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  Table of Contents  
LETTER TO THE EDITOR
Year : 2016  |  Volume : 7  |  Issue : 6  |  Page : 545-546  

Implementation of enhanced gonococcal antimicrobial surveillance program in Thailand


Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Chennai, Tamil Nadu, India

Date of Web Publication11-Nov-2016

Correspondence Address:
Saurabh R Shrivastava
3rd Floor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai Village, Thiruporur - Guduvancherry Main Road, Sembakkam Post, Kancheepuram - 603 108, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2229-5178.193920

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How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Implementation of enhanced gonococcal antimicrobial surveillance program in Thailand. Indian Dermatol Online J 2016;7:545-6

How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Implementation of enhanced gonococcal antimicrobial surveillance program in Thailand. Indian Dermatol Online J [serial online] 2016 [cited 2019 Jun 25];7:545-6. Available from: http://www.idoj.in/text.asp?2016/7/6/545/193920

Sir,

Globally, sexually transmitted infections (STIs) have an immense impact on the sexual and reproductive health, and the quality of life of the affected persons, and have been acknowledged as one of the five most common disease categories for which adults avail health care services.[1],[2] In fact, in excess of 1 million people acquire STIs everyday, and more than 350 million people every year acquire an infection among one of the four STIs, including gonorrhea.[2]

Although antibiotic resistance against most of the STIs has been reported, the situation is quite worse for gonorrhea, which might soon become intractable.[3] In fact, the resistance of gonorrhea to antibiotics has increased extensively in the recent years with cases of multidrug resistant gonorrhea, namely, penicillin, broad spectrum antibiotics, cephalosporins, and so on, being reported across 36 nations.[2],[3] In India, gonococcal resistance has been first reported from Madras, and since then its periodic monitoring has been done through the regional reference laboratory located in New Delhi.[4] The earmarked laboratory is conducting a nationwide Gonococcal Antimicrobial Surveillance Programme (GASP) since the year 2000 to evaluate the quality of resistance data and the capacity to detect newer resistance cases.[4] Furthermore, 10 nations have already reported that existing treatment guidelines are ineffective to contain gonorrhea.[2],[3]

The emergence of multidrug resistance against gonorrhea is quite a serious proposition, as a disease, which until very recently could be cured by taking a single dose of antibiotic, might now result in dramatic complications (such as infertility in women, pregnancy complications, and blindness in babies acquiring infection during childbirth), worry, and stigma among the affected persons and their family members.[5] This is quite a difficult aspect for the policy makers to contend with as they are already falling short in effectively responding to the existing challenges of deficiencies in infrastructure or resources, manpower constraints, low awareness, stigmatization, poor quality of services, limited follow-up of partners, absence of a comprehensive package of services under a single roof, deficiencies in screening, and offering quality-assured services to the high-risk groups.[1],[2],[3],[5]

To prevent the spread of gonorrhea, including the drug-resistant forms, it is crucial to offer prompt detection and appropriate care services to the people.[5] This is extremely important as most sections of people are quite reluctant to approach health care establishments, and thus it is our important responsibility to offer effective treatment when they do actually attend.[5],[6] Acknowledging the magnitude of the problem, its public health impact, and in an attempt to respond effectively, the World Health Organization (WHO) has advocated for the GASP to track the emergence and spread of gonorrhea resistance.[5] Over the years, this programme has been launched across various European nations, United States of America, and Morocco to streamline the extent of the problem and alter the treatment guidelines at the right time.[5],[6],[7]

Realizing the benefits of the GASP, an enhanced version of the program has been launched in Thailand in the month of November, 2015 in collaboration with the various international stakeholders to precisely estimate the number of people with illness, their demographic attributes, and nature of treatment desired, so that nondiscriminatory health services can be offered.[5] This program aims to strengthen the existing surveillance mechanism in the nation by standardizing the procedure for testing samples of gonorrhea in laboratories, obtain additional clinical/demographic/behavioral information, and to modify the current treatment guidelines based on the prevalence of antibiotic resistance to gonorrhea.[5] The generated data will simultaneously assist the WHO in monitoring the global trends and comparing the situation in different regions of the world.[5],[6],[7] The generated reports can be utilized by the policy makers from India as well, and necessary modifications in the existing policies can be made for containing the problem of antimicrobial resistance.[5],[6],[7]

In addition, the ability of a nation to assess and advocate for the most effective evidence-based, locally available antibiotic regimen, can be of immense utility for ensuring gonorrhea control.[6],[7] At the same time, there is an extensive need to strengthen the existing STI control services, work collectively to enable behavior modifications, ensure adherence to standardized treatment guidelines by the trained health professionals, and involve community in different stages of the program.[2],[5]

To conclude, the initiative to address the problem of gonococcal resistance through an enhanced surveillance mechanism can provide important evidence to formulate and implement cost-effective approaches to treat the disease without risking the lives of future generations.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
   References Top

1.
Chauhan V, Shah M, Thakkar S, Patel SV, Marfatia Y. Sexually transmitted infections in women: A correlation of clinical and laboratory diagnosis in cases of vaginal discharge syndrome. Indian Dermatol Online J 2014;5(Suppl 1):S1-5.  Back to cited text no. 1
    
2.
World Health Organization. Sexually Transmitted Infections (STIs)-Fact sheet No. 110; 2015. Available from: http://who.int/mediacentre/factsheets/fs110/en/. [Last accessed on 2015 Dec 10].  Back to cited text no. 2
    
3.
World Health Organization. Antibiotic Resistance-Fact Sheet; 2015. Available from: http://who.int/mediacentre/factsheets/antibiotic-resistance/en/. [Last accessed on 2015 Dec 5].  Back to cited text no. 3
    
4.
Bala M, Kakran M, Singh V, Sood S, Ramesh V; Members of WHO GASP SEAR Network. Monitoring antimicrobial resistance in Neisseria gonorrhoeae in selected countries of the WHO South-East Asia Region between 2009 and 2012: A retrospective analysis. Sex Transm Infect 2013;89(Suppl 4):iv28-35.  Back to cited text no. 4
    
5.
Spiteri G, Cole M, Unemo M, Hoffmann S, Ison C, van de Laar M. The European Gonococcal Antimicrobial Surveillance Programme (Euro-GASP)–a sentinel approach in the European Union (EU)/European Economic Area (EEA). Sex Transm Infect 2013;89(Suppl 4):iv16-8.  Back to cited text no. 5
    
6.
World Health Organization. Clinics in Thailand Target Antibiotic-Resistant Gonorrhea; 2015. Available from: http://who.int/features/2015/thailand-gonorrhea/en/. [Last accessed on 2015 Dec 8].  Back to cited text no. 6
    
7.
Hançali A, Ndowa F, Bellaji B, Bennani A, Kettani A, Charof R, et al. Antimicrobial resistance monitoring in Neisseria gonorrheae and strategic use of funds from the Global Fund to set up a systematic Moroccan gonococcal antimicrobial surveillance programme. Sex Transm Infect 2013;89(Suppl 4):iv24-7.  Back to cited text no. 7
    




 

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