STIs

(Sexually Transmitted Infections)

By. Mrs. Murtiningsih

STIs
Definition
• Are infections of the reproductive tract caused
by micoorganism transmitted through vaginal,
anal, or oral sexual intercourse (CDC: Central
for Disease Control; 2002)
STIs contribute to
• Cervical cancer
• LBW
• Fetal wastage (abortions and death)
• Vertical transmission (maternal to fetal
transmission while in utero), infertility, ectopic
pregnancy, chronic pelvic pain, and death.
CDC classifications of STI

• Infections characterized by vaginal discharge

• Vulvovaginal candidiasis (trichomoniasis,
bacterial vaginosis)
• Infections characterized by cervicitis
(chlamidia, gonorrhea)
• Infections characterized by genital ulcers
(genital herpes simplex, syphilis)
CDC classifications of STI

• PID (Pelvic Inflammatory Disease)

• HIV (Human Immunodeficiency Virus)
• HPV (Human Papilloma Virus Infection)
VULVOVAGINAL CANDIDIASIS

• Is one of the most common causes of vaginal

discharges.
• It is also referred to as yeast, monilia, and a
fungal infection.
• An estimated 75% of women will have at least
one episode of vulvovaginal candidiasis, and
40% to 50% will have two or more episodes in
their lifetime (CDC, 2002).
CANDIDA ALBICANS
Clinical Manifestations

• Pruritus
• Vaginal discharge (thick, white, curd-like)
• Vaginal soreness
• Vulval burning
• Erythema in the vulvovaginal area
• Dyspareunia
• External dysuria
Predisposing factors for Candidiasis
• Pregnancy
• Use of oral contraceptive with a high estrogen
• Use a broad-spectrum antibiotics
• DM
• Use of steroid & immunosuppressive drugs
• HIV infection
• Wearing tight, restrictive clothes & nylon
underpants
• Trauma to vaginal mucosa for chemical
irritants or douching
Diagnosis
• Based on the history of symptoms & pelvic
examination.
• The speculum examination will reveal
white plaques on the vaginal walls.
• The definitive diagnosis is made by a wet
smear.
Treatment
 Miconazole cream or suppository
 Clotrimazole tablet
 Terconazole cream or suppository
 Fluconazole oral tablet
 If vulvovaginal candidiasis is not treated
effectively during pregnancy, the newborn can
develop an oral infection known as thrush
during the birth process.
Preventive measures for women
 Reducing the dietary intake of simple sugar & soda.
 Wearing white, 100% cotton underpants.
 Avoiding wearing tight pants.
 Washing with a mild, unscented soap & drying the
genital gently.
 Avoiding the use of bubble bath
 Washing underwear in hot water, drying in hot dryer.
 Practicing good body hygiene
 Avoiding vaginal sprays/deodorants, douching,
wearing pantyhose or use tampons.
 CLAMYDIA

 Is the most common bacterial STIs.

 Asymptomatic infection is common among
both men & women.
 Men primarily develop urethritis.
 In women – is linked with cervicitis, acute
urethral syndrome, salpingitis, PID, and
infertility (Youngkin & Davis, 2004)
CLAMYDIA
CLINICAL MANIFESTATIONS
• 70%-80% are asymptomatic (CDC, 2002)
• If the client is symptomatic, clinical
manifestations include:
 mucopurulent vaginal discharge
 urethritis
 bartholinitis
 endometritis
 salpingitis
 DUB
DIAGNOSIS
 Nucleic acid amplification method by
polymerase chain reaction or ligase chain
reaction.
 First void urine specimens
 Culture, nucleic acid probes, and enzime
linked immunoassays.
TREATMENT

• Antibiotics – doxycycline or azithromycin, or

• A combination cefriaxone with doxycyline or
azithromycin.
• Annual screening of all sexually active women
aged 20-25 years old.
• Screening of all high-risk people, and
treatment with antibiotics effective against
both gonorrhea & clamydia.
• Choose to lead a healthy lifestyle

Thank You…