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Prevention and management of sexually transmitted diseases in adolescents.

This review focuses on the diagnosis and treatment of common sexually transmitted diseases (STDs) encountered among adolescents in the U.S. and other developed countries. Included are new recommendations for the treatment of primary and recurrent genital herpes, management of pelvic inflammatory disease, and a revised approach to the care of adolescent victims of sexual assault. Diagnosis begins with a classification based on major clinical findings: genital ulcers with lymphadenitis, urethritis, vaginal discharge, pelvic inflammatory disease, and male STD syndromes. Appropriate laboratory evaluation for each of these clinical presentations is detailed and treatment options are summarized. Preventive interventions along with suggestions for an approach to the preadolescent well care visit, generally scheduled at age 11ñ12 years, are offered. Routine preventive therapy after a sexual assault takes into account difficulty in follow-up and the need to reassure adolescents and their families that all prophylaxis for possible infection has been provided.

Adolescent↗

Genital ulcers disease among sexually transmitted disease clinic attendees in Ibadan, Nigeria.

Genital ulcer disease (GUD) is a risk factor in the transmission of human immuno deficiency virus (HIV). The goal of this study is to estimate proportion, identify risk factors, and improve prevention and control of GUD. This is a retrospective study of 211 cases of GUD seen between 1993 and 1997 in an urban public sexually transmitted disease (STD) clinic. Genital ulcers form 7.6% of all STDs seen. Overall, genital herpes was commonest (89 or 42.25%). It was the predominant infection (84 or 44.7%) in the males, while lymphogranuloma venereum (52 or 24.7%) was in females. The peak incidence in both sexes occurred in the 20-29 age group. Males out numbered females by a ratio of 8:1. Most of the patients were single 114 (68.3%) and most 70 or 33.3% were students. Risk markers identified were: casual sex (103 or 53.5%) and multiple sexual partners (77 or 36.5%). Both were significantly higher (P < 0.05) in single patients. Self-treatment, use of multiple drugs and incomplete course of antibiotics were also common. The need to intensify STDS education programmes to all occupational groups and to students in particular is highlighted. Commercial sex workers require periodic education, screening and treatment.

Adolescent↗