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Department of Reproductive Health and Research (RHR), World Health Organization

Sexually transmitted and other reproductive tract infections

A guide to essential practice

 

 
    

Annexes
Annex 5. STI/RTI reference table


 

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
html files

 

Infections of the male and female reproductive tract and their consequences:

What are RTIs?

Why STI/RTIs are important?

What can be done about RTIs?

The role of clinical services in reducing the burden of STI/RTI

Preventing STIs/RTIs and their complications

How to prevent STI

How to prevent iatrogenic infections

How to prevent endogenous infections

Detecting STI/RTI

Detecting STI/RTI

Syphilis

Vaginal infections

Cervical infections

Pelvic inflammatory disease

HIV counselling and testing

STI/RTI education and counselling

Key points

Privacy and confidentiality

General skills for STI/RTI education and counselling

Health education

Counselling

Promoting prevention of STI/RTI and use of services

Key points

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

Key points

Integrating STI/RTI assessment into routine FP services

Family planning methods and STIs/RTIs

STI/RTI Assessment in pregnancy, childbirth and the postpartum period

Key points

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

Key points

Infection in early pregnancy

Infection in lated pregnancy

Infection following childbirth

Vaginal discharge in pregnancy and the postpartum period

Sexual violence

Key points

Medical and other care for survivors of sexual assault

Annex 1. Clinical skills needed for STI/RTI

History-taking

Common STI/RTI symptoms

Examining patients

Annex 2. Disinfection and universal precautions

Preventing infection in clinical settings

High-level disinfection: three steps

Universal precautions

Annex 3. Laboratory tests for RTI

Interpreting syphilis test results

Clinical criteria for bacterial vaginosis (BV)

Wet mount microscopy

Gram stain microscopy of vaginal smears

Use of Gram stain for diagnosis of cervical infection

Annex 4. Medications

Medications in pregnancy

Antibiotic treatments for gonorrhoa

Annex 5.

STI/RTI reference table

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Additionnal resources

 

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