In South America, the number of women at risk for gonococcal pelvic inflammatory disease has increased greatly along with the incidence rates for gonorrhea. Further information is needed on the epidemiologic aspects of gonorrhea and PID in order to develop programs for optimal control of sexually transmitted disease (STD). We think that the control of STD, including PID, requires improvement of four basic factors: professional training in STD, management of STD by all levels of health care services, laboratory diagnostic services, and public education in STD.
PIP: The number of women at risk for gonococcal pelvic inflammatory disease has increased greatly in South America as has the incidence rates for gonorrhea. IN an effort to summarize the problems encountered in the control of sexually transmitted disease (STD) agents associated with pelvic inflammatory disease (PID), official documents prepared for the Pan American Health Organization and articles published in South American journals were reviewed. The problem of PID essentially involves fertile women between the ages of 15 and 49 years. Fertile women are at greater risk for STD, and the number of such women has increased markedly. Between 1970 and 1975, the reported incidence rates of gonoccal infection increased 29% in Bolivia, 25% in Uruguay, 15% in Argentina, and 13% in Colombia. The rates in Paraguay declined by 50%. Surveillance systems for STD are inaccurate in South American countries, and the health care services offer highly variable population coverage. In most South American countries, programs for the control of STD are limited to the control of prostitution and evaluation and treatment of prostitutes, prenatal serologic screening for syphilis, and studies performed in women attending hospital gynecology clinics. The other factors contributing to poor STD control are: the medical care system; medical care coverage; professional STD training; laboratory system; antibiotic misuse; and public education. Ignorance regarding STD on the part of physicians works as a major barrier to more effective control programs. It is essential that clinical services for STDs be available for the majority of a country's population.