특수층의 성병에 대한 지식도와 세균학적 검사

Abstract

[한글]

지금까지 특수지역 위안부의 실태 및 성병이환에 관한 조사연구에 대해서는 다수 보고 되었으나 실제로 이들의 대상중에 큰 비중을 차지하는 병사율에 대한 보고는 많지 않다.

이에 저자는 1977년 10월 1일부터 1978년 5월 31일까지 특수집단으로 간주되는 육군사병 성병환자 중 임질 50예, 비임균성 뇨도염 100예를 대상으로 하여 이들의 성병에 대한 지식도와 세균학적 검사를 시행하였으며 그 결과의 요지는 다음과 같다.

1. 교육정도는 89.3%가 고졸이상의 교육을 받은자로 성병에 대한 교육을 충분히 이해할 수 있는 학력을 지니고 있었다.

2. 성교육을 받은 경험이 있는 환자는 31.3%에 불과했으며 그나마 고교, 대학때 교수로부터 나, 입대후 군의관, 부대 중대장으로부터 비정규적으로 받은게 대부분이었다.

3. 입대전 성병의 경험이 있었던 예는 26%에 불과한데 비하여 입대후 처음으로 성병에 걸린 환자는 74%였다.

4. 가장 무서워하는 성병으로는 매독이 76.0%로 가장 많았으며, 성병치료제로 가장 좋다고 생각되는 약으로서는 49.3%에서 모른다고 하였으나 나머지에서는 penicillin, kanamycin, bactrim, terramycin등 다양하게 지적됨으로서 부적당한 자가처방에 의한 성병치료제의 남용 및 내성균의 증가가 우려되었다. 성병예방에 가장 좋다고 생각되는 방법으로 50.7%에서 condom을 20.0%에서 성교전후 항생제 투여가 지적되었으며 성병에 감염되어도 강력한 항생물질이 있기 때문에 안심이라는 위험한 생각을 지닌 한자도 32.7%가 있었다.

5. 성병의 감염원으로는 매춘부가 51.3%, 접대부 30.6%로 대부분이었으며 성병의 감염기회는 외박(54.5%), 휴가(36.0%)가 대부분이었다.

6. 분리 배양된 임균중 28.9%에서 다른 균과 복합배양 되었으며 그 대부분은 포도상구균이었다. 비임균성 뇨도염은 64.5%에서 coagulase양성 포도상구균이 분리 배양되었다.

7. 임균에 대한 약제 감수성 검사에서 cephalothin, cephacoridine예는 강한 내성균이 없었으며, coagulase양성 staphylococcus aureus에 대한 약제 감수성 검사에서도 이에 대

한 강한 내성균이 없어 가장 감수성이 높은 약제로 사료된다.

[영문]Since Dr. Fleming found out penicillin at the first time in 1946 many antibiotics were developed. Nevertheless, the incidence rate of venereal diseases have been increasing all over the world including in Korea. Therefore, the Korean government is now implementing venereal diseases control as a part of governmental medical care program since 1977.

Considering the importance of venereal diseases in the public health field, its control is more urgent and serious in the military group rather than in the civilian community.

A study on knowledge and attitude for the venereal disease and its control was tried with microbiological examination for 50 cases of gonorrhea and 100 cases of non-gonococcal urethritis among soldiers from October 1977 to May 1978.

The results obtained in this study were as follows;

1. In both patients of gonococcal and non-gonococcal urethritis, the majority (80.3%) received an education higher than the high school.

2. Only 31.3% of the patients had experiences of receiving sex education by teachers on high school or college, or military officers after military enlistment but not regular teaching.

3. Only 26.0% had the experience of venereal disease previously before enlisment.

This means 74.0%, not having any past history of venereal disease before enlisment, became to get once or more experiences of venereal disease after enlisment.

4. In understanding as the most dangerous venereal disease by patients, syphilis was indicated in 76.0%, gonorrhea 4.0%, nongonococcal urethriis 3.3%, and "Don't know" 15.3%.

5. In understanding as best kind of antibiotics for the treatment of venereal disease, various durgs were indicated, for example penicillin in 20.0%, kanamycin 9.3%, bactrim 4.7%, terramycin 4.0%, and others such as vibramycin, salvarsan,

tetracycline, gentamicin, trobicin. But 49.3% said "Don't know".

This implied the possibility of abuse of antibiotics for the treatment and increasing of resistant strains due to inappropriate self prescription.

6. As the best method of the prevention of the venereal disease, condom was answered in 50.7%, taking antibiotics before or after sexual contacts in 20%, washing genitalia or urination after sexual contact in some cases, but 25% of them

said "Don't know".

7. Of the patients, 32.7% didn't think it's serious to have venereal disease because of the presence of good natibiotics.

8. Prostitutes were 51.3% as infectious source of venereal disease, waitress of tearoom of saloon 30.6% followed in order by jobless girls, office girls, house maids and students.

9. In opportunity of infection of the venereal disease, sleeping outside of military camp was the highest rate 54.6%, followed in order by furlough 36.0% and official trips and going out in some cases.

10. Gonococcus was found in association with other organisms in 28.9%, mainly staphylococcus aureus. In non-gonococcal urethritis, coagulase positive staphylococcus aureus was found in 64.5%. So the prominent role of staphylococcus aureus, as the cause of non-gonococcal urethritis, appears clear.

11. In the in-vitro sensitivity to N. Gonorrhea, there was no resistant strains to cepholothin and cephaloridine, but 13% to penicillin, 3.3% to ampicillin and oxacillin, 6.7% to cloxa cillin and vibramycin, 20.0% to gentamicin and gantrisin,

23.3% to kanamycin, 30.0% to terranmycin, 63.1% to streptomycin and 80.0% ochloramphenicol.

12. In the in-vitro sensitivity test to coagulase positive staphylococcus aureus, the strains showed the greatest sensitivity to cephalothis and cephaloidine (no resistant strains)

Among the other antibiotics, 12.0% of the strains were resistant to oxacillin, 32.0% to cloxacillin, 22.0% to gentamicin, 24.0% to lincomycin, 40-80% to kanamycin, streptomycin, crythromycin, minocin, oleandomycin and more than 90% to tetracycline, terra mycin, gantrisin and chloramphemcol