Overview of the Prevalence of Patients with Sexually Transmitted Infections at Dr RM Djoelham Binjai Hospital in the Period of January 2019-July 2023

ABSTRACT


INTRODUSTION
Infection Infectious Sexual (IMS) is infection channel reproduction in cause by entry and development of causative germs to in channel reproduction .Transmitted through vaginal, anal/sexual intercourse anus, And oral/mouth (Nopitasari, Wahid, and Baharudin 2020) .Disease This No only causes clinical symptoms in the genitals only, but it can also cause interference on organ body other.In Indonesia venereal disease has been around for a long time known, with advances in science term general disease changed become Sexually Transmitted Disease (STD) or Disease Infectious Sexual (PMS), then Name STDs changed become Sexually Transmitted Infection (STI) Because involve sufferer without symptom or asymptomatic.Since 1998, known designation infection infectious sexual (IMS) Which meaning an infection transmitted from one person to person other through connection sexual [3] [4].
Based on data from World Health Organization (WHO) in 2012 , every year happen 357 million case new STIs on aged 15-49 years and the infection can still occur heal.Syphilis on Mother pregnant can cause death fetus And neonate ,more from 300,000 every year.Infection HPV( Human Papilloma Viruses ) relate with 530,000 ASUS cancer cervix And 264,000 deaths due to cervical cancer every year.Gonorrhea And chlamydia is reason leading cause of infertility worldwide.So that WHO declared strategy global For year 2030 with target between other lower incident syphilis, gonorrhea, infection new HIV (Human Immunodeficiency Virus ) , and death due to AIDS ( Acquired Immuno deficiency Syndrome ) as much 90%, as well as lower case congenital syphilis not enough from 50 per 100,000 birth life.Diseasedisease This spread throughout world, the highest incidence rate was recorded in South Asia and Southeast Asia, followed by Africa parts of the Sahara, Latin America and the Caribbean.Millions STIs by virus Also happen every year, including  301 HIV, herpes virus, human papilloma virus, and hepatitis B virus.According to data World Health Organization (2015) as much 36.9 million person Which HIV infection in 2014 was 34.3 million people happened in adults 17.4 million Woman And 2.6 million infect child aged,15 year [24].
In Indonesia, STIs Which most Lots found to be syphilis gonorrhea.Prevalence on citycity in Indonesia like in city Bandung, ie prevalence of gonorrhea (37.4%), chlamydia( 34.5%),And syphilis ( 25.2%).In city Surabaya prevalence infection chlamydia( 33.7%), syphilis (28.8% ) And gonorrhea (19.8%).In Jakarta prevalence infection gonorrhea (29.8%), syphilis (25.2%)And chlamydia ( 22.7% ).In Medan, disease syphilis increase especially on group of women workers sexual and disease This each year Keep going increase, since year 2003 increase ( 15.4 %),year 2004 ( 18.9 %), And year 2005 become( 22.1 %), And seen enhancement every the year 3% -4 %.Data Service Health Province Sumatra North (2012) found as much 1,464 case HIV/AIDS and 6,973 cases of STIs, meanwhile In Deli Serdang Regency there are cases HIV/AIDS as much 131 case And STIs as much 1,249 case.Case STIs in Regency Deli Serdang is amount the most the 3rd in Province Sumatra North after Medan City and Labuhan Regency Rock [9].Age mature And teenager (age 15-24 Year) constitutes 25% of all population who is sexually active, but provides share nearly 50% of all new STI cases Which obtained.In America case STIs Which detected only describe 50%-80% of all existing STI cases, perhaps in cause limitations screening And low news will STIs [7] .
Sexually Transmitted Infections (STIs) known as a disease sex This spread through sexual intercourse, vaginally, rectum or anal, oral or oral,otherwise through blood transfusions or sharing syringes on sufferer Which infected , sex free (change partner And without security, like condoms).STIsThis ,if No treated with optimal , can cause complications infertility until cancer neck rahi m on female , medium on Mother pregnant, can cause miscarriage or baby born disabled.
Infection infectious sexual This No always give rise to symptom And or only symptom light, so sufferer sometimes new aware of himself after complications arise or when their partner is diagnosed with it sexually transmitted infections.Symptoms that appear depending on the type of disease, generally symptoms include lumps, sores, or blisters on around the penis, vagina , anus, or mouth, itching in vagina or penis, taste burnt and pain i when throw away water small l or relate intimate, discharge from the penis (gonorrhea) or vaginal ( vaginal discharge ), pain in the lower abdomen down, fever And shivering, swelling gland sap clear or lump in groin , skin rash on the body, hands, or foot.
Symptom other on woman bleeding in outside the menstrual period and unpleasant odor from vagina , and on man Can sperm occurs bleeding , And swelling testicles [31] [12].
