Velarde-Jurado E, Estrada-Reyes E, Eraña-Guerra L, Raya-Rivera A, Velázquez-Armenta EY, Nava-Ocampo AA

Language: English
References: 34
Page: 641-646
PDF size: 88.02 Kb.

ABSTRACT

Objective. To identify clinical, laboratory and ultrasonographic evidence of a probable sexually transmitted infection associated with vulvovaginal symptoms in adolescents denying sexual activity. Material and Methods. The medical records of female adolescents, aged 10-18 years were reviewed. These women received first-time medical care for vulvovaginitis, between 1995 and 1999 at Hospital Infantil de México Federico Gómez, (Children’s Hospital). Comparisons between groups were performed, as appropriate, by the unpaired Student’s t-test, the Z test or the chi-square test; statistically significant differences were set at a twotailed p‹0.05. Odds ratios with 95% confidence intervals were calculated. Results. Of 258 adolescents with vulvovaginitis, 53 (20.5%) had a sexually transmitted microorganism and 52 of them denied ever having sexual activity. Age, education and socioeconomic level, development of sexual characters, and presence of menstruation did not differ between patients with and without sexually transmitted infections. The presence of sexually transmitted infections was associated with lower abdominal pain, abnormally colored vaginal discharge, a positive urine culture, and an abdominal ultrasonographic evidence, compatible with pelvic inflammatory disease (ultrasonographic odds ratio 144.8; 95% CI 51.0 to 411.3). Conclusions. There is an association between sexually transmitted infections in young women with vulvovaginitis and lower abdominal pain abnormally colored vaginal discharge, a positive urine culture, and an abdominal ultrasonographic evidence compatible with pelvic inflammatory disease.

REFERENCES

1. Instituto Nacional de Estadística, Geografía e Informática. Estados Unidos Mexicanos. XII Censo General de Población y Vivienda 2000: Resultados Finales. México, DF: INEGI, 2002. Disponible en: http://www.inegi.gob.mx/difusion/espanol/poblacion.

2. Instituto Nacional de Estadística, Geografía e Informática. Estados Unidos Mexicanos. Incidencia de enfermedades por grupo de edad. México, DF: INEGI, 1998.

3. Arredondo-García JL, Narcio-Reyes ML, Casanova-Román G, Figueroa-Damián R. Enfermedades transmitidas sexualmente (ETS) en un grupo de adolescentes que asisten a un instituto de atención perinatal. Gac Med Mex 1993;129:75-79.

4. Fernández-Paredes F, Sumano-Avendaño E, Escamilla-Avilés E, Hernández-Méndez JT. Infección genital por Chlamydia trachomatis en niñas y adolescentes. Bol Med Hosp Infant Mex 1986;43:595-598.

5. Velarde-Jurado E, Velázquez-Armenta Y, Nava-Ocampo AA. Mexican adolescents and sexually transmitted diseases: A privacy problem. J Adolesc Health 2002;31:4.

6. Daly LE, Bourke GJ. Interpretation and uses of medical statistics. Osney Mead (UK): Blackwell Science Ltd, 2000.

7. Tobías BB, Ricer RE. Counseling adolescents about sexuality. Prim Care 1998;25:49-70.

8. World Bank. Investing in young lives: The role of reproductive health. Washington, DC: World Bank, 1998. Disponible en: http://www.worldbank.org/html/extdr/hnp/ population/ynglives/ynglives.htm.

9. US Preventive Services Task Force. Screening for chlamydial infection: Recommendations and rationale. Am J Prev Med 2001;20(3 Suppl 1):90-94.

10. Buve A, Weiss HA, Laga M, van Dyck E, Musonda R, Zekeng L et al. The epidemiology of trichomoniasis in women in four African cities. AIDS 2001;15(Suppl 4):S89-S96.

11. Sellors JW, Karwalajtys TL, Kaczorowski J, Mahony JB, Lytwyn A, Chong S et al. Incidence, clearance and predictors of human papillomavirus infection in women. CMAJ 2003;168:421-425.

12. Stevens-Simon C, Nelligan D, Breese P, Jenny C, Douglas JM Jr. The prevalence of genital human papillomavirus infections in abused and nonabused preadolescent girls. Pediatrics 2000;106:645-649.

13. Sherman ME, Lörincz AT, Scott DR, Wacholder S, Castle PE, Glass AG et al. Baseline cytology, human papillomavirus testing, and risk for cervical neoplasia: A 10-year cohort analysis. J Natl Cancer Inst 2003;95:46-52.

