Department of Reproductive Health and Research (RHR), World Health Organization
Sexually transmitted and other reproductive tract infections
A guide to essential practice
Preventing infection in clinical settings1
Wash your hands before and after caring for another person. It is the most important way to kill germs on your skin. You need to wash your hands even more thoroughly and for a longer time:
Use soap or other disinfectant to remove dirt and germs. Count to 30 as you scrub your hands all over with the soapy lather. Use a brush or soft stick to clean under your nails. Then rinse, using running water. Do not reuse water.
Disinfect or sterilize equipment and instruments. Cleaning instruments and equipment to get rid of nearly all the germs is called high-level disinfection. Instruments must first be washed and then disinfected if they are to be used to:
1. Soaking. Soak instruments for 10 minutes. If possible, use a 0.5% solution of bleach (chlorine) (see below). Soaking instruments in bleach solution will help protect you from infection when cleaning them. If you do not have bleach, soak your instruments in water.
2. Washing. Wash all instruments with soapy water and a brush until each one looks very clean, and rinse them with clean water. Be careful not to cut yourself on sharp edges or points. Wear gloves when washing instruments; if possible, use heavy gloves.
3. Disinfecting. Steam or boil the instruments for 20 minutes.
The same precautions against spreading infection —universal precautions —should be used with all patients whether they appear sick or well, and whether or not you know their HIV or other infection status.
A number of RTIs can be spread from patient to health care provider or to other patients if basic precautions are not followed. Hepatitis B and C viruses and HIV are incurable infections that are easily transmitted by reuse of contaminated sharps. Because RTIs are often asymptomatic, it is not possible to know which patients have an infection. For this reason, universal precautions should be followed for all patients regardless of known or suspected infection status.
Use precautions with every person you see. Every time you have to cut the skin or touch body fluids, follow the advice below. This includes any time you must give an injection, stitch skin or tissue, help with childbirth, or examine a woman’s vagina.
If you follow these rules, there is no risk of spreading infection from one person to others, or of being infected yourself.
1 Adapted from Burns et al. Where women have no doctor. Berkeley, CA, USA, Hesperian Foundation, 1997.
Infections of the male and female reproductive tract and their consequences:
Preventing STIs/RTIs and their complications
STI/RTI education and counselling
Promoting prevention of STI/RTI and use of services
STI/RTI Assessment during Routine Family Planning Visits
STI/RTI Assessment in pregnancy, childbirth and the postpartum period
Management of symptomatic STIs/RTIs
STI/RTI complications related to pregnancy, miscarriage, induced abortion, and the postpartum period
Annex 1. Clinical skills needed for STI/RTI
Annex 2. Disinfection and universal precautions
Annex 3. Laboratory tests for RTI
Annex 4. Medications