Comparative Efficacy Of Fexofenadine, Levocetirizine, And Desloratadine In Chronic Spontaneous Urticaria: Impact Of Dose Escalation And Antihistamine Switching

Abstract

Background:
Sexually transmitted infections (STIs) remain a significant public health concern in India, contributing to increased morbidity and a heightened risk of HIV transmission. The COVID-19 pandemic has further influenced STI epidemiology by disrupting healthcare access and altering sexual behaviors. This study examines the epidemiological trends, syndromic presentations, and risk factors associated with STIs in a tertiary care hospital in Central Gujarat, India, during the second wave of the pandemic.

Methods:
A retrospective, cross-sectional, observational study was conducted at the STI clinic of a tertiary care hospital from April 2021 to March 2022. Medical records of 4,490 clinic attendees were reviewed, and 1,444 patients diagnosed with STIs were included. Data on demographic characteristics, syndromic presentations, and laboratory-confirmed infections (RPR, TPHA, and HIV) were analyzed. Statistical tests, including Chi-square analysis, were used to assess associations between variables.

Results:
The highest burden of STIs was observed among individuals aged 25–44 years (65.92%), with a notable predominance of female patients (77.4%). The most common syndromic presentations were lower abdominal pain (45.32%) and vaginal/cervical discharge (32.42%). Serological analysis revealed 181 RPR-reactive cases, with 85.64% showing TPHA positivity. Among 118 asymptomatic but high-risk patients, men who have sex with men (MSM) had the highest syphilis seropositivity (51 TPHA-positive cases). A significant association was found between syphilis and HIV co-infection (χ² = 33.83, p < 0.05), with 28.9% of HIV-positive individuals also testing positive for syphilis.

Conclusion:
This study highlights the continued burden of STIs in India, particularly among reproductive-age individuals, with a significant proportion of cases in women. The strong correlation between syphilis and high-risk sexual behaviors underscores the need for targeted interventions. Additionally, the high prevalence of HIV-syphilis co-infection reinforces the necessity of integrated STI and HIV screening programs. Strengthening surveillance, enhancing public awareness, and improving healthcare accessibility are critical for effective STI control in resource-limited settings, particularly during public health emergencies.