STIs in cause by infection bacteria, parasites, viruses nor mold .Consequence bacteria are: 1.Gonorrhea (GO) is caused by Neisseria Gonorrhoeae bacteria .Spread to other parts of the body through the bloodstream.Often happen on man ,after relate sexual with suspect Which infected previously, with symptom form itchy And hot moment BAK( Throw away Water Small), out fluid or pus yellow greenish spontaneously, the tip of the penis is red, swollen and felt hot .On Woman seldom cause complaints, unless they are serious, namely pain when urinating and thick white fluid coming out greenish.2. Urethritis Nonspecific / Infectious Genital Nonspecific (UNS) causes bacteria Chlamydia trachomatis And Ureaplasma ureallyticum .In women infectious diseases it attacks the cervix, often No give rise to complaints, pain on area pelvis, bleeding during sexual intercourse.On man attack channel urine in penis, with period shoots 1-3 Sunday or more with symptom form fluid runny in urinary tract, especially in the morning ( morning drop ) Sick moment BAK And Can in join in blood .Chlamydia is Wrong One disease infectious sexual Which number the incident Enough big.On year 2020 alone, WHO recorded approximately 129 million case in all over world [14] [21].3.Syphilis (lion king) the cause Treponema pallidum And nature chronic And attack Lots organ, depending level severity.Divided into: 1) Stage I Syphilis or Primary syphilis, appears 2-4 weeks after enter germs, lumps small ,changed So wound Which No Sick can is lost with itself without treatment lasts approx 3-10 week, sometimes happen swelling gland sap clear (KGB) .
After This Then enter to stadium II or syphilis secondary.2)Syphilisstadium II or syphilis secondary, emerges after 6 week-9 month after stadium I. Symptoms systemic appear form lust Eat decreased, fever, pain headaches, joint pain appear similar symptoms disease skin other, form spotting red in whole body, no itching, hair baldness, warts And Also can accompanied enlargement gland sap clear Which nature comprehensive.Stadium latent early (if syphilis untreated secondary), after several weeks or month symptoms will disappeared as if will recover spontaneously.However, the infection still occurs continues and enters the latent stage carry on .Late latent stage (after 1 year) Which can taking place many years 3) Stage III syphilis or tertiary syphilis, generally arise between 3-10 year after infection stadium This be marked 2 type abnormality, namely in the form of an abnormality destructive on skin, membrane mucus, bone joints, as well as inflammation that occurs slowly on the heart, vascular system blood And on nerve.[21]  Infection infectious sexual consequence virus between others: 1. Herpes genitals caused by herpes simplex virus (HSV), especially HSV type-2 Which often nature repeated.Symptom flavor burnt And itchy, a number of O'clock before the appearance of lesions, sometimes accompanied by symptoms general, for example weakness, fever and muscle aches as well as clustered bubbles and easy broken.Symptom lesion beginning can more heavy and long, if it occurs recurrence of disease or recurrence, usually preceded by a factor triggers, for example psychological stress, trauma, coitus excessive, stimulating foods, alcohol, drugs And a number of matter Which difficult known.
Virus This nature No active or hiding in in body without causes symptoms.Virus spread occurs through contact direct with partner who have been infected with .2. Condyloma acuminata or comb chicken or warts sex caused by Human Papilloma Virus (HPV).Arose rash on area place caught traumatized moment relate sexual form grow nodules Which pointed like warts, can grow, so that resembling a cock's comb.In women, often simultaneously with symptom vaginal discharge, whereas on man, especially found on Which No circumcised or with immunity disturbed .
Cause of cervical cancer 99.7% is a Human Papilloma Virus (HPV) infection Which persistent, infection HPV Which No managed well will be persistent, And circumstances This can become reason cervical cancer [33] [21] [14].3. HIV ( Human Immunodeficiency Virus ) spread through body fluids and attacks the immune system body, beginning its spread No will show symptom, Because virus will Sleep or silent self temporary time.However in turn, when the immune system is weakened, HIV developed into Acquired Immuno deficiency Syndrome (AIDS) Which very turn off.A number of stages HIV Which develop become AIDS i.e. 1).Period period window ,in where inspection test HIV antibodies still show negative results even though the virus has entered the blood large number of patients.Antibody HIV infection usually only appears in 3-6 weeks Sunday until 12 Sunday after infection primary.2).Acute phase of infection.HIV infects cell target, happen process replication Which produce virus new (virion) with amount until millions virions , And trigger appearance syndrome infection I with symptom Which similar disease flu or infection mononucleose.Also often give rise to abnormality on system nerve even though HIV exposure only occurs at a stage infection Which Still early.Symptoms on skin form rash macropapular erythematous And ulcer mukokuta.3).
