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Sexually transmitted disease

Sexually transmitted disease. Syndromic approach to the diagnosis/management of STDs. Syndromic approach to the diagnosis and management of STDs - WHO strategy for the immediate management of STDs in resource-poor settings. Use flowcharts to guide diagnosis and treatment

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Sexually transmitted disease

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  1. Sexually transmitted disease Syndromic approach to the diagnosis/management of STDs

  2. Syndromic approach to the diagnosis and management of STDs • - WHO strategy for the immediate management of STDs in resource-poor settings. • Use flowcharts to guide diagnosis and treatment • Effective for urethral discharge and genital ulcer. • Unpractical for vaginal discharge (gonorrhoea, chlamydia and other cervical infections).

  3. Main syndromes of STDs • Urethral discharge • Vaginal discharge • Genital ulcers • Inguinal swellings • Genital growth • Pelvic pain • Rash

  4. “Sores” (ulcers) – Syphilis – Genital herpes (HSV-2, HSV-1) – Others: Chancroid/LGV/GI

  5. “Drips” (discharges) – Gonorrhea – N.G. urethritis/vaginitis/cervicitis – Bacterial Vaginosis – Candidiasis – Douching, chemical irritants

  6. Other major concerns – Genital HPV – Cervical Cancer

  7. What’s your diagnosis? 24 year male， 4 day of dysuria， painful urination and penile discharge

  8. 1.

  9. 2.

  10. Your diagnosis?

  11. What’s your diagnosis?

  12. 3.

  13. What’s your diagnosis?

  14. Smooth papular wart - ?

  15. Keratotic flat wart - ?

  16. Flat cervical warts - ?

  17. 4.

  18. General Principles of STDs Management • - Diagnose by history, P.E. and Laboratory testing • Prompt, simple and standard treatment • Screen for other STDs (HIV*) • Pregnacy evaluation • Psychosocial assessment • Contact tracing/follow-up • Health education/vaccination

  19. Global strategy for STD prevention/control

  20. Global strategy for STD prevention/control • Prevention by promoting safer sexual behavior • Provide STD treatment in basic health services • Proper treatment of STDs and sexual partners • Screening of clinically asymptomatic patients • Education Services for high-risk populations • Counseling and voluntary testing for HIV • Prevention and care of congenital STDs

  21. Key points • In their early stages, STDs are generally simple infections capable of rapid assessment and single dose treatment. • Some STDs are common infections in everyday practice, clinicians should be familiar with their management and inform the patients about these conditions. • In some situations, prolonged treatment is necessary. regular dose-missing may result in treatment failure. • STDs introduce psychosocial and sexuality questions in patients; clinician has a vital role in providing opportunities for patients to talk about and explore these uncertainties.

  22. • Contact tracing is an integral part of STDs treatment. All clinicians have a responsibility to help achieve successful outcomes in contact tracing. • Once the clinician has excluded pregnancy in a patient with pelvic pain, if the sexual history is suggestive, she or he should treat immediately for STD-related PID, pending results of tests and response to therapy. • Think of primary HIV infection in any patient diagnosed with STD, as well as in any patient with a flu-like illness.

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