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Department of Reproductive Health and Research (RHR), World Health Organization
A guide to essential practice
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STI/RTI basics
Key points
What are RTIs? Reproductive tract infections are infections of the genital tract. They affect both women and men. Some RTIs (such as syphilis and gonorrhoea) are sexually transmitted, but many are not. In women, overgrowth of endogenous microorganisms normally found in the vagina may cause RTI (yeast infection, bacterial vaginosis). Medical interventions may provoke iatrogenic infection in several ways—endogenous organisms from the vagina or sexually transmitted organisms in the cervix may be pushed during a transcervical procedure into the upper genital tract and cause serious infection of the uterus, fallopian tubes and other pelvic organs. Organisms from outside the body can also be introduced into the upper genital tract during medical procedures if infection control is poor. In men, sexually transmitted infections are much more common than endogenous or iatrogenic infections. These different categories of infections are included together in this Guide for several reasons:
Figure 1.1. Sites of infection
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Contents
Infections of the male and female reproductive tract and their consequences: The role of clinical services in reducing the burden of STI/RTI Preventing STIs/RTIs and their complications How to prevent iatrogenic infections How to prevent endogenous infections Detecting STI/RTI STI/RTI education and counselling General skills for STI/RTI education and counselling Promoting prevention of STI/RTI and use of services Reducing barriers to use of services Raising awareness and promoting services Reaching groups that do not typically use reproductive health services STI/RTI Assessment during Routine Family Planning Visits Integrating STI/RTI assessment into routine FP services Family planning methods and STIs/RTIs STI/RTI Assessment in pregnancy, childbirth and the postpartum period Management of symptomatic STIs/RTIs Syndromic management of STI/RTI Management of common syndromes STI case management and prevention of new infections STI/RTI complications related to pregnancy, miscarriage, induced abortion, and the postpartum period Infection following childbirth Vaginal discharge in pregnancy and the postpartum period Sexual violence Medical and other care for survivors of sexual assault Annex 1. Clinical skills needed for STI/RTI Annex 2. Disinfection and universal precautions Preventing infection in clinical settings High-level disinfection: three steps Annex 3. Laboratory tests for RTI Interpreting syphilis test results Clinical criteria for bacterial vaginosis (BV) Gram stain microscopy of vaginal smears Use of Gram stain for diagnosis of cervical infection Annex 4. Medications Antibiotic treatments for gonorrhoa Annex 5. --------
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