Phase infection latent, that is formation of an HIV-specific immune response and trapped virus in cell Dendritic follicular (SDF) in center germinativum Lymph glands can cause virions recognized, symptom is lost, And start enter phase latent .Phase This seldom found virions in plasma so that the number virions in plasma decrease Because part Most of the virus accumulates in the lymph nodes and replication occurs in the lymph nodes.Infectious phase Latency lasts around 8-10 years (can be 3-13 years) after HIV infection.In the year of 8th after being infected with HIV, sufferers may will experience various symptom clinical, in the form of: fever , sweating on Evening day,lost heavy body not enough from 10% , diarrhea, lesions on mucosa And skin repeated.This symptom is an early sign of appearance infection opportunistic, incl swelling gland lymph And diarrhea in a way continously 4).The chronic infection phase (AIDS) is internal The lymph glands continue to replicate the HIV virus Which followed damage And death SDF ( Stromal Cell Derived Factors/Proteins in brain, marrow , etc.) Because many virus.Function gland lymph is as virus traps decrease or even disappear and the virus is shed into the blood.In phase This happen enhancement amount virions in a way excessive in the systemic circulation.Immune response No capable muffle amount virions Which excessive .temporary That, lymphocytes the more stressed Because intervention HIV Which increasingly Lots.This decrease in lymphocytes results in the immune system decreases and the sufferer becomes more prone to to various sick infection secondary.Journey disease Then the more progressive Which push to direction AIDS.Frequent accompanying secondary infections and sometimes several are also found type cancer, ie cancer gland sap clear And cancer sarcoma Kaposi's.On stage This, sufferer HIV/AIDS must quick taken to the doctor and underwent anti-Retrovirals Virus (ARVs).ARVs will rely on virus HIV in in body so that impact infection Can pressed.So HIV Actually can recognized as early as Possible so that Can push opportunity emergence AIDS [15] [22] [14].
Sexually transmitted infections caused by parasites, namely trichomoniasis, are caused by the parasite Trichomonas vaginalis, often without symptoms, if there are usually vaginal discharge (vaginal discharge) that is profuse and smelly, yellow-green in color, sometimes foamy, vaginal discharge that often causes complaints of itching and soreness of the vulva and surrounding skin and painful urination, dyspareunia, intermenstrual bleeding, postcoitus and strawberry cervix and only 2% of women cause vaginal discharge.In men, rarely gives complaints, if there are symptoms in the form of mild urethritis, sometimes there are no symptoms but can infect sexual partners [34] [21] STIs caused by fungi, namely candidiasis, vulvovaginitis, are caused by candida fungi, most often the albican species , apathogen but can become pathogen.Transmitted through connection sexual or arise due to certain conditions, such as stress, fatigue, long spiral contraception on partner age fertile.Period shoots hard is known by Because disease This have factor trigger, like pregnancy, diabetes, irritation local, usage drugs (group immunosuppressive, antibiotic, contraception hormonal).On normal circumstances, this fungus there is in skin nor in in burrow genitals woman And circumstances certain, mold This widespread so that give rise to vaginal discharge colored white like milk, lumpy, odorless or sour smelling, accompanied by hot itching and redness areas sex (Menaldi 2016) [21] [14].
For prevention done between other: postpone relate sex until aged over 20 years due to sexual intercourse First on age 15-20 year most risky sparked malignancy neck womb .Maintain the cleanliness of reproductive organs such as, trousers not strict, often changes clothes clean underwear, underwear material from cotton Which easy absorb dry.Avoid sex pre-wedding, changing partner or casual sex.Looking for information the truth about risk transmission of infection infectious sexual .Use condom when relate sexual .Don't use drugs/needles inject or Narcotics Psychotropics And Substance Addictive (Drugs).Screening routine For all man And woman age 15-65 year Which active having sex and all couples Which plan pregnancy.Vaccination, especially the HPV vaccine and hepatitis B [2] .Through good control like counseling in a way routine to layer public , expected prevalence STIs will decrease, which will be next impact to decline transmission HIV/AIDS, as well as morbidity and rates deaths related to STIs [20].

METHOD
This type of research is descriptive retrospective with design cross sectional And secondary data collection means, namely data patient visit new Which in diagnosis sexually transmitted infections (STI) recorded in Medical record Dr. General Hospital RM Djoelham .Purposeful For know description of the prevalence of sufferers of infectious infections sexual (IMS) at Dr RM General Hospital Djoelham Binjai January Period 2019-July 2023.Gonorrhea disease Which have high incidence of STIs.Gonorrhea infection occurs widely throughout world with a higher prevalence in various country develop including Indonesia [24].According to World Health Organization as much 70% female patients and some male patients infected with gonorrhea or chlamydia with symptoms who are asymptomatic (Rezeki, Halijah, Nasrawati 2020).Based on Report Survey Integrated And Biological Behavior (IBST) by Ministry Health R.I (2011), prevalence sexually transmitted disease in Indonesia on year 2011with infection gonorrhea And chlamydia as big as 179 % And syphilis as big as 44% [25] STIs own impact big on reproductive sexual health especially on public in country develop.In Asia, the number of new cases consisted of four types of STIs in 2008 it was estimated at 78.5 million; 7, 2 million case Chlamydia trachomatis; 25.4 million case Neisseria gonorrhea, 3.0 million case syphilis, And 42.9 million case Trichomonas vaginalis.Apart from that, in several other cases, like herpes simplex And HPV Also found on Woman reproductive (Puspitasari et al. 2019).. [12].

RESULTS AND DISCUSSIONS
According to WHO, on year 2016 It is estimated that there are 376 million new cases consists of the 4 most frequent types of PMS, namely chlamydiosis (127 million), gonorrhea (87 million), syphilis (6,3 million), And trichomoniasis (156 million [30].Also data World Health Organizations also globally more from 1 million person in world diagnosed suffer from STIs with a total of 276 million infections per year Which covers chlamydia, gonorrhea, trichomoniasis, and syphilis.Gonorrhea prevalence occupy position peak from all type STIs namely 32.4% then syphilis as much 21.7% .STI Estimation Results, in Indonesia in year 2020 show prevalence gonorrhea And infection chlamydia  307 on population key reach until 30 time more tall compared to the general population .According to Centers for Disease Controls (CDC) year 2022 disease infectious sexual Which most widely reported from various countries are syphilis (including syphilis congenital), gonorrhea, chlamydia, chancroid, And HIV ( human immunodeficiency virus ) [2] All  [14].
Adolescence is a period of life transition from period child And before enter period mature according to Act no.23 2002 concerning child protection (until aged 18 years).According to WHO adolescence age 10-19 year.Based on results report from Survey Demographics And Health Indonesia (SDKI) in 2017, around 8% were men and 2% women in the age range 15-24 years confess Once relate sexual before married [30].Number sexually transmitted diseases from year to year the more increase, part big case happen on group teenager aged 20-29 year.In terms of age, young people between 20-29 years is the highest group 46.4%, followed group age 30-39 year as much as 31.5% and aged 40-49 years as much 9.8% [24] [25] .
Based on survey Centers For Disease Controls and Prevention on year 2011, found as much 47% Student School Medium in the US has made contact sexual and 40% of them are classified as active, they No use condom.Connection sex Which No safe This can puts teenagers at high risk of contracting STIs.(Nur, Hendayani, and goddess 2018)(Ahmed 2019) .According to WHO, on year 2016 It is estimated that there are 376 million new cases consists from 4 type STIs Which most often.Based on group age, incidence And prevalence PMS Which most tall found on group age young 15-24 year, Where more from half sufferer case STIs new is at on range age the (Ahmad 2019) [30].

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On study Which done by researcher For group age Which most Lots is teenager And mature young And according to researcher matter This Possible in cause by condition they Which Still unstable look for teak himself, more easy affected, as well as Not yet know Good or or not something deed.Lack of knowledge teenager will impact association free started dating without exists supervision Which cause fell into in free association.At least information STIs make them have a willing attitude know and try to try.Including error in pattern foster person old Which covers aspects important like spirituality/faith, physique /physical, mental /psychic, intellectual, emotional, moral, social, sexual, And economy Which should in give it balance And in accordance with conditionhis children.So too case with education in school Can provide knowledge about the danger of STIs, then will achieved understanding And awareness about danger caused by this disease .Including characteristic want to copy something seen, environment in surroundings .
Based on type sex Period January 2019-July 2023 from 63 patient show type sex most Lots namely in the male gender as many as 39 patients (61.9 %).For kind multiple genders study has in do that is study by Fitri Abdullah Jawas [27].
On study Which done by researcher in HOSPITAL Dr. RM Djoelham Binjai, of the most common gender is man.Maybe this is because it happens very often patient man come treatment Alone And reject check it out partner sexual and also women's ignorance regarding problem sexual is sign chastity so that said that man more know problem sexuality than Woman Because Woman more passive whereas man active in look for information about sexuality, want to try activity sexual without looking Who his sex partner .Infection in women more often asymptomatic, so it was just discovered after cause consequence Which Serious, with thereby Lots Which No realize if Already infected so that can transmit to partner sexual.Apart from That on Woman Which Already Marry tend own perception very limited information about STI susceptibility This, consequence lack of diagnosis early when they infected STI, group This tend delay treatment, thereby continuing on development complications And Keep going do transmission on partner the sex.Aside difference characteristics Which owned man And Woman Also influence, where women tend to have feminine traits such as tending to be passive, not frank, not confident, reluctant talk about sexual And inclined feel Embarrassed or matter reluctant For in know.So that often in diagnosis after experience complications as a result development this STI disease.On study Which done researcher For type work Which most Lots is No apparatus civil country.According to Researchers can do many types of work make pressure on somebody so that give rise to stress Which continues give rise to pattern with behavior And changing habits It is good change productivity, activity, diet increasing smoke, consume alcohol, nervous, disturbance Sleep And others Also ,including behavior life sexual free Which used as road For remove stress they.Association free or sexual behavior is usually always on associated with social interactions among teenagers, will but moment This No only circles Only teenagers can socialize free the will but circles age mature even not escape from association free the.Along with the development of the sexual era free Can just happen on all type work.Maybe just Can in connect with condition social economy, behavior moral, lifestyle , cleanliness and other.
[14].4.Ulcer mole ( Chancroid ) is an infection genitals I, caused by the bacterium Haemophylus ducreyi , masa shoots 2-35 day, average 7 day.No Prodromal symptoms are found before they occur sores or ulcers and wounds are usually more than 1 fruit, pain, signs of inflammation, lumps were found in the groin that hurts or easily broken, leave ulcer And Klebsiella granulomatis.MomentThis disease This almost No Once or seldom found Again in Indonesia, first Lots found in area Papua , symptoms starting with a single lump or Lots, red, mushy, sometimes like boils, very itchy .The lump quickly bursts become wound with edge Which rising, smells fishy and easy bleeding.6.Lymphogranuloma veneer e um(LGV/ Bubo) is infection about system channel vessels lymph And gland lymph, Which caused by bacteria Chlamudia trachomatis L1, Chlamudia trachomatis L2, and Chlamudia trachomatis L3 (the cause The same with reason chlamydia but with different types).This disease too It is rarely found in Indonesia.Symptom The beginning starts with a nodule or resilience small Which in And in time short Then become erosion or wound Which sometimes No realized by sufferer because it is painless and can heal itself in time 1-4 Sunday.After wound heals, swelling of the gland will appear fold thigh Which accompanied flavor painful, hard, shaped like a sausage.7.Bacterial vaginosis happen consequence replacement Lactobacillus spp is flora normal vagina, with bacteria anaerobes in concentration tall.Complaint can without or with A little vaginal discharge Which smell fishy like fish, especially after relate sexual[30][21][14].

Table 1 .
Frequency Distribution Based on Diagnosis

Sexually Transmitted Infections (STIs) Table 1. Distribution Frequency Based on 3.1 Diagnosis Table 1. Frequency Distribution Based on Diagnosis STIs No
Based on table 1 on, results study show that incident STIs based on diagnosis Period January 2019-July 2023 from 63 the patient shows the form diagnosis most Lots that is gonorrhea as much 27 patients (42.9%)Table 2. Distribution Frequency STIs Based on Group Age

Table 2 . Frequency Distribution of STIs Based on Group Age
Based on table 2 on, results study show that incident STIs based on group age Period January 2019-July 2023 from 63 the patient pointed out group age most Lots that is on group age 17-25 year as much 27patient (42.9%)

Table 3 .
Frequency Distribution of STIs Based on Group Type Sex

.3 Table 4. Frequency Distribution of STIs Based on Group Age Based
on table 4 on, results study show that incident STIs based on group education Period January 2019-July 2023 from 63 patient show group education most many ie high school graduate/equivalent group as much 29 patients (21.4%)

Table 5 . Frequency Distribution of STIs Based on Type Work
Based on table 2 on, results study show that incident STIs based on group work Period January 2019-July 2023 from 63 patient show type work most Lots that is, not a State Civil Apparatus as much 20 patients (31.7 %).Based on study descriptive retrospective on new patient visits First with diagnosis STIs Which taken from data secondary from data Record Medic in HOSPITAL Dr RM Djoelham Binjai January Period 2019 -July 2023, with sample size 63 people .Based on the diagnosis January Period 2019-July 2023 from 63 the patient pointed out most common form of diagnosis namely gonorrhea as much 27 patients (42.9 %).A number of study other like research carried out Fitri Abdullah et al, with title Sufferer Gonorrhea in Division Disease Infectious Sexual Units Treat Road Knowledge Health Skin And Sex RSU Dr. Soetomo Surabaya 2002-2006, that sufferer gonorrhea from amount sufferer new gonorrhea in the period January 1, 2002-31 December 2006, that is as much 321 person sufferer, amount sufferer the most year 2004 as big as 69 sufferer, And Which most in 2002, namely 60 sufferers.In distribution month visit, Which the most is month September (10%), whereas Which most A little is month November (5.9%)Which state condition infection gonorrhea is in a relatively stable state (Jawas and Murtiastutik 2008).According to study by Ismiralda Okay Putranti, et al ,with title Difference Prevalence Disease Infection Infectious Sexual In Installation Treat Road HOSPITAL Prof. Dr. Margono Soekarjo Period 2010 -2014, with diagnosis the most Urethritis gonorrhea is disease STIs the most on man (76.8%), whereas condyloma acuminata the most on Woman (62.2%) [27].Study by Windiyaningsih Cicilia et al, with title Determinant Incident Infection Infectious Sexual (IMS) On Visitors Clinic Jelia, Jakarta Year 2014.Proportion visitors Clinic Jelia Which experience incident STIs There is as much 19.8%,Which consists from gonorrhea 7.8%, candidiasis 5.2%, HIV as much 5.2%, syphilis 1.9%, condyloma acuminata 0.8%, And Trichomoniasis 0.1%, whereas Which No experience incident There are as many as 80.2% STIs, because that's always the case use condom There is as big as 63.6%(Cicilia 2015).Study other by Venny Vildayanti , et al , with the title Knowledge and Attitude of Integrated Citizens at Ar-Rahman Foundation Towards the Behavior of Preventing Sexually Transmitted Infections Based on report Ministry Health Arab Saudi that STIs as much 39,049.Infection Infectious Sexual Which reported including trichomoniasis (28.1%), urethritis gonococele (14.2%), syphilis (8.7%)And HIV (7.5%)(Yulina, Jawiah, and Pastuty 2022) .Study other by Sri Widyastuti 1 , et al , with title Prevalence Trichomoniasis on Woman Risk Tall in Region Tour Baturaden Regency Banyumas Prevalence of Trichomoniasis in High Risk Women in the Baturaden Tourism Areas, Banyumas Regency.Found a case of trichomoniasis in woman risk tall in area tour Baturaden Regency Banyumas, as much 6,7 % [34].Study other by Resati Nando's Panonsih ,with title Profile of Patients with Sexually Transmitted Diseases On Service Primary Level I In City Bookie Lampung Year 2015.Frequency patient PMS on second Public health center Bookie Lampung year 2015 most Lots patient Which treatment to Health Center Treat Stay Long compared to Inpatient Health Centers Sukaraja (Panonsih 2016).Results study shows patients who seek treatment at the IMS polyclinic on month January-December year 2015 in Public health center Treat Stay Long recorded total 409 patient whereas in Public health center Treat Stay Sukaraja recorded total 395 patient.Based on data from Public health center Treat Stay Long And Public health center Treat Inap Sukaraja, the top five types of PMS diagnosis the most that is Bacterial vaginosis as many as 178 patients (45%), cervicitis in 23 patients (5.8%), UNG 20 patients (4.9%), UG 19 patients (4.6%), and syphilis in 11 patients (Panonsih 2016).Study other by Rachel Tamrat, et al ,with title Prevalence and Factors Associated with Sexually Transmitted Infections among Jimma University Students, Southwest Ethiopia.Infection infectious sexual Which the most Neisseria gonorrhoeae (7.4%) , Q. vaginalis (4.8%)And Q. pallidum (3.7%)(Tamrat et al. 2020).Research by Ni Putu Candra Nirmalasari et al.By title Prevalence And characteristics infection infectious sexual at the UPT Ubud II Orchid Clinic on month January -December 2016 ,with a total of 273 samples.Research result shows that the most common STI is HIV there is 134 case (49.1%), followed Syphilis There were 69 cases (25.3%), there were 61 cases of gonorrhea case (22.3%) as well as Condyloma Acuminata there is 9 case (3.3%)(Ni Putu Chandra Nirmalasari and Ni Made Bi Puspawati 2018).Meanwhile, there is another research by Mukhlisiana Ahmad ,with title Factor-Factor Which Relate With It happened Gonorrhea At the Tanah Sareal Community Health Center, Bogor City.Results study based on diagnosis is gonorrhea (Ahmad 2019).Study other by Abiyot Wolie Asres, et al, with title Prevalence and trends of sexually transmitted infections among pregnant women in Mizan Edge University Teaching Hospital, Southwest Ethiopia.Of the 300 samples there were 50 person ( 16.7%) with STIs , consists on HIV 15 samples (5%), candidiasis vulvovaginitis 11 person (3.7%), Q. vaginitis 10 person (3.3%), Hepatitis B virus 9 (3.0%),Hepatitis C virus 2 person (0.7%), and chlamydia as many as 3 people (1.0%)(Asres 2022).According to study Tuntun Maria ,with title Factor risk STIs at RSUD Dr.H. Abdul Moeloek Lampung Province 2012 -2016.Place study in HOSPITAL Dr. H. Abdul Moeloek Province Lampung, on month November-December 2017.Population in this study is sufferer STIs Which recorded in medical record books for 2012-2016 as many as 191 people, and a sample of 186 people.Results study get 4 type STIs Which caused by bacteria, that is gonorrhea, syphilis, condyloma And bartholinitis.Range age sufferer STIs that is 12-62 year, And Most are in the 12-25 year age group that is 93 person (50%).Sufferer STIs the most is man that is 100 person (53.8%), with the most education being High school students, namely 121 people (65.1%), suffer from STIs Which Work more Lots that is 102 person (54.8%), and STI sufferers originating from Bandar Lampung has more people, namely 103 people (55.4%)(Tutun 2018) .
results of research conducted showing results Which vary.On study Which done by researcher in RSUD Dr RM Djoelham Binjai is for diagnosis from STIs Which most Lots found is with diagnosis gonorrhea, indeed transmission gonorrhea Also is Wrong One from four disease infection infectious Which Lots in meet in public Indonesia And all over world , besides syphilis, chlamydia and trichomoniasis.2.Based on .groupage Period January 2019-July 2023 from 63 patient show group age most Lots that is on group age 17-25 year as much 27 patients (42.9%)Several studies have been carried out like study by Fitri Abdullah Jawas, Bi Murtiastutik with title Sufferer Gonorrhea in Division Disease Infectious Sexual Units Outpatient Knowledge Skin health And Gender RSU Dr. Soetomo Surabaya Year 2002-2006 .Based on distribution group age, sufferer gonorrhea the most found in the age group 25-44 years as much 169 sufferer (52.6%)(Jawas and Murtiastutik 2008).According to study Ismiralda Okay Putranti et al, with title Difference Prevalence Disease Infection Infectious Sexual In Installation Treat Road HOSPITAL Prof. Dr. Margono Soekarjo Period 2010 -2014, with the peak incidence Lots at the age of 20 -30 years [27].Tian researcher by Sri Widyastuti et al, with title Prevalence Trichomoniasis on Woman Risk Tall in Region Tour Baturaden Regency Banyumas Prevalence of Trichomoniasis in High Risk Women in the Baturaden Tourism Areas, Banyumas Regency.Found a case of trichomoniasis in respondents is at on age 21-30 years [34].Currently study other by Mukhlisiana Ahmad ,with title Factor-Factor Which Associated with the occurrence of gonorrhea in Public health center Land Sareal City Bogor.Results study based on age Which the most is group highest on age 20-29 year 22 people (45.80%) [34].According to study Tuntun Maria , with the title Risk factors for STIs in HOSPITAL Dr. H. Abdul Moeloek Province Lampung Year 2012 -2016.Place study in HOSPITAL Dr. H. Abdul Moeloek Province Lampung, on month November-December 2017.Population in this study is sufferer STIs Which recorded in medical record books for 2012-2016 as many as 191 people, and a sample of 186 people.Research results Age range of STI sufferers that is 12-62 year, And the most on age group 12-25 year that is 93 person (50%) (Tuntun 2018).In research by Ni Putu Chandra Nirmalasari et al ,with title Prevalence And characteristics infection infectious sexual at the UPT Ubud II Orchid Clinic on January -December 2016, with total sample as much 273 sample.Population STIs most in the age group 25-49 years as many as 166 cases (60.8%) (Ni Putu Candra Nirmalasari and Ni Made Bi Puspawati 2018).Research by Wiwin Mulianingsih, with the title Pathogen Description and Profile Sexually Transmitted Infections (STIs) during the year 2015-2020 is dominated by early adulthood (age 25 year -49 year) a number 1192 (50.9) and followed by late adolescence (age 20-24 year) a number 793 (33.9%), as well as teenager beginning (12.1%),And elderly (2.9%)(Mulianingsih et al. 2022).Study other by Resati Nando's Panonsih, with title Profile Patient Disease Infectious Sexual On Service Primary Level I In City Bookie Lampung Year 2015 Based on data from long-stay health centers and Public health center Treat Stay Sukaraja, type age Which the most, namely on age 25-49 year 491 patient (121.7%),age 20-24 year 264 patient (66%), age ≥50 year 26 patient (6.4%)And age 15-19 year 23 patient (5.7%)(Panonsih 2016) .Research by Moch.Maswan, with title Prevalence Disease Sexually Transmitted Infections in Entertainment Performers in Region Work Public health center Meninting Regency Lombok West Year 2020.On study This obtained distribution age a number 56 sample sufferer STIs namely, part big consists from group age 19 -35 year And Which most A little on age group < 19 years.Meanwhile agents reason STIs on study This most Lots found ie infection syphilis , Dwi Murtiastutik with title Sufferer Gonorrhea in Division Disease Infectious Sexual Units Treat Road Knowledge Health Skin And Sex RSU Dr. Soetomo Surabaya Year 2002-2006.Based on the gender distribution of sufferers over a period of 5 years, the most were men, namely 291 sufferers (90.7%), with ratio man And Woman as big as 10:1(Jawas and Murtiastutik 2008).According to study Which in do by Wiwin Mulianingsih, with the title Overview Pathogens And Infection Profile Sexually Transmitted (STI), where the gender is male suffer disease infection infectious sexual during 2015-2020 as many as 605 people, And disease infection infectious sexual in domination by type sex Woman a number 1735 (74.1%)(Mulianingsih et al. 2022).According to research by Resati Nando Panonsih with the title Disease Patient Profile Infectious Sexual On Service Primary Level I In City Bookie Lampung Year 2015, with results study show patients who went to the IMS polyclinic in 2018 January-December year 2015 in Public health center Long Hospitalization was recorded as a total of 409 patients while at the Sukaraja Inpatient Health Center a total of 395 patients were recorded.Based on data from Public health center Treat Stay Long And Sukaraja Inpatient Health Center, gender Which the most that is Woman 711 patient (177.2%)And man 93 patient (22.8%)(Panonsih 2016).Research by Ni Putu Candra et al.With title Prevalence and Characteristics Infection Infectious Sexual in Clinic Orchid UPT Ubud II on month January -December 2016, from 273 samples and found case STIs on man more tall that is 251 case (91.9%) whereas in women as many as 22 cases (8.1%) (Ni Putu Chandra Nirmalasari, Ni Made Bi Puspawati 2018).Research other by Mukhlisiana Ahmad, with title Factor-Factors Associated With Occurrence Gonorrhea In Community Health Center Land Sareal City Bogor.Research results according to gender type sex Woman 32 person (66.70%)(NiPutu Candra Nirmalasari and Ni Made Bi Puspawati 2018).According to study Fitri Abdullah Jawas, Bi Murtiastutik with title Sufferer Gonorrhea in Division Disease Infectious Sexual Units Treat Road Knowledge Health Skin And Gender RSU Dr. Soetomo Surabaya Year 2002-2006 .From total sufferer 321 people, types sex Which most Lots is , Which the most is man that is 291 sufferer (90.7%)(JawasMurtiastutik 2008).According to study Tuntun Maria , with the title Risk factors for STIs in HOSPITAL Dr. H. Abdul Moeloek Province Lampung Year 2012 -2016.Place study in HOSPITAL Dr. H. Abdul Moeloek Province Lampung, on month November-December 2017.Population in this study is sufferer STIs Which recorded in book record medical year 2012-2016 as much 191 person, And sample as much 186 people(Tuntun 2018).Results study in meet Most STI sufferers are men man that is 100 person (53.8%)(Tutun 2018).According to study Ismiralda Okay Putranti et al , with the title Differences in Disease Prevalence Infection Infectious Sexual In Installation Treat Road HOSPITAL Prof. Dr. Margono Soekarjo Period 2010 -2014.With research result, There were 54.9% male cases and Woman as much 45.1% (Sari 2017)oup education Period January 2019-July 2023 from 63 patient show group education most Lots that is group finished High school/equivalent 29 patients(21.4%).Several studies have also been carried out among them study Which done by Beautiful Inayah Sari, with title Description Factor Risk On Woman Age Fertile With Sexually Transmitted Diseases in Regional Hospital Sheikh Joseph from 90 respondents found most widely with an elementary school education level (37%), relate sex First time in under 25 years of age (66%), personal hygiene bad (64%) and behave unprotected sex (62%)(Sari 2017).Research by Wiwin Mulianingsih, with title Description Pathogens And Infection Profile Sexually Transmitted (IMS) Disease Infection Infectious Sexual During Year 2015-2020 ,with amount sample of 2340 people, from various types of education most Lots education JUNIOR HIGH SCHOOL (39.2%), followed by SENIOR HIGH SCHOOL (30.6%),Bachelor (3.9%),And No There is a number 1423 (61.8%) (Mulianingsih et al. 2022).According to Tuntun Maria's research, entitled Factors Risk of STIs at RSUD dr.H. Abdul Moeloek Province Lampung Year 2012 -2016.Place study in HOSPITAL Dr. H. Abdul Moeloek Lampung Province, in the month November-December 2017.Population on study This is sufferer STIs Which recorded in the medical record book in 2012-2016 as much 191 person, And sample as many as 186 people.Research results with The most education is high school, namely 121 people (65.1%) (Tuntun 2018).Meanwhile in study other by Resati Nando's Panonsih ,with title Profile Patient Disease Infectious Sexual On Service Primary Level I In City Bookie Lampung Year 2015.Based on data from the Inpatient Health Center Panjang and Sukaraja Inpatient Health Center, level education final Which most were junior high school graduates, 350 patients (87.3%), elementary school ,225 patient (56.%),SENIOR HIGH SCHOOL ,204 patient (50.4%), college ,22 patients (5.4%), and not attending school, 3 patients (0.7%) (Panonsih 2016)..On study Which done by researchers for groups of types of education the most is finished High school/equivalent.According to researcher finished High school/equivalent ,is level education Which Still not enough For get information ,experience And knowledge a individual, And naturally can impact to formation attitude somebody.Knowledge Which Good can influence someone's positive attitude, too It could also be that there is a lack of knowledge can influence somebody That behave negative.Individual with level education Which more tall in Possible right with many knowledge , they can do action prevention or preventive ,And treatment more OK.Education is element important someone to know various things There is in environment, incl protect yourself from risk of infection STIs.Based on group work Period January 2019-July 2023 from 63 patients show type work most Lots that is, not a State Civil Apparatus as much 20 patients (31.7 %).Some results research namely by Fitri Abdullah Jawas, Bi Murtiastutik with title Sufferer Gonorrhea in Division Disease Infectious Sexual Units Treat Road Knowledge Health Skin And Sex RSU Dr. Soetomo Surabaya Year 2002-2006.Based on work sufferer the most is private that is as much 134 sufferer (41.7%) (Jawas and Murtiastutik 2008).According to study by Wiwin Mulianingsih, with title l Overview Pathogen And Profile Infection Infectious Sexual (IMS) Disease infection infectious sexual during year 2015-2020 with amount sample of 2340 people, from various types of work the most by non-working employment status (37.1%), followed by Work (25.1%)And his occupation is unknown of (36.9%) (Mulianingsih et al. 2022) .Study other by Mukhlisiana Ahmad ,with title Factor-Factor Which Relate With It happened Gonorrhea In Public health center Land Sareal City Bogor.Results study based on work work highest among self-employed people 27 people (56.30%) (Ahmad 2019).According to study Fitri Abdullah Jawas, Bi Murtiastutik with title Gonorrhea Sufferers in the Infectious Diseases Division Sexual Units Treat Road Knowledge Health Skin And Sex RSU Dr. Soetomo Surabaya Year 2002-2006 .From total 321 people suffer from the largest number of jobs were 134 sufferers (41.7%) (Jawas and Murtiastutik 2008).According to study Tuntun Mary, with title Factor Risk STIs at Dr.H Regional Hospital.Abdul Moeloek Lampung Province 2012 -2016.Place study in HOSPITAL Dr. H. Abdul Moeloek Province Lampung, on month November-December 2017.Population in this study is sufferer STIs Which recorded in medical record books for 2012-2016 as many as 191 people, and a sample of 186 people.From results study 121 person (65.1%),STI sufferers, by status still working more, namely 102 people (54.8%) (Tuntun 2018) .