SEXUALLY TRANSMITTED INFECTIONS.

INTRODUCTION

Sexually transmitted infections (STIs) are infections that are passed from one person to another through sexual contact (Vaginal intercourse, oral sex or anal sex). The causes of STDs are bacteria, parasites, yeast, and viruses. There are more than 20 types of STDs, including

*Chlamydia

*Genital herpes

*Gonorrhea

*HIV/AIDS

*Syphilis

*Trichomoniasis

*Chancroid

*Candidiasis

*Genital warts

*Human Papiloma Virus (HPV)

STIs are widespread to all parts of the world but more commonly in the tropics.

About 340million new cases of curable STIs are reported annually throughout the world in adults aged between 15-49years.

Most STDs affect both men and women, but in many cases the health problems they cause can be more severe for women. If a pregnant woman has an STD, it can cause serious health problems for the baby.

RISK FACTORS FOR STT

*Unprotected sexual intercourse

*New sexual partner in the last three months

*Number of sexual partners

*Partners symptomatic or asymptomatic.

GONORRHOEA

Gonorrhoea is caused by the bacterium Neisseria gonorrhea which  can affect the vagina, cervix, urethra,rectum, throat and the eye. Infected mothers may also pass on their children during delivery, which can later cause blindness if not treated.

PATHOPHYSIOLOGY

The gonococci infect the mucus secreting epithelial surfaces of the cervix and urethra in males. It then penetrates through or between the cells to the connective tissue causing inflammation and discharge.

The incubation period is 2-14 days with most symptoms occurring between days 2 and 5 in males and may be longer in females.

SYMPTOMS (Men)

*White or yellow pus like discharge from the penis

*A burning sensation while urinating

*Swelling and pain around the testicles, mostly occuring when infection is left untreated.

*Sore throat

SYMPTOMS (Females)

*Unusual whitish discharge from the vagina.

*Pain on urination

*Abdominal pain

*Sore throat

COMPLICATIONS

*Pelvic Inflammatory disease

*Infertility and ectopic pregnancy

*Ophthalmia neonatorum causing scarring and blindness if not treated.

*Enlargement if the testicles

 Diagnosis

By testing the;

  • urine
  • fluid or discharge from the vagina, cervix (opening to the womb), urethra (where urine comes out), throat, or anus

treatment

It can be treated with antibiotics . All sexual partners from the past 2 months need treatment too, even if they do not show signs of gonorrhea.

If someone still has symptoms after treatment, they may need treatment with different antibiotics. Or they may have been infected with gonorrhea again.

You should not have sex again until:

  • at least 7 days of treatment
  • you and your sexual partner(s) do not have signs of gonorrhea

People can be reinfected

  • their partners aren’t treated with antibiotics
  • they get treated but then have sex with someone else who has gonorrhea

What Problems Can Happen?

If it’s not treated, gonorrhea can lead to:

  • in girls: pelvic inflammatory disease (PID), which can damage the reproductive system, making it hard or impossible for a woman to get pregnant later on
  • in guys: swelling in the testicles and tubes at the back of the testicles, possibly preventing a man from fathering kids later on
  • problems peeing due to scars in the urethra
  • infection of the blood that can lead to joint problems and other problems

PREVENTION

*Use condoms. Use a male latex condom or a female polyurethane condom during each sexual contact. Condoms used properly during every sexual encounter reduce but don’t eliminate the risk of infection.

*Limit your number of sex partners. Having multiple sex partners puts you at a high risk of contracting chlamydia and other sexually transmitted infections.

*Get regular screenings. If you’re sexually active, particularly if you have multiple partners, talk with your doctor about how often you should be screened for chlamydia and other sexually transmitted infections.

*Avoid douching. Douching isn’t recommended because it decreases the number of good bacteria present in the vagina, which may increase the risk of infection.

CHLAMYDIA.

Chlamydia is caused by the bacterium Chlamydia trachomatis. Chlamydia is found only in humans and can be transmitted during vaginal, oral and anal sex. It can also be transferred to a baby from the infected mother during childbirth. Chlamydia accounts for 3.6% of blindness worldwide in 2002. (WHO)

Chlamydial infection of the genital tract is seen most frequently in young women who are sexually active. Most infections are asymptomatic and can lead to sequelae such as tubal damage, tubal infertility and ectopic pregnancy. In addition, untreated infections are estimated to increase the likelihood of HIV transmission.

Risk factors

Factors that increase your risk of chlamydia trachomatis include:

*Being sexually active before age 25

*Multiple sex partners within the past year

*Not using a condom consistently

*History of prior sexually transmitted infection

PATHOPHYSIOLOGY

Like other Chlamydia species, C. trachomatis has a life cycle consisting of two morphologically distinct forms. C. trachomatis attaches to a new host cell as a small spore-like form called the elementary body. The elementary body enters the host cell, surrounded by a host vacuole.  

C. trachomatis transforms into a larger form called the reticulate body. The reticulate body substantially makes it a more hospitable environment for rapid replication of the bacteria, which occurs over the following 30 to 72 hours. The massive number of intracellular bacteria then transition back to resistant elementary bodies, before causing the cell to rupture and being released into the environment. These new elementary bodies are then she

d in the semen or released from epithelial cells of the female genital tract, and attach to new host cells.

SYMPTOMS ( Females)

*An increase in vaginal discharge caused by inflamed cervix.

*Frequent urination

* Painful urination

*Lower abdominal tenderness and pains

* Irregular menstrual bleeding

SYMPTOMS (Males)

* White or cloudy discharge from the penis that may stain underwear.

*Burning sensations while urinating

* Painful urination

* Pain and swelling of the testicles

COMPLICATIONS

Chlamydia trachomatis can be associated with:

*Other sexually transmitted infections. People who have chlamydia trachomatis are at higher risk of also having other STIs — including gonorrhea and HIV, the virus that causes AIDS.

*Pelvic inflammatory disease (PID). PID is an infection of the uterus and fallopian tubes that causes pelvic pain and fever. Severe infections may require hospitalization for intravenous antibiotics. PID can damage the fallopian tubes, ovaries and uterus, including the cervix.

*Infection near the testicles (epididymitis). A chlamydia infection can inflame the coiled tube located beside each testicle (epididymis). The infection may result in fever, scrotal pain and swelling.

*Prostate gland infection. The chlamydia organism can spread to a man’s prostate gland. Prostatitis may result in pain during or after sex, fever and chills, painful urination, and lower back pain.

*Infections in newborns. The chlamydia infection can pass from the vaginal canal to your child during delivery, causing pneumonia or a serious eye infection

*Infertility. Chlamydia infections — even those that produce no signs or symptoms — can cause scarring and obstruction in the fallopian tubes, which may make women infertile.

*Reactive arthritis. People who have chlamydia trachomatis are at higher risk of developing reactive arthritis, also known as Reiter’s syndrome. This condition typically affects the joints, eyes and urethra — the tube that carries urine from your bladder to outside of your body.

PREVENTION

The surest way to prevent a chlamydia trachomatis infection is to abstain from sexual activities. Other ways of prevention includes;

*Use condoms. Use a male latex condom or a female polyurethane condom during each sexual contact. Condoms used properly during every sexual encounter reduce but don’t eliminate the risk of infection.

*Limit your number of sex partners. Having multiple sex partners puts you at a high risk of contracting chlamydia and other sexually transmitted infections.

*Get regular screenings. If you’re sexually active, particularly if you have multiple partners, talk with your doctor about how often you should be screened for chlamydia and other sexually transmitted infections.

*Avoid douching. Douching isn’t recommended because it decreases the number of good bacteria present in the vagina, which may increase the risk of infection.

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