Sexually Transmissible Infections in Clinical Practice: A Problem-Based Approach


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Table of Contents

They are simple and can be used even in remote areas as long as the necessary medicines are available. Equally important, syndromic management of these problems prevents new infections by providing curative treatment without delay and breaking the chain of infection. The syndromic approach to lower abdominal pain in women is widely used, even in developed countries.

Gonorrhoea and chlamydia are among the important causes of lower abdominal pain in women. This approach is designed to offer effective treatment to women with symptoms that could indicate pelvic inflammatory disease. Health care providers should realize that some women managed with this algorithm might not actually have PID false positives.

Vaginal infection bacterial vaginosis, trichomoniasis or yeast infection is the main cause of vaginal discharge. Vaginal discharge algorithms are not designed to detect the more serious and often asymptomatic cervical infections. At present, accurate detection of gonococcal and chlamydial cervicitis requires expensive laboratory tests, which are not available in most settings see Chapter 3 for advice on detecting cervical infections. In some special situations, treatment for cervical infection is justified. Sexually transmitted and other reproductive tract infections A guide to essential practice.

Table 8. What can be done about RTIs? Disinfection and universal precautions Preventing infection in clinical settings High-level disinfection: three steps Universal precautions Annex 3. One of the key questions identified was whether the use of POC diagnostic tests with lower sensitivity is acceptable for use. Such tests may be acceptable for use in certain settings where patients are not routinely tested or treated for STIs.

Adolescents and Young Adults | Prevention | STDs | CDC

In other words, there is a need to balance the sensitivity of POC tests with overall access to care. In addition to an expansion of existing tests that perform well, exciting new methods of pathogen detection were discussed. The ability to miniaturize tests, multiplexing technologies, and paper-based detection methods to reduce costs are all promising approaches. In regards to nanotechnology, use of nanochords or particles to amplify signals is promising development for POC STI diagnostics. Nanotechnology could therefore be used to make the detection of STIs better, faster, and easier.

A barrier to POC test development is how the current regulatory environment often makes it difficult to bring dual and multiplex diagnostic tests into practice. An additional challenge is in the regulation of multiplexed tests, where FDA requirements for analytical and clinical performance may be too stringent and insurmountable. Although making tests too inexpensive could deincentivize production, higher costs could limit adoption of such tests in developing countries.

In summary, although there is a clear and urgent need for rapid POC diagnostics for STIs, the field is in its very early stages. There are exciting new developments in diagnostic technology, but limited demand and challenges in the regulatory approval of such devices exist. Funders and developers will need vision and steady motivation to bring new diagnostics forward.

When and how that potential will be realized, however, remains to be seen. You may be trying to access this site from a secured browser on the server. Please enable scripts and reload this page. Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. For more information, please refer to our Privacy Policy. Subscribe to eTOC. Advanced Search. Toggle navigation. Subscribe Register Login.

A problem-based approach

Your Name: optional. Your Email:. Colleague's Email:. Separate multiple e-mails with a ;. Thought you might appreciate this item s I saw at Sexually Transmitted Diseases. Send a copy to your email. Some error has occurred while processing your request. Please try after some time. Conflict of interest: None declared. Received for publication October 10, , and accepted November 21, Back to Top Article Outline. National Institutes of Health. Cited Here World Health Organization. CDC and World Bank.


  • Fierce Family.
  • Final Recommendation Statement.
  • Table of Contents.

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Using Condoms Properly

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Sexually transmitted infection

Clinical Infectious Diseases. Preventing ophthalmia neonatorum. World Health Organization PLoS One ; e Point-of-care testing for sexually transmitted infections: Recent advances and implications for disease control. Are Treponema pallidum specific rapid and point-of-care tests for syphilis accurate enough for screening in resource limited settings? Evidence from a meta-analysis. PLoS One ; 8:e Epub Feb Sex Transm Infect Peeling RW. Diagnostics in a digital age: An opportunity to strengthen health systems and improve health outcomes.

Sexually Transmitted Infections: Stanford Medical Minutes with Dr. Zolopa

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Adolescents and Young Adults

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Maternal syphilis infection is associated with increased risk of mother-to-child transmission of HIV in Malawi. AIDS ; — High HIV and ulcerative sexually transmitted infection incidence estimates among men who have sex with men in Peru: Awaiting for an effective preventive intervention.

Virulent Treponema pallidum , lipoprotein, and synthetic lipopeptides induce CCR5 on human monocytes and enhance their susceptibility to infection by human immunodeficiency virus type 1. J Infect Dis ; — Cost-effectiveness of HIV and syphilis antenatal screening: A modelling study. Simultaneous triple point-of-care testing for HIV, syphilis and hepatitis B virus to prevent mother-to-child transmission in India.

Pant Pai N, Daher J. Multiplexed testing for HIV and related bacterial and viral co-infections. Expert Rev Mol Diagn;— Diagnostic accuracy of rapid tests for sexually transmitted infections in symptomatic women.

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Sexually Transmissible Infections in Clinical Practice: A Problem-Based Approach Sexually Transmissible Infections in Clinical Practice: A Problem-Based Approach
Sexually Transmissible Infections in Clinical Practice: A Problem-Based Approach Sexually Transmissible Infections in Clinical Practice: A Problem-Based Approach
Sexually Transmissible Infections in Clinical Practice: A Problem-Based Approach Sexually Transmissible Infections in Clinical Practice: A Problem-Based Approach
Sexually Transmissible Infections in Clinical Practice: A Problem-Based Approach Sexually Transmissible Infections in Clinical Practice: A Problem-Based Approach
Sexually Transmissible Infections in Clinical Practice: A Problem-Based Approach Sexually Transmissible Infections in Clinical Practice: A Problem-Based Approach

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