MADE BY: AVINASH BAINS &
ROLL NO. 27 & 31
What is RTI/STI ?
Reproductive Tract Infections (RTIs):
Any infection of reproductive tract in male and female
Sexually Transmitted Infections (STIs):
STIs are infections caused by germs such as bacteria,
viruses, or protozoa that are passed from one person to
another through sexual contact.
Factor contributing to RTI/STI spread
•Lack of access to healthcare
•Lack of awareness about STIs
•Healthcare providers not adequately
•Poor medical services
•Hygiene and environmental factors
•Hormonal and other factors
High risk groups
Adolescent boys and girls
Women who have multiple partners
Sex workers and their clients
Men having sex with men
Partners of various high risk groups
Syndrome – is group of symptoms patient complains about
and clinical signs that a physician observes during
Identification of consistent group of symptoms and
easily recognised signs (syndromes)
Treat the main organisms responsible for causing
Pt. diagnosed and treated in one visit.
Highly effective for most of the syndromes.
No need for patient to return for lab results.
All possible STIs are treated at once.
Scientifically tested in many part of the world.
Easy for health workers to learn and practice for patients.
Integrated into primary health care services more easily.
Can be used by providers at all levels.
Syndromic Management- Limitations
Not useful in asymptomatic individuals.
Over-treatment in patient with one STI that causes a syndrome.
Financial cost of over-treatment, side- effects.
Increases potential for antibiotic resistance especially if full
course not completed.
The Five Steps in Syndromic STI Case
History taking and examination
Syndromic diagnosis and treatment, using flow
Education and counseling on HIV testing and
safer sex, including condom promotion and
Management of sexual partners
Recording and reporting
Patient complains of urethral
discharge or dysuria
Take history and
Milk urethra if necessary
TREAT FOR GONOCOCCAL INFECTION
AND CHLAMYDIA TRACHOMATIS
Educate and counsel
Promote condom use and provide condoms
Manage and treat partner
Offer HIV counselling and testing if both
facilities are available
Ask patient to return in 7 days if symptoms
Use appropriate flow chart
use and provide
testing if both
Review if symptoms
Man complains of scrotal swelling and
Painful scrotal swelling confirmed
Treatment for Gonorrhoea and
Patient Education, counselling
Provide and promote condom
Testes rotated/ elevated
or history of trauma
Refer immediately for a
Take history & examine
Testes normal. No history of
Cured Return in 7 days if
Refer to higher care center
Syndrome of index patient Treatment for partner/s
Urethral discharge Treat partner/s for gonorrhea and
Genital ulcer Treat partner/s for syphilis and
Patient treated for vaginitis and
Patient treated for vaginitis
Treat partner/s for gonorrhea and
Not necessary for partners to be
treated unless there is recurrent
Pelvic inflammatory disease Treat partner/s for gonorrhea and
Scrotal swelling Treat partner/s for gonorrhea and
Inguinal bubo Treat partner lymphogranuloma
Neonatal conjunctivitis Treat both parents for gonorrhea
KIT 1 GREY : URETHRAL DISCHARGE, CERVICITIS
KIT 2 GREEN : VAGINITIS
KIT 3 WHITE : GENITAL ULCERS
KIT 4 BLUE: GENITAL ULCERS
KIT 5 RED : GENITAL ULCERS
KIT 6 YELLOW : LOWER ABDOMINAL PAIN
KIT7 BLACK : SCROTAL SWELLING
COLOUR CODED STI/RTI DRUG KITS ACCORDING TO SYNDROME
AVAILABLE AT SURAKSHA CLINICS
To sum up ………
Syndromic management is a scientific and proven approach.
Syndromic approach does not deny use of lab tests, it can
supplement the approach (Enhanced syndromic approach).
This approach ensures correct and complete treatment of all most
common organisms responsible for a particular syndrome.
Syndromic management goes beyond pharmaceutical treatment to
include client education and counseling.
The clinical skills of a doctor are well utilized in syndromic