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 MADE BY: AVINASH BAINS &
DILJOT SINGH
 ROLL NO. 27 & 31
What is RTI/STI ?
 Reproductive Tract Infections (RTIs):
Any infection of reproductive tract in male and female
 Sexuall...
Factor contributing to RTI/STI spread
•Human behaviour
•Lack of access to healthcare
•Lack of awareness about STIs
•Migrat...
High risk groups
 Adolescent boys and girls
 Women who have multiple partners
 Sex workers and their clients
 Men havi...
Syndromic Approach
 Syndrome – is group of symptoms patient complains about
and clinical signs that a physician observes ...
Identifying Syndromes
SYNDROME MOST COMMON CAUSE
Vaginal discharge Vaginitis (Trichomoniasis, Candidiasis, Bacterial
Vagin...
Syndromic Management-
Advantages
 Pt. diagnosed and treated in one visit.
 Highly effective for most of the syndromes.
...
Syndromic Management- Limitations
 Not useful in asymptomatic individuals.
 Over-treatment in patient with one STI that ...
The Five Steps in Syndromic STI Case
Management
 History taking and examination
 Syndromic diagnosis and treatment, usin...
Syndromic Management
Flowcharts
Module 4
Yes
Patient complains of urethral
discharge or dysuria
Take history and
examine
Milk urethra if necessary
TREAT FOR GONOCO...
Man complains of scrotal swelling and
pain
Painful scrotal swelling confirmed
Treatment for Gonorrhoea and
Chlamydia.
Pa...
Partner Management
Module 10
Partner Treatment
Syndrome of index patient Treatment for partner/s
Urethral discharge Treat partner/s for gonorrhea and
c...
KIT COLOUR
KIT 1 GREY : URETHRAL DISCHARGE, CERVICITIS
KIT 2 GREEN : VAGINITIS
KIT 3 WHITE : GENITAL ULCERS
KIT 4 BLUE: GE...
To sum up ………
 Syndromic management is a scientific and proven approach.
 Syndromic approach does not deny use of lab te...
Syndromic approach
Syndromic approach
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Syndromic approach

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syndromic approach to sti/rti

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Syndromic approach

  1. 1.  MADE BY: AVINASH BAINS & DILJOT SINGH  ROLL NO. 27 & 31
  2. 2. 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.
  3. 3. Factor contributing to RTI/STI spread •Human behaviour •Lack of access to healthcare •Lack of awareness about STIs •Migrating population •Healthcare providers not adequately trained •Poor medical services •Hygiene and environmental factors •Hormonal and other factors
  4. 4. 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
  5. 5. Syndromic Approach  Syndrome – is group of symptoms patient complains about and clinical signs that a physician observes during examination  Syndromic diagnosis:  Identification of consistent group of symptoms and easily recognised signs (syndromes)  Syndromic treatment:  Treat the main organisms responsible for causing the syndrome
  6. 6. Identifying Syndromes SYNDROME MOST COMMON CAUSE Vaginal discharge Vaginitis (Trichomoniasis, Candidiasis, Bacterial Vaginitis) Cervicitis (Gonorrhea, Chlamydia) Urethral discharge Gonorrhea, Chlamydia Genital ulcer Syphilis, Chancroid, Herpes Lower abdominal pain Gonorrhea, Chlamydia, Mixed Anaerobes Scrotal swelling Gonorrhea, Chlamydia Inguinal bubo LGV, Chancroid Neonatal conjunctivitis Gonorrhea, Chlamydia
  7. 7. Syndromic Management- Advantages  Pt. diagnosed and treated in one visit.  Highly effective for most of the syndromes.  Relatively inexpensive  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.
  8. 8. 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.
  9. 9. The Five Steps in Syndromic STI Case Management  History taking and examination  Syndromic diagnosis and treatment, using flow charts  Education and counseling on HIV testing and safer sex, including condom promotion and provision  Management of sexual partners  Recording and reporting
  10. 10. Syndromic Management Flowcharts Module 4
  11. 11. Yes Patient complains of urethral discharge or dysuria Take history and examine 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 persist Use appropriate flow chart Educate and counsel Promote condom use and provide condoms Offer HIV counselling and testing if both facilities are available Review if symptoms persist Discharge confirmed? Any other genital disease? Yes No No Urethral Discharge
  12. 12. Man complains of scrotal swelling and pain Painful scrotal swelling confirmed Treatment for Gonorrhoea and Chlamydia. Patient Education, counselling  Provide and promote condom Partner management Testes rotated/ elevated or history of trauma Refer immediately for a surgical opinion Take history & examine Testes normal. No history of trauma Cured Return in 7 days if symptoms persist No improvement Refer to higher care center SCROTAL SWELLING
  13. 13. Partner Management Module 10
  14. 14. Partner Treatment Syndrome of index patient Treatment for partner/s Urethral discharge Treat partner/s for gonorrhea and chlamydia Genital ulcer Treat partner/s for syphilis and chancroid Vaginal discharge: Patient treated for vaginitis and cervicitis Patient treated for vaginitis Treat partner/s for gonorrhea and chlamydia Not necessary for partners to be treated unless there is recurrent discharge Pelvic inflammatory disease Treat partner/s for gonorrhea and chlamydia Scrotal swelling Treat partner/s for gonorrhea and chlamydia Inguinal bubo Treat partner lymphogranuloma venereum Neonatal conjunctivitis Treat both parents for gonorrhea and chlamydia
  15. 15. KIT COLOUR 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
  16. 16. 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 approach.

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