Sexually-transmitted infections

I refer to The Times report (March 23) where it was stated that there were 143 cases of sexually- transmitted infections (STIs) in Malta during 2009. This number is based solely on three conditions (gonorrhoea, chlamydia and syphilis) which happen to be notifiable. However, this gives a falsely reassuring picture since the number of STIs diagnosed by the GU Clinic is actually much higher and most of these are not notifiable by law. Not being notifiable does not make them any less serious or worthy of mention. The STIs seen during 2009 by the GU Clinic were:

Non-specific Urethritis - 140
Muco-purulent cervicitis - 69
Chlamydia - 63
Gonorrhoea - 58
Syphilis -19
Trichomoniasis - 2
Ano-genital warts (HPV) - 248
Hepatitis B -10
Hepatitis C - 15
Genital Herpes Simplex - 37
Scabies - 9
HIV - 7

This amounts to a total of 677.

Moreover, the following conditions, which are not necessarily (or usually) sexually acquired are nonetheless associated with STIs:

Bacterial vaginosis -115
Candida - 211
Molluscum contagiosum - 53
Total: 379.

These figures are still very much an under-estimate as they do not represent the general population but only the select patients who attend the GU Clinic. Most patients with a potential STI frequent other practitioners, full screening is not done in most cases and notification is generally poor. Moreover, in the majority of cases it was not possible to trace the infected partners. One reason is that the GU clinic does not have a health adviser whose main task would be to trace patients thought to be infected. The clinic has therefore to rely on the index patient's goodwill to inform potentially infected partners. This is sadly often lacking. Moreover in some 50 per cent of cases these patients are not traceable as the sex is so casual that not even names are exchanged, never mind contact details.

I therefore suggest that the problem of STIs in Malta is much more serious than is first apparent.