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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

 

 
    

STI/RTI basics
Chapter 3. Detecting STI/RTI


 

Pelvic inflammatory disease

Upper genital tract infection or PID leads to serious and life-threatening complications including infertility and ectopic pregnancy, yet can often develop silently with few symptoms or none at all. Women with lower abdominal tenderness on examination should be managed for PID.

 

Indications for screening

Screening should be performed:

  • any time a speculum or bimanual pelvic examination is performed, or when women have vague complaints of lower abdominal discomfort, back pain, spotting between periods, or pain during sexual intercourse;
  • prior to transcervical procedures.

 

Available screening tools

  • Careful abdominal and bimanual pelvic examination are the only tools for detecting silent PID.

 

Implementing screening

Bimanual pelvic examination skills are reviewed in Annex 1. Signs of upper genital tract infection include lower abdominal, cervical motion, uterine or adnexal tenderness. Women with these signs should be managed without delay using the lower abdominal pain flowchart (Flowchart 2 in Chapter 8).

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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