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    Sexually Transmitted Infections: BY: DR Olasinde Abdulazeez Ayodeji Department of Community Medicine, ABUTH Zaria

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    Salihu Mustapha
    This document discusses syndromic management of sexually transmitted infections (STIs). It defines syndromic management as treating STI symptoms based on the most common causative organisms for each syndrome. The advantages are rapid treatment and avoiding expensive tests, while disadvantages include overtreatment and missing asymptomatic infections. Common STI syndromes covered are genital ulcer disease, urethral discharge, and vaginal discharge, along with their typical symptoms and most common causes.

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    Sexually Transmitted Infections: BY: DR Olasinde Abdulazeez Ayodeji Department of Community Medicine, ABUTH Zaria

    Uploaded by

    Salihu Mustapha
    36 views14 pages
    This document discusses syndromic management of sexually transmitted infections (STIs). It defines syndromic management as treating STI symptoms based on the most common causative organisms for each syndrome. The advantages are rapid treatment and avoiding expensive tests, while disadvantages include overtreatment and missing asymptomatic infections. Common STI syndromes covered are genital ulcer disease, urethral discharge, and vaginal discharge, along with their typical symptoms and most common causes.

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    This document discusses syndromic management of sexually transmitted infections (STIs). It defines syndromic management as treating STI symptoms based on the most common causative organisms for each syndrome. The advantages are rapid treatment and avoiding expensive tests, while disadvantages include overtreatment and missing asymptomatic infections. Common STI syndromes covered are genital ulcer disease, urethral discharge, and vaginal discharge, along with their typical symptoms and most common causes.

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    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    36 views14 pages

    Sexually Transmitted Infections: BY: DR Olasinde Abdulazeez Ayodeji Department of Community Medicine, ABUTH Zaria

    Uploaded by

    Salihu Mustapha
    This document discusses syndromic management of sexually transmitted infections (STIs). It defines syndromic management as treating STI symptoms based on the most common causative organisms for each syndrome. The advantages are rapid treatment and avoiding expensive tests, while disadvantages include overtreatment and missing asymptomatic infections. Common STI syndromes covered are genital ulcer disease, urethral discharge, and vaginal discharge, along with their typical symptoms and most common causes.

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    © All Rights Reserved
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    of 14

    SEXUALLY TRANSMITTED

    INFECTIONS
    BY:
    Dr OLASINDE ABDULAZEEZ AYODEJI
    Department of Community Medicine, ABUTH Zaria.
    OUTLINE
    • INTRODUCTION
    • SYNDROMIC MANAGEMENT OF SEXUALLY TRANSMITTED INFECTIONS
    • ADVANTAGES AND DISADVANTAGES OF SYNDROMIC MANAGEMENT
    OF STIs
    • COMMON STI SYNDROMES
    • FLOW CHART (PROTOCOLS) FOR STIs SYNDROMIC MANAGEMENT
    INTRODUCTION
    • Sexually transmitted infections (STIs) are infections spread predominantly by sexual
    contact, including vaginal, anal and oral sex.
    • Some STIs can also be spread through non-sexual means such as via blood or blood
    products. Many STIs including syphilis, hepatitis B, HIV, chlamydia, gonorrhoea, herpes,
    and HPV can also be transmitted from mother to child during pregnancy and
    childbirth.
    • More than 30 different bacteria, viruses and parasites are known to be transmitted
    through sexual contact.
    • Eight of these pathogens are linked to the greatest incidence of sexually transmitted
    disease. Of these 8 infections, 4 are currently curable: syphilis, gonorrhoea, chlamydia
    and trichomoniasis. The other 4 are viral infections which are incurable: hepatitis B,
    herpes simplex virus (HSV or herpes), HIV, and human papillomavirus (HPV).
    INTRODUCTION (contd.)
    • STIs are spread predominantly by sexual contact, including vaginal, anal
    and oral sex. Some STIs can also be spread through non-sexual means
    such as via blood or blood products. Many STIs—including syphilis,
    hepatitis B, HIV, chlamydia, gonorrhoea, herpes, and HPV—can also be
    transmitted from mother to child during pregnancy and childbirth.

    • A person can have an STI without having obvious symptoms of disease.


    Common symptoms of STIs include vaginal discharge, urethral discharge
    or burning in men, genital ulcers, and abdominal pain.
    SYNDROMIC MANAGEMENT OF
    SEXUALLY TRANSMITTED
    INFECTIONS (STIs)
    • Many healthcare facilities in developing countries lack the equipment and trained
    personnel required for etiological diagnosis of STIs (using laboratory tests to
    identify the causative agent).
    • Where no laboratories or point-of-care diagnostic tests are available, a syndrome-
    based approach to the management of STI patients should be promoted.
    • With the syndromic management approach, accessible, affordable, and effective
    management of individuals with STIs relies on utilization of flowcharts (algorithms)
    for each STI syndrome. The flowcharts enable diagnoses of common STI syndromes,
    provision of current country-specific appropriate treatment, and advice on the
    management of sexual partners.
    • Preferably, the flowcharts should be based on local etiological and antimicrobial
    susceptibility data. Otherwise, WHO treatment recommendations should be used.
    SYNDROMIC MANAGEMENT OF STIs
    (contd.)
    • Syndromic management refers to the approach of treating STI symptoms
    and signs based on the organisms most commonly responsible for each
    signs and symptoms (syndrome).
    • Syndromic management is simple, assures rapid, same-day treatment, and
    avoids expensive or unavailable diagnostic tests for patients that present
    with symptoms.
    • This approach results to overtreatment and missed treatment as majority of
    STIs are asymptomatic. Thus, in addition to syndromic management,
    screening strategies are essential.
    • To interrupt transmission of infection and prevent re-infection, treating
    sexual partners is an important component of STI case management.
    ADVANTAGES AND DISADVANTAGES
    OF SYNDROMIC MANAGEMENT OF
    STIs
    ADVANTAGES
    • Highly sensitive when used to detect infection among symptomatic patients,
    does not miss mixed infections, which are common
    • Treatment is given at first visit so delays in treatment are avoided and the
    patient is not lost to follow-up before treatment is initiated — this increases client
    satisfaction, and reduces further transmission and complications from untreated
    infections
    • Provides opportunity and time for education and counselling
    • Avoids expensive laboratory tests
    • Can be implemented at primary care level because it is easy to use, does not
    require highly trained STI specialists
    ADVANTAGES AND DISADVANTAGES
    OF SYNDROMIC MANAGEMENT OF
    STIs (contd.)
    ADVANTAGES (contd.)
    • Limits referral to specialist centres
    • Problem-orientated (based on patient’s symptoms)
    • High rates of cure, provided that the effectiveness of the drugs
    selected is adequate and properly monitored
    • The use of flow charts standardises diagnosis, treatment, referral and
    reporting, allowing for improved surveillance and programme
    management
    ADVANTAGES AND DISADVANTAGES
    OF SYNDROMIC MANAGEMENT OF
    STIs (contd.)
    DISADVANTAGES
    • Over-diagnosis and over-treatment that may result in increased drug costs, possible side-
    effects of multiple drugs, alterations in vaginal flora and potential for increased drug
    resistance
    • Cannot be used to detect infections among asymptomatic individuals
    • The syndromic approach for vaginal discharge is poorly predictive of the presence of cervical
    chlamydial and/or gonococcal infection
    • Over-treatment of partners of women with vaginal discharge, most of whom do not have an
    STI, may lead to potentially serious social and physical consequences for the female index case
    • Not easily accepted by doctors as thought of as inferior quality
    • Does not address the issue of poor treatment-seeking behaviour by symptomatic individuals
    COMMON STI SYNDROMES
    Most common
    Syndrome Symptoms Signs
    causes

    Chancroid
    Genital ulcer
    Genital sore Genital ulcers Genital herpes
    disease (GUD)
    Syphilis

    Dysuria (pain during urination) Urethral discharge (if


    Chlamydia
    Urethral discharge Frequent urination necessary, ask the patient to
    Gonorrhea
    Urethral discharge milk the urethra)

    Dyspareunia (pain during sexual


    Candidiasis
    intercorse)
    Abnormal vaginal Chlamydia
    Vaginal discharge Dysuria (pain during urination)
    discharge Gonorrhea
    Unusual vaginal discharge
    Trichomoniasis
    Vaginal itching

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