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Department of Reproductive Health and Research (RHR), World Health Organization
A guide to essential practice
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Annexes STI/RTI reference table STI/RTI Etiological agent Acute manifestations Possible complications Effect on pregnancy and newborn Sexually transmitted infections Gonorrhoea Neisseria gonorrhoeae In women: cervicitis, urethritis In men: urethritis In women: pelvic inflammatory disease (PID),
infertility, ectopic pregnancy, chronic pelvic pain In men: epididymitis, prostatitis, urethral
strictures In both women and men: disseminated gonococcal
infection, arthritis, endocarditis, meningitis Pregnancy: spontaneous abortion, postpartum
endometritis, prelabour rupture of membranes, preterm delivery Newborn: ophthalmia neonatorum Chlamydial infection Chlamydia trachomatis In women: cervicitis, urethritis In men: urethritis In women: PID, infertility, ectopic pregnancy,
chronic pelvic pain In men: epididymitis, prostatitis, urethral
strictures In both women and men: disseminated gonococcal
infection, arthritis, endocarditis, meningitis Pregnancy: preterm delivery Newborn: low birth weight, conjunctivitis,
pneumonia, otitis Trichomoniasis Trichomonas vaginalis In women: vaginitis In men: urethritis In women: not known In men: prostatitis, urethral strictures,
possibly infertility Pregnancy: prelabour rupture of membranes,
preterm delivery, post-caesarean endometritis Newborn: transientvaginal infection Syphilis Treponema pallidum In both women and men: painless oral and anal
genital ulcers, secondary (disseminated) syphilis: skin rash,
malaise, headaches, muscle aches, weight loss, low-grade fever In both women and men: neurological,
cardiovascular and other systemic complications resulting from
tertiary (late) syphilis Pregnancy: spontaneous abortion, postpartum
endometritis, prelabour rupture of membranes, preterm delivery Newborn: congenital infection
abnormalities Chancroid Haemophilus ducreyi In both women and men: genital ulcer (often
painful), painful inguinal adenitis In women: rectovaginal fistula, inguinal abscess In men: inguinal abscess None known Lympho-granuloma venereum (LGV) Chlamydia trachomatis In both women and men: small, painless
genital ulcer, non-specific urethritis, acute lymphadenitis with
bubo formation In women: cervicitis In both women and men: fistulas, rectal
strictures, genital elephantiasis None known Donovanosis Klebsiella granulomatis In both women and men: genital ulcer (could be
cervical lesion in women) In both women and men: pseudoelephantiasis,
stenosis of the urethra, anus or vagina (in women) None known Genital herpes Herpes simplex virus (HSV) In both women and men: multiple vesicle lesions,
ulceration, pain, itching, dysuria In both women and men: aseptic meningitis,
transverse myelitis, disseminated infections Pregnancy: dissemination of infection
(especially if acquired in the third trimester), spontaneous
abortion, preterm delivery Newborn: neonatal herpes, encephalitis,
disseminated infection, skin, eye, and mouth infection STI/RTI Etiological agent Acute manifestations Possible complications Effect on pregnancy and newborn Genital warts/cervical lesions Human papilloma virus (HPV) In both women and men: genital and anal warts In women: squamous intraepithelial lesions of
the cervix In women: cervical cancer, vaginal and vulvar
carcinoma, anal carcinoma In men: penile and anal carcinoma Pregnancy: not known Newborn: laryngeal papillomatosis Hepatitis B Hepatitis B virus (HBV) In both women and men: acute hepatitis In both women and men: chronic hepatitis,
cirrhosis, liver cancer Pregnancy: not known Newborn: perinatal hepatitis B HIV/AIDS Human immuno-deficiency virus (HIV) In both women and men: headache, muscle ache,
sore throat, fever, and swollen lymph nodes In both women and men: AIDS Pregnancy: possible increased progression of
AIDS Newborn: perinatal transmission of HIV Non-sexually transmitted infections in women Bacterial vaginosis Gardnerella vaginalis, anaerobic bacteria,
genital mycoplasma, streptococci Vaginitis Increased risk of PID (postabortion) Pregnancy: preterm delivery, prelabour rupture
of membranes, chorioamnionitis, postpartum endometritis Newborn: low birth weight Vulvovaginal candidiasis Candida albicans Vaginitis None known Pregnancy: increased susceptibility to
Candida Newborn: neonatal thrush |
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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The Mother and Child Health and Education Trust
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Sexually
transmitted and other reproductive tract infections