Sexually transmitted diseases on a tropical island.

The epidemiology control and treatment of sexually transmitted diseases (STD) in Singapore are outlined. The incidence of gonorrhea and syphilis increased from 136 and 14 cases/1000 respectively in 1970 to 149 and 21.4 cases/1000 in 1975. The number of cases of syphilis fell from 428 in 1975 to 201 in 1976 and a further 40% decline was recorded for the 1st half of 1977. Gonorrhea rates increased overall in 1976 but the number of cases among men declined and the identification rate among women (who outnumber men by 3:1 among gonorrhea cases) markedly improved. Singapore has exceptionally high rates of chancroid any lymphogranuloma venereum. 30% of STD cases are ages 20-24 and 21% are ages 25-29. 18.5% of male cases are ages 15-19 in contrast to only 5.6% of female cases. Health education programs are aimed at the general public secondary school children and boys in military service. A national health campaign against 6 infectious diseases including STD was launched in 1976 and followed in 1977 by a booster campaign on STD alone. A significant increase in knowledge was measured among students and military personnel. Since prostitutes comprise an important source of infection a medical scheme to periodically check and treat prostitutes was initiated in 1976. The decline in syphilis and in gonorrhea among men observed in 1977 is attributed to this scheme. Contact tracing has a 30% success rate. All contacts are investigated but not routinely treated. If epidemiologic investigation suggests infection the contact is treated after tests are performed. STD patients may seek treatment from a general practitioner or from a free public clinic operated by the Hospital Division of the Ministry of Health. Syphilis is treated with the long-acting benzathine penicillin and gonorrhea with either 3 megaunits of injection procaine penicillin or 2 gm of ampicillin with probenecid. Although there is no full-time department of dermato-venereology in the university medical students are taught the entire spectrum of STD. It has been government policy to share Singapores advanced laboratory facilities and expertise with neighboring countries.