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STDs

STDs

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SUBJECT
Medicine
TOPIC
Sexually Transmitted Infections
LECTURER
Dr. Gabriel (June 23, 2008)
TRANSGROUP Kapitan Boom and Friends
Page1
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\ue000WHO has estimated about 315 million
cases of the curable STD occur each year
in the world
\ue000SOUTHEAST ASIA estimate between 9-17%
of individuals aged 15-49 may acquire an
infection in any one year
\ue000USA STD Cases
o
CDC estimates 19 million new
infection occur each year
o
About 8.5 million among young
people ages 15 to 24 yrs
o
$14.7 billion for direct medical cost
each year in US
o

In 2006, chlamydia, gonorrhea & syphilis are the three notifiable STD in US

\ue000STD Cases Worldwide
o

Certain STD\u2019s (syphilis, gonorrhea, HIV, Hep B, chancroid) are most concentrated

within

\u201ccore populations\u201d having high rates of partner

change,
concurrent
partners
or
\u201cdense\u201d

sexual networks like prostitutes and their clients and persons involved in the use of illicit drugs.

Factors that determine the spread of
STD\u2019s

1. rate of exposure
2. efficiency of transmission per exposure
3. duration of infectivity of those infected

Host factors on the spread of STD
1. Risk behaviors
2. Socio-economic
3. Beliefs & Gender identification

\u201cPHILIPPINES have started to provide STI data which might be under reported. \u201cGuesstimate suggest that STD are quite common\u201d

Current problems of STI detection in
the Philippines
\ue000Reports from social hygiene clinics were
obtained from select high risk groups
\ue000Social hygiene clinics do not have
laboratory capability to perform diagnostic
screening test
\ue000Lack of equipment and reagents for STD
testing
\ue000Private practitioner were reluctant to
report STD to DOH
\ue000Problems on data result from inadequate
training of doctors, nurses & midwife
STD in the Philippines
\ue000In Philippines, STI prevalence from 1999

to 2002 of chlamydia infection among high risk group (registered female sex workers) was 27-36%; and in general population group was 5.75% in women and 4.4% in men.

\ue000Factors related to transmission include

extramarital relationships, multiple sex partners and low condom use in men. Young people have relatively high prevalence.

\ue000Most men would never divulge their STI
status to their partners, thus, making
women more vulnerable to STIs.
Transmitted in Adults by Sexual Intercourse
Viruses
Others
Neisseria
gonorrhea
HIV 1 & 2
Trichomonas

vaginalis
Chlamydia
trachomatis

HTLV 1
Phthirus
pubis
Treponema
palidium

Herpes
simplex
Type 2

Hemophylus
ducreyi

Human
papilloma
virus

Calymmatobacter
ium granulomatis Hepatitis B
Ureaplasma
urealyticum

Molluscum
contagiosu
m

Risk-behavior
Practices

Multiple Partners
Men Having Sex
with men

STD SURVEILLANCE
Number of STD Cases per Year (1999 - 2004)
19
20
20
20
20
2
STD STATISTICS
EPIDEMIOLOGY OF STD
SUBJECT
Medicine
TOPIC
Sexually Transmitted Infections
LECTURER
Dr. Gabriel (June 23, 2008)
TRANSGROUP Kapitan Boom and Friends
Page1
99
00
01
02
03 004
Gonorrhea
268 198 211 266 257 221
Syphilis
38
99
129 108
65
64
Non-
specific
3
155
2
376
2
404
4
321
7
534
7
371
Trichomoni
asis
10
11
4
8
2
0
Candidiasis859 516 399 491 163
62
Bacterial
Vaginosis
17
24
24
1
Herpes
2
3
2
1
2
Venereal
Wart
11
13
31
18
29
63
Hepatitis B
23
9
31
24
25
28

\ue000Urethritis & Urethral discharges in men
\ue000Vaginal discharges
\ue000Genital ulcers
\ue000Genital lesions
\ue000Blood-borne STIs

Genital Discharges
Gonococcal Urethritis
\ue000Caused by Neisseria gonorrhea which can
be cured with antibiotics
\ue000Spread is through vaginal, anal, or oral-
genital contact with an infected person
\ue000Most women and an increasing no. of men
exhibit no symptoms at all
\ue000Impossible to catch Gonorrhea from toilet
seats, towels, drinking cups, etc.
\ue000If symptoms do appear, they will be 2
days to 2 weeks after sexual contact
\ue000Copious and grossly
purulent and
sometimes blood- stained
Gonorrhea in Women
\ue000Bleeding between periods
\ue000Creamy or green, pus-like or bloody
vaginal discharge
\ue000Excessive bleeding during menstrual
period

\ue000Irritation of the vulva
\ue000Lower abdominal pain
\ue000Pain during intercourse
\ue000Painful urination

Neisseria gonorrhoeae

Cervix, Urethra, Rectum
Treatment:
Cefixime 400 mg
Ceftriaxone 125 IM

STD CLASSIFICATION
CLINICAL STDs
SUBJECT
Medicine
TOPIC
Sexually Transmitted Infections
LECTURER
Dr. Gabriel (June 23, 2008)
TRANSGROUP Kapitan Boom and Friends
Page1
Ciprofloxacin 500 mg
Ofloxacin 400 mg/Levofloxacin 250 mg
PLUS Chlamydial therapy if infection not ruled out
Chlamydia Infection
\ue000The most prevalent STD worldwide & can
coexist with gonorrhea and other STD
\ue000Prevalence is highest in younger age 15-
25
years and most likely to experience
complications and long term sequelae.
\ue000In women: over 50% with gonorrhea and
70% with Chlamydia had no symptoms
\ue000In men: 68-92% with gonorrhea and 92%
with Chlamydia reported no symptoms
\ue000In men, the infection may cause urethritis,
epidimytis, proctitis, Reiter\u2019s syndrome
(arthritis) and infertility.

Prevalence Studies on Chlamydia
Trachomatis Infection Among Population
Groups

Target
Popula
tion

High Risk Groups

Monzo
n,
1991

FHI,
1994
Agdama
g, 1996
FHI,
1999
Femal
e

13 %
N=936
Manila

FSW

17.3 %
N=311
Manila
22.7 %;
N=297
Cebu

FSW
15.5 %
FSW

36%
N=450
Angeles

City
FSW
Male

12 %
N=100
Angeles

City;
16%
N=100

FSW

Target
Popula
tion

Low Risk Groups
FHI,
1994

Agdam
ag,
1996

Aplasca,
1998
FHI,
2002
Femal
e

5.6 %
N=203
Antena

tal
women
2.5 %

11.7 %
N=308
Antenata

l Baguio;
9.6%
N=343
Cebu;
7.5 %

5.75 % N=300 Gen

pop;
Selected
sites;
7.7%
youth

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