1. Sexually Transmitted Infections
Dr.Mittal Rathod

2. Introduction
• STDs vs STIs
• 5 “classical” venereal diseases
1. Syphilis,
2. Gonorrhoea,
3. Chancroid,
4. Lymphogranuloma venereum
5. Donovanosis
• second generation STDs

3. STIs can have serious consequences ,
• STIs like herpes and syphilis can increase the
risk of HIV acquisition three-fold or more.
Mother-to-child transmission of STIs can
result in stillbirth, neonatal death, low-birth-
weight and prematurity, sepsis, pneumonia,
neonatal conjunctivitis, and congenital
deformities.

4. Problem Statement
• 1 million sexually transmitted infections
(STIs)- world (WHO)
• 6 percent – India
• At any moment- 40% of women infected
• 1% completes the treatment

5. Agent Factors

6. Viral
AIDS
Genital
herpes
simplex
Genital warts
Bacterial
Syphilis
Gonorrhea
Non-
gonorrheal
urethritis
Chancroid
Non-specific
vaginitis
Granuloma
inguinale
Parasitic
Trichomonus
vaginitisand
urethritis.
Scabies
Pediculosis
pubis.
Fungal
Vaginal thrush
Valvovaginitis.
Balanitis

10. Host factors
1.Age: 20-24 years> 25-29 years> 15-19 years
The most serious morbidity is observed during fetal
development and in the neonate.
2. Gender:
• Morbidity-Male> Female
• Severity- Female> Male
3. Marital status: Single, separated, divorced>
Married
4. Socio economic status: Lower socio economic
status

11. Environmental Factors
1. Demographic factors:
• population explosion
• Increase in the number of young people,
• rural to urban migration;
• increasing educational opportunities for
women delaying their marriage and
increasing STD risks.

12. 2. Social Factors:
• Prostitution
• Broken homes
• Sexual disharmony
• Easy money
• Urbanization and industrialization
• Social disruption
• Changing behavioral patterns
• International travel
• Social stigma
• Alcoholism

14. Characteristics
Organism Spirochaete, treponema pallidum
Incubation Period 9-90 days
Reservoir Man
Infective material Body fluids
Transmission Contact with open lesion
Congenital infection
Inoculation infection
Signs/Symptoms Chancre-1 ,2, 3, Congenital
syphillis
Diagnosis dark field microscopic exam
Treatment Penicillin

15. Gonorrhea

16. Characteristics
Organism Neissearia Gonorrhea (Gonococcus)
Incubation Period 1- 5 days
Reservoir Man
Infective material Discharges of infected mucous
membranes, During birth
Transmission Only Sexual
Signs/Symptoms Urethritis, Cervicitis, Epididymitis
Complications Infertility
Diagnosis H/O, Pus, Complement fixation test
Treatment Penicillin, Amoxicillin,
Ceftrioxone

18. Characteristics
Organism Chlamydia trachomatis
Incubation Period 7- 21 days
Reservoir Man
Infective material Genital fluids
Transmission Sexual, during child birth
Signs/Symptoms Vaginal discharge, Pain, Burning
urination
Complications Infertility, PIDs, Epididymitis, LGV
Diagnosis Swab, Urine analysis, NAATs
Treatment Azithromycin, Doxycycline

19. TRICHOMONIASIS

20. Characteristics
Organism Trichomonas vaginalis
Incubation Period 5- 28 days
Reservoir Man
Infective material Discharges of infected mucous
membranes/ Genital fluids
Transmission Sexual
Signs/Symptoms Vaginal discharge, Pain, Burning,
Itching
Complications Prematurity, LBW
Diagnosis Microscopy
Treatment Metronidazole

21. DONOVANOSIS

22. Characteristics
Organism Klebsiella granulomatis
Incubation Period 3-21 days
Reservoir Man
Infective material Discharges of infected mucous
membranes
Transmission Sexual
Signs/Symptoms Granuloma Inguinale
Complications Ulceration, Fibrosis
Diagnosis Donovan bodies- Wright’s stain,
Giemsa stain
Treatment Azithromycin, Doxyxycline

23. GENITAL HERPES

24. Characteristics
Organism Herpes Simplex Virus
Incubation
Period
8 days-12 weeks
Reservoir Man
Infective
material
Discharges of infected mucous
membranes
Transmission Sexual, Skin –Skin contact
Signs/Symptom
s
Ulcers, Itching, Blisters
Complications Ulceration
Diagnosis Viral culture,
PCR
Treatment Acyclovir

25. HUMAN PAPILLOMA VIRUS

26. Characteristics
Organism Human Papilloma Virus
Incubation Period 1-20 months
Reservoir Man
Infective material Discharges of infected mucous
membranes
Transmission Sexual
Signs/Symptoms Warts, Abnormal vaginal bleeding
Complications Cancer
Diagnosis Microscopy, Cell culture,
Colposcopy
Treatment Cryotherapy, Surgical removal,
Vaccine

27. Syndromic Approach

28. Great Green Asked to ise Blue R You Black
1 2 3 4 5 6 7

29. 1.a Syndromic management of
urethral discharge in males

30. 1.b Management of Cervical Discharge/scrotal swelling

31. 2. Syndromic management of vaginal
discharge

32. 3. Management of genital ulcers

33. 4. Management of lower abdominal
pain in females

34. 5. Management of Inguinal Bubos

36. Prevention & Control
1. Case detection
2. Case holding and treatment
3. Epidemiological treatment
4. Personal prophylaxis
5. Health education

37. Support components
1. STD clinics
2. Laboratory services
3. Primary health care
4. Information system
5. Legislation
6. Social welfare measures