSWs w i t h o u t STD symptoms (20% vs 12.9%, p = 0.22). The rate of Gonorrhea and HIV in t w o groups were not different. FSWs w i t h STD symptoms had risk cervicitis 2.2 times than those w i t h o u t STD .symptoms, (p = 0.03). FSWs w i t h cervicitis had risk Chlamydia infection 3.4 times than other FSWs, (p
= 0.002). FSWs, w h o worked at many places and had unsafe sex were easy to get STDs.
Conclusions:The rate of t h e t w o FSWs groups having STD symptoms or not having STD symptoms were not significant different. It showed that FSWs w i t h o u t STD symptoms might be a hidden source of infecrion for c o m m u n i t y
Key words: Female sex workers, Chlamydia trachomatis, N.gonorrhoeae.
So 10 (Thang 03/2013) D A L i S U H O C I 2 1