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Public Health Aspects of Urogenital System Diseases: Irwin Aras
Public Health Aspects of Urogenital System Diseases: Irwin Aras
ASPECTS OF
UROGENITAL SYSTEM
DISEASES
IRWIN ARAS
Epidemiology ;
8-10 million people in US develop UTI
each year
Women develop the condition much
more often than men (US ; 20% and 20%
have a reccurence)
Rare in boys and young men
UTI more common in under the age of 2
Epidemiology ;
Greeks and Romans recorded urolithiasis as
early 4800 BC
Common disorder affecting 0.2% of
population
More commons in males 3 : 1 ratio
ORCHIO-EPIDIDYMITIS
(Epididymo-orchitis)
Overview ;
OE is an inflammation of the epididymis and
the testicle
Chronic epididymitis refers to epididymal
pain and inflamation (usually without scrotal
swelling)
Hippocrates first described mumps orchitis
during the fifth century BC
ORCHIO-EPIDIDYMITIS
(Epididymo-orchitis)
Epidemiology ;
In the US ; estimated 1 in 1000 men is affected
yearly. More than 600,000 medical visits /year for
acute epididymitis (AE)
In the UK ; 13,000 medical visits /year for acute
epididymitis
OE have no predilection for any racial or ethnic group
AE most commonly occurs in patient aged 15-30 years
older than 60 years.
Mumps orchitis occurs in 20-40% of postpubertal boys
with the mumps, it is rare in prepubertal boys
ORCHIO-EPIDIDYMITIS
(Epididymo-orchitis)
Prevention ;
Prevent from UTI
Avoid the scrotum from trauma ; a
precipitating event
Get health sex ; prevent from STDs
Overview ;
A disease caused by pathogen (e.g., virus, bacterium,
parasite, fungus) that is spread from P to P primarily
through sexual contact
STDs can be painful, irritating, debilitating and lifethreatening
More than 20 STDs have been identified
A person infected with an STD is more likely to
become infected with HIV, and a person infected with
HIV and another STD is more likely to transmit HIV
Infertility:
20-40% of males with untreated chlamydia and
gonorrhea
55-85% of females with untreated PID
(8-20% of females with untreated gonorrhea
develop PID)
Increased risk of HBV and HIV/AIDS transmission
Epidemiology ;
Occur most commonly in sexual active in teenagers
and young adults (especially with multiple sex
partners)
An estimated 200-400 million people worldwide are
infected
Representing men and women of all economic class
In the US, more than 13 million people are infected
each year
Prevention ;
Sexual abstinence is the only 100% effective method to prevent
sexually transmitted diseases
MONOGAMY WITH AN UNINFECTED PARTNER
The risk for transmission is dramatically reduce with the use of
condoms
HIV/AIDS
Background
AIDS first recognized in US in 1981
Homosexual males in large cities diagnosed with
Pneumocystis carinii pneumonia (PCP) and Kaposis
Sarcoma (KS)
Syndrome soon recognized in hemophiliacs, injection
drug users, children of high-risk mothers
AIDS patients presented with a marked decrease of
CD4-positive T-helper lymphocytes which left them
susceptible to opportunistic infections and neoplasms
HIV/AIDS
Transmission
Modes of Transmission
sexual contact with an infected
person
sharing needles and/or syringes
blood transfusions with infected
blood
mother to child before or during
birth or through breast feeding
Sexual Transmission
Pre-existing STD
Ignorance of HIV status
Sexual mixing
Low levels of male circumcision
Lack of treatment to suppress viral load- more
infectious
Surveillance purposes:
school-based programs
peer-to-peer interventions
strategies that limit needle sharing
strategies that use parent-to-child communication
HIV vaccine???
Microbicide for women that is safe and
effective in reducing transmission of HIV
Ensure sustained access to HIV tests,
preventive and treatment services
Continue education and behavior
intervention
Migration
STD Treatment
Antiretroviral Treatment
Access to condoms
Female condoms/microbicides
Behavior change communication/education
Increased access to HIV testing
Antiretroviral therapy during pregnancy and for
neonate
Mothers counseled not to breast feed if safe
alternatives to breast feeding exist
Needle exchange or bleach
HIV vaccine???