14. Lazcano-Ponce E, Herrero R, Muñoz N, Cruz A, Shah KV, Alonso P et al. Epidemiology of HPV infection among Mexican women with normal cervical cytology. Int J Cancer 2001 91:412-420.

15. Linaldi-Camacho A, Urbina-Guerrero JR, Castañeda-Narváez JL. Vaginitis por Gardnerella vaginalis en niñas y adolescentes. Bol Med Hosp Infant Mex 1988;45:101-103.

16. Lazcano-Ponce E, Herrero R, Muñoz N, Hernández-Avila M, Salmerón J, Leyva A et al. High prevalence of human papillomavirus infection in Mexican males: Comparative study of penile-urethral swabs and urine samples. Sex Transm Dis 2001;28:277-280.

17. Elsner P, Hartmann AA, Wecker I. Gardnerella vaginalis is associated with other sexually transmittable microorganisms in the male urethra. Zentralbl Bakteriol Mikrobiol Hyg (A) 1988;269: 56-63.

18. Centers of Disease Control. Sexually transmitted disease surveillance 2001 supplement: Gonococcal Isolate Surveillance Project (GISP) annual report – 2001. Atlanta (GA): US Department of Health and Human Services, 2002. Disponible en: http://www.cdc.gov/std/g2SP2001text8.fig.pdf.

19. World Health Organization Task Force on the Prevention and Management of Infertility. Tubal infertility: Serologic relationship to past chlamydial and gonococcal infection. Sex Transm Dis 1995;22:71-77.

20. Steinhandler L, Peipert JF, Heber W, Montagno A, Cruickshank C. Combination of bacterial vaginosis and leukorrhea as a predictor of cervical chlamydial or gonococcal infection. Obstet Gynecol 2002;99:603-607.

21. Golden N, Cohen H, Gennari G, Neuhoff S. The use of pelvic ultrasonography in the evaluation of adolescents with pelvic inflammatory disease. Am J Dis Child 1987;141:1235-1238.

22. Tepper R, Aviram R, Cohen N, Cohen I, Holtzinger M, Beyth Y. Doppler flow characteristics in patients with pelvic inflammatory disease: Responders versus nonresponders to therapy. J Clin Ultrasound 1998;26:247-249.

23. Siegel DM, Aten MJ, Roghmann KJ. Self-reported honesty among middle and high school students responding to a sexual behavior questionnaire. J Adolesc Health 1998;23:20-28.

24. Chilton L, Berger JE, Melinkovich P, Nelson R, Rappo PD, Stoddard J et al. American Academy of Pediatrics, Pediatric Practice Action Group and Task Force on Medical Informatics. Privacy protection and health information: Patient rights and pediatrician responsibilities. Pediatrics 1999;104:973-977.

25. Chesney RW. Privacy and its regulation: Too much too soon, or too little too late. Pediatrics 2001;107:1423-1424.

26. Gotlieb EM. Privacy rights, HIPAA, and the AAP: About right; about time. Pediatrics 2002;109:146-149.

27. Vu HH. Cultural barriers between obstetrician-gynecologists and Vietnamese/Chinese immigrant women. Tex Med 1996;92:47-52.

28. Martínez-Ayala H, Villanueva LA, Torres C, García-Lara E. Agresión sexual en adolescentes. Estudio epidemiológico. Ginecol Obstet Mex 1999;67:449-453.

29. Population Action International. The PAI report card 2001: mundos diferentes, salud y riesgo sexuales y reproductivos. Washington, DC: PAI, 2001. Disponible en: http://www.64.24.182.238/resources/publications/worldofdifference/rr2_downloads.htm.

30. Saito MI. Sex education in school: Preventing unwanted pregnancy in adolescents. Int J Gynaecol Obst 1988;63(Suppl 1):S157-S160.

31. Carey MP, Braaten LS, Maisto SA, Gleason JR, Forsyth AD, Durant LE et al. Using information, motivational enhancement, and skills training to reduce the risk of HIV infection for low-income urban women: A second randomized clinical trial. Health Psychol 2000;19:3-11.

32. Speizer IS, Mullen SA, Amégee K. Gender differences in adult perspectives on adolescent reproductive behaviors: Evidence from Lomé, Togo. Int Fam Plann Perspect 2001;27:178-185. Disponible en: http://www.guttmacher.org/pubs/journals/ 2717801.pdf.

33. Hutson LA. Development of sexual assault nurse examiner programs. Nurs Clin North Am 2002;37:79-88.

34. Stermac LE, Stirpe TS. Efficacy of a 2-year-old sexual assault nurse examiner program in a Canadian hospital. J Emerg Nurs 2002;28:18-23.