In recent years HIV infections have declined in many parts of the world, however, there are still 35 million persons living with HIV infection and 2.1 million new infections occurred in 2011 worldwide. In many areas HIV continues to affect certain at risk communities viz. men who have sex with men, sex workers, clients of sex workers and injecting drug users. In Singapore the number of newly diagnosed HIV infections appears to have stabilised, however the current trend is that infected individuals are presenting at a late stage of infection and more HIV infections are being diagnosed among MSM and fewer in heterosexuals. The trend for other sexually-transmitted infections is generally stable, with gonorrhea, Chlamydia trachomatis infection and anogenital herpes showing decreases, whilst the incidence of syphilis showed an increase in 2012. Interviews with patients attending the DSC Clinic indicate that most STIs are contracted locally from casual partners. Unregulated sex workers are more frequently cited as primary contacts than are local regulated sex workers, who continue to have very low levels of STIs, underlining the benefits of the programme of routine screening, treatment and condom negotiation skills training provided by the Department of STI Control (DSC) Clinic in Singapore.

INTRODUCTIONThis is a review of the epidemiology and trends of sexually transmitted infections (STIs) in Singapore from 1994 to 2003.

MATERIALS AND METHODSData collated for both notifiable and non-notifiable STIs from 1994 to 2003 were analysed. This data consisted of STI notifications from medical practitioners in Singapore as well as from the Department of STI Control clinic itself.

RESULTSThere was a decline in the overall STI incidence in Singapore in the first half of the last decade from 215 cases per 100,000 population (7,200 cases) in 1994 to 162 cases per 100,000 population (6,318 cases) in 1999, followed by an increasing trend in the number of acute STIs (both bacterial and viral) over the past 5 years to 195 cases per 100,000 population (8,175 cases) in 2003 (P <0.001). The incidence of HIV has risen sharply over the last decade whilst that of other viral STIs has not decreased. Singaporeans are becoming sexually active at a younger age, with casual partners constituting the main primary contacts.

CONCLUSIONSAlthough there has been a significant decline in the overall incidence of STIs in Singapore over the last decade, a rise in acute STIs over the last 5 years has resulted in the need to identify the causal factors, and to intensify existing as well as develop new STI/HIV prevention programmes for the general population and certain core groups.

Adolescent ; Adult ; Child ; Female ; HIV Infections ; epidemiology ; Humans ; Incidence ; Male ; Middle Aged ; Prevalence ; Retrospective Studies ; Sexually Transmitted Diseases, Viral ; epidemiology ; Singapore ; epidemiology

Objective: To evaluate an aqueous preparation from the Azadirachta indica leaves (AEA) against Setaria cervi (. S. cervi), a model filarial parasite. Method: In vitro efficacy of AEA was evaluated against S. cervi through estimation of relative motility value, dye exclusion test and MTT assay. Visible morphological alterations were monitored using conventional microscopic techniques in microfilariae and haematoxylin-eosin stained sections of AEA-treated adults. Results: Enhancement of reactive oxygen species in S. cervi treated with AEA was established through alteration in the activity of glutathione S-transferase, superoxide dismutase, catalase, peroxidase and level of superoxide anion and reduced glutathione. Conclusion: In vitro filaricidal activity of AEA is possibly through disturbing redox homeostasis by down-regulating and altering the level of some key antioxidants and regulatory enzymes like reduced glutathione, glutathione S-transferase, superoxide dismutase, catalase and glutathione peroxidase of S. cervi.