They are infection transmitted through sexual contact caused by bacteria, viruses or parasites. It involve the transmission of organism between sexual partners through different routes of sexual contact, either oral, anal or vaginal.
Symptoms and signs of RTIs/STIs in Men
• Urethral Discharge.
• Burning or pain during micturition or urination.
• Genital Itching.
• Inguinal swelling/scrotal Swelling / swollen and painful testicles.
• Blisters or ulcers on the genitals, anus or surrounding area, mouth, lip.
• Warts on genitals, anus or surrounding area.
• Fever, body-ache, muscle-ache, dark coloured urine, jaundice.
Symptoms and signs of RTIs/STIs in women
• Unusual Vaginal Discharge.
• Genital Itching.
• Abnormal and/or heavy vaginal bleeding.
• Dyspareunia
• Lower abdominal pain (pain below the belly button, pelvic pain).
Complications in Women
• Pelvic Inflammatory Disease (PID).
• Infertility.
• Ectopic pregnancy.
• Spontaneous abortions.
• Stillbirths.
• Low birth weight babies.
• Increased susceptibility to opportunistic infections.
• Cervical cancer.
• Chronic pelvic pain.
Complications in men
• Urethral stricture.
• Phimosis/paraphimosis.
• Disfigurement of genitals.
• Infertility.
• Cardiovascular complications (syphilis).
• Neurosyphilis.
Based on various presentations, seven major RTI/STI syndromes are incorporated in the National Guidelines on Management of RTI/STI, they are:
• Urethral Discharge
• Vaginal Discharge
• Genital Ulcers
• Inguinal Buboes
• Lower Abdominal Pain
• Acute scrotal pain and /or scrotal swelling
• Genital skin conditions STI / RTI syndromes in men
Symptoms | Syndrome | RTIs/STIs |
Urethral Discharge | Urethral / Vaginal discharge syndrome | Gonorrhoea, chlamydia, trichomonas |
Genital ulcers | Genital ulcer syndrome, | Chancroid, syphilis, genital herpes |
Inguinal buboes | Inguinal bubo syndrome | Lymphogranuloma venereum, Chancroid |
Scrotal swelling | Painful Scrotal Swelling | Gonorrhoea, chlamydia |
Genital skin conditions | Genital skin conditions | Genital warts. molluscum contagiosum, pediculosis pubis, scabies |
STI Syndromes in Women
Symptoms | Syndrome | RTIs/STIs |
Vaginal discharge |
Vaginal discharge syndrome | Gonorrhoea, chlamydiu, trichomoniasis, herpes simplex, Candidiasis, bacterial vaginosis, cervicitis |
Lower abdominal pain |
Lower abdominal pain syndrome | Gonorrhoea, chlamydia, mycoplosma, gardnerella, anaerobic bacteria (bacteroids, e.g. gram positive cocci) |
Genital Ulcers | Genital Ulcer syndrome | Syphilis, chancroid, genital herpes |
Genital skin conditions | Genital skin conditions | Genital warts, Molluscum contagiosum, pediculosis pubis, scabies |
Non-pharmacological treatment
• Educate and counsel the client and sexual partner regarding sexually transmitted infection/ reproductive tract infection, safer sex practices and importance of taking complete treatment.
• Treat partner. Advice sexual abstinence or condom use during the course of treatment. Provide condoms, educate about correct and consistent condom use.
• Refer all patients to ICTC.
• Follow up after 7 days for all sexually transmitted infections; on 3rd, 7th and 14th day for lower abdominal pain and on 7th, 14th and 21st day for inguinal bubo.
• If symptoms persist, re-assess for re-infection and advice prompt reference.
• Consider immunization against Hepatitis B.
Pharmacological treatment
• Various drug kits which are available as per Syndromic Management Protocol and provided by NACO at different health care levels in India.
Kit | Colour | Composition of kit | Syndrome/disease |
| Grey |
Tab. Azithromycin1g stat + TabCefixime 400 mg stat | Urethral discharge, cervical discharge, anorectal discharge, Painful scrotal swelling |
| Green | Tab. Secnidazole2g stat + Cap. Fluconazole 150mg stat | Vaginal discharge |
| White | Inj. Benzathine penicillin2.4mu IM Stat + Tab. Azithromycin 1g stat | Genital ulcerative disease (non-herpetic) |
| Blue | Cap. Doxycycline100mg BD for 15 Days + Tab. Azithromycin 1g stat | Genital ulcerative disease (non-herpetic) |
| Red | Tab. Acyclovir 400mg TDS for 7 days | Genital ulcerative disease (herpetic) |
| Yellow | Tab. Cefixime 400 mg stat + Tab. Metronidazole 400mg BD for 15 days + Cap. Doxycycline 100mg BD for 14 days |
Lower abdominal pain (LAP) |
| Black | Cap. Doxycycline100mg BD for 21 Days + Tab. Azithromycin 1g stat | Inguinal bubo |
References
No references available