Department of Reproductive Health and Research (RHR), World Health Organization
Sexually transmitted and other reproductive tract infections
A guide to essential practice
What can be done about RTIs?
Most of the serious health problems caused by STIs/RTIs are preventable. Communities with good access to effective prevention and treatment services have lower rates of STI/RTI and STI/RTI complications than communities where services are poor, disrupted or not used by people at risk. Reducing the burden of STI/RTI requires more than good clinical management of individual patients, however. STIs/RTIs are transmitted in the community, and limiting interventions to clinic settings misses much of the problem. Box 1.4 lists some important barriers to controlling STIs/RTIs at the community level, and what can be done about them.
Box 1.4. Some barriers to STI/RTI control at the community level
Some countries have greatly reduced the prevalence and transmission of common STIs/RTIs by addressing such social and structural factors. Thailand recently reduced the incidence of the most common STIs by over 90% by promoting increased condom use and improving STI treatment among commercial sex workers (Box 1.5). Maternal morbidity due to complications of childbirth and abortion has declined dramatically in countries where safe services are available. High rates of preventable reproductive morbidity and mortality in other countries make prevention and control of these infections a public health priority.
Box 1.5. Effective STI control and HIV prevention in Thailand
Figure 1.2. Clients using condoms and reported STI cases—Thailand
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