CPH STD

Sexually Transmitted Disease (STD)

A group of communicable diseases that are transmitted predominantly by sexual contact and caused by a wide range of bacterial, viral, protozoal, fungal agents and Ecto parasites.

Ecto parasite

parasite outside

Endo parasite

parasite inside

• Prostitution

• Broken homes

• Sexual disharmony

• Easy money

• Emotional immaturity

• Urbanization

• International travel

• Changing behavioral patterns

• Alcoholism

Social Factors

• Sexual intercourse (vaginal, anal, oral)

• Blood-to-blood contact

• Sharing needles or other drug equipment

• Tattoo or body piercing

• Infected mother to her baby

Methods of Transmission

• BACTERIAL AGENTS

• VIRAL AGENTS

• PROTOZOAL AGENTS

• FUNGAL AGENTS

• ECTOPARASITES

Classification of Sexually Transmitted Agents

• Gonorrhea

• Chlamydia Trachomatis

• Haemophilus ducreyi

• Shigella

Bacterial Agents:

Gonorrhea

• cervix, urethra, rectum, throat, and occasionally, the eyes

• o Ciproflaxin

  o Ceftrioxone

  o Cefixine

  o Septinomycin

• Major cause of morbidity among sexually active individuals worldwide

• Major cause of cervicitis in women

• Can affect the ___

• Can be treated with antibiotics: ___

• Often NO symptoms, especially in females

Neisseria gonorrhoeae 

Causative agent of Gonorrhea

Gonococcal Ophthalmia Neonatorum

• occurs when a newborn is infected with neisseria gonorrhoeae during birth

• “eye infection”

• Profuse, purulent conjunctival discharge, frequently bilateral

• When left intreated, may lead to blindness

Cervicitis

• yellowish to greenish

• Inflammation of the uterine cervix

• Can be classified as infectious or non-infectious, acute or chronic

• Clinically important because it left untreated, it may ascend and cause endometritis or pelvic inflammatory disease

• Discharge may be _______

Chlamydia trachomatis

: Doxicycline, Azithromycin, Amoxycillin, Ofloxacin, Erythromycin or Tetracycline

• Individuals may not exhibit clinical manifestations

• The symptoms mimic like gonorrhea

• It can result in vertical transmission to the fetus

The drug of choice include:

Haemophilus ducreyi

· Transmitted through direct contact with open lesions and exudates from lymph nodes during sexual intercourse

: Treatment : Antibiotics

SHIGELLA

• _ can be passed from poop or unclean fingers of one person to the mouth of another person

• Also transmitted through direct sexual contact like Anal, oral sex or anal play (rimming, fingering)

• Causes fever, diarrhea, and stomach cramps

• To avoid contracting it, wash your hands with soap and water before doing things like preparing food or engaging in sexual activity as well as after using the bathroom.

• Hepatitis B Virus

• Human Papilloma Virus

• HIV

Viral Agents:

Hepatitis B Virus

· Transmission has thus been associated with sexual contact, blood transfusions, sharing of needles and syringes by intravenous drug users, tattooing, and occupational needle-stick injury

Human Papilloma Virus

· Causes genital warts, which vary from the common soft, flesh colored protuberances which may become exuberant (cauliflower like) to popular flat warts on drier areas (shaft of the penis)

· Can cause cervical cancer in women

HIV

Transmission occurs by one of three major routes: Intimate sexual contact, contact with blood or body fluids, perinatally from infected mother to infant

• Stage 1: Acute HIV infection

• Stage 2: Chronic HIV infection

• Stage 3: Acquired Immunodeficiency Syndrome(AIDS)

HIV Staging

Stage 1: Acute HIV infection

- People have lot of HIV in their blood

- Some people have flu like symptoms

- Only Antigen/antibody tests or nucleic acid test (NATs) can diagnose acute infection

Stage 2: Chronic HIV infection

- Aka Asymptomatic HIV/clinical Latency

- HIV is still active but reproduces at very low levels

- People can transmit HIV at this phase

- People who take HIV medicine as prescribe may never move into stage 3

Stage 3: AIDS

- The most severe phases of HIV infection

- People with _____ have such badly damaged immune systems that they get an increasing number of sever illnesses, called opportunistic infections

- Without treatment, people with ____ typically survive about 3 years

- Combination Antiretroviral Therapy (CART), High Active Antiretroviral Therapy (HAART)

- Staphylococcus aureus

Molluscum contagiosum

· Raised, round skin colored bumps. Bumps with a small dent or dot at the top near the center

· The infection usually resolves itself but treatment can shorten the length of symptoms

PREVENTION: Good hygiene, Do not share towels or clothing, wash hands thoroughly, avoid skin to skin contact, abstinence from sex

• Entamoeba histolytica

• Giardia lamblia

• Trichomonas vaginalis

Protozoal Agents:

Entamoeba histolytica

· Only pathogenic amoeba

· MOT: Ingestion of food and water contaminated with the cysts

· The typical manifestation of intestinal amoebiasis is amoebic dysentery(blood stool)

· Hepatic involvement is the most common extraintestinal complication of amoebiasis

· Involvement of the CNS leads to Secondary Amoebic Meningoencephalitis

Giardia lamblia

· Appearance: Old man with eye glasses

· MOT: Person to person contact. Ingestion of contaminated water

Giardiasis

- aka “beaver fever”(muskrat, beaver, watervoules) , is a condition caused by a parasitic intestinal infection, which results in uncomfortable symptoms that affect the digestive system

Trichomonas vaginalis

· Aka Ping-Pong disease

· This parasitic infection leads to vaginitis and vaginal discharge in women

· The most common infection site in males is the prostate gland region and the epithelium of urethra

· Asymptomatic cases most frequently in men; symptomatic men often experience persistent or recurring urethritis.

· Can live for more than 24 hours in urine, 6 hours on toilet seat

Metronidazole/Tinidazole

Treatment of Trichomonas vaginalis

• Petechial hemorrhage (strawberry mucosa)

• Metaplastic changes

• Desquamation of the vaginal epithelium

Causes of Trichomonas vaginalis

• Candida albicans

Fungal Agents:

Candida albicans

· Sometimes causes a mild yeast infection

· Can get into bloodstream and cause severe illness

-Most opportunistic infection in the world

Candidiasis

• causes oral or vaginal rush

• It also causes irritation, discharge and intense itchiness of the vagina and the vulva

• Phthirus pubis

• Sarcoptes scabiei

Ectoparasites:

Phthirus pubis

· Aka Pubic lice or Crab louse

· Causes itching around your genitals or back passage

· Tiny blue spots around your genitals

· The lice or eggs of it are visible on your pubic hair

· If left untreated, the affected are will continue to itch and may result in serious skin infections

· Treatment: Over the counter prescription (lice killing lotion containing 1% permethrin or a mouse containing pyrethrins and piperonyl butoxide

Sarcoptes scabiei

· ___ is not an infection(inside) but an infestation(outside)

· Causes itching, sores, thick crusts on the skin

· Transmitted by prolonged skin to skin contact

· Scabies mites burrow, or tunnel under the outer layer of skin

· There mites lat eggs under the skin and feed on blood

· The mites are about the size of a pinhead, are nearly transparent, and usually cannot be seen

· Crusted Scabies-Occurs only when the scabies is already severe

• Initial planning

• Intervention Strategies

• Support Components

• Monitoring and Evaluation

Control of Sexually Transmitted Disease