DR . MODDATHIR

 Welcome your clients
 Encourage your clients to talk
 Look at your clients
 Listen to your clients

 Obtain reason for consultation (infection,
fear of infection)
 Reassure patient that absolute confidentiality
will be maintained Find out what symptoms
and signs if any prompted the visit
 Conduct a risk assessment

.
Male- GENIT- anatomy

Scrotum
 Testes: position, size, tenderness, masses,
Epididymiditis
Rectal examination
 Tone
 Fissure, hemorrhoids, or mass lesions
 Prostate: Size, tenderness, masses

 Inspect external genitalia for irritation and
ulcers
 Palpate the inguinal region for enlarged
Lymph nodes and buboes
 Palpate the abdomen (superficial and deep)
for pelvic masses and tenderness

Conduct a speculum examination
swab the cervix
see vaginal epithlium
Bimanual exam
cervical motion tenderness

“ that are
recommended in the National Guidelines for
the Management of STIs”
Ineffective or sub-therapeutic treatment:
 loosing the confidence of your patient
 spread of the infection
 emergence of drug resistance

 Compliance with treatment
 Counseling/Education
 Condