Rti & Sti
Rti & Sti
Rti & Sti
M2/1
Definitions
Reproductive Tract Infections (RTIs): Any infection of reproductive tract in male and female
Sexually Transmitted Infections (STIs): STIs are infections caused by germs such as bacteria, viruses, or protozoa that are passed from one person to another through sexual contact.
RTIs
RTIs in both men and women include: STIs RTIs in women also include: Disruption of normal vaginal flora (candida and bacterial vaginosis) Postpartum and postabortion infections Infections following procedures (e.g. IUD insertion)
M2/4
HIV AIDS
HIV is an STI
Transmitted through same behaviour (85% sexual route) Risk of STI = Risk of HIV
M2/5
Human behaviour Lack of access to healthcare Lack of awareness about STIs Migrating population Healthcare providers not adequately trained Poor medical services Hygiene and environmental factors Hormonal and other factors
M2/9
Biological Age Sex Immune status Behavioural Personal sexual behaviour Other non-sexual personal behaviour Even without any risk behaviour Social
M2/11
M2/12
Major cause of ill health in country Cause serious complications in men and women
M2/13
M2/17
Lack of knowledge Misconceptions Asymptomatic infections Where to go/Knowledge about service sites Reluctance to discuss sexual matters Stigma Fear of judgmental attitude of providers Reluctance for physical examination
M2/18
Preventive Curative
Prevents complications
M2/23
RTI/STI control needs both curative as well as preventive strategies working in tandem. We (the doctors) can play a major role in addressing either strategies. We must keep in mind the strong link between STIs and HIV while managing any RTI/STI case.
M2/24
To sum up .
RTIs/STIs are a major public health problem in India They cause serious complication in men, women and newborn Affect disease and financial burden to country There is a strong link between STIs and HIV There are bottlenecks in implementation and unless addressed quality services can't be provided
M2/16
M3/1
M3/3
Common RTIs/STIs
Male and female Gonorrhoea HIV HBV
Chlamydia
Syphilis Chancroid
Scabies
Pubic lice Molluscum contagiosum
Genital herpes
Lymphogranuloma venerium Trichomonas Genital warts Candidiasis
M3/4
Common RTIs/STIs
Only in Males:
Epididymitis/Orchitis
Only in Females
M3/5
M3/6
Urethral Discharge Burning or pain during micturation or urination. Genital Itching Inguinal swelling/Scrotal Swelling /swollen and painful testicles Blisters or ulcers on the genitals, anus or surrounding area, mouth, lips Itching or tingling in genital area. Warts on genitals, anus or surrounding area. Fever, body ache, muscle ache, dark coloured urine, jaundice.
M3/7
Blisters/ulcers on the genitals, anus or surrounding area, mouth, lips Burning micturation Itching or tingling in genital area. Warts on genitals, anus or surrounding area. Fever, body ache, muscle ache, dark coloured urine, jaundice.
M3/8
According to causative organisms According to modes of transmission According to most common presenting symptoms
M3/10
Bacterial: Examples: Gonorrhoea, Chlamydia, syphilis Viral: Example: Herpes, HPV, HIV Protozoal: Example:Trichomonas Fungal: Example: candidiasis Mixed: Example:PID, epididymitis
M3/11
Endogenous infection: Examples: yeast infection, vaginosis Sexually Transmitted Infections: Examples: Gonorrhoea, chlamydia, syphilis Iatrogenic Infections: Examples: PID following abortion or transcervical procedure
M3/12
Complications in Men
Urethral stricture Phimosis/paraphimosis Disfigurement of genitals Infertility Cardiovascular complications (syphilis) Neurosyphilis
M3/13
Complications inWomen
M3/14
Pelvic Inflammatory Disease (PID) Infertility Ectopic pregnancy Spontaneous abortions Stillbirths Low birth weight babies Increased susceptibility to opportunistic infections Cervical cancer Chronic pelvic pain
Complication in neonates
Congenital eye infections Syphilis, Chlamydia, gonorrhea Sepsis Arthritis Meningitis Infant pneumonias Mental retardation
M3/11
Systemic complications
Gastrointestinal: Proctitis, proctocolitis Renal: Acute membranous granulonephritis Neurological: GPI, Tabes dorsalis Cardiovascular: Myocarditis, aortitis Ophthalmic: Iritis, coroidoretinitis Musculoskeletal: Osteomyelitis, arthritis Septicemia
M3/15
To sum up .
The RTIs/STIs occur both in men and women , infect the reproductive organs. Classified according to the causative organisms and modes of transmission. Classification by presenting symptoms is practical for providers in easy and quick syndromic diagnosis management of STIs. Besides HIV infection, many other dreaded complications of STIs in men, women and neonates. Therefore, the healthcare providers must not waste any opportunity of treating RTIs/STIs at the first visit.
M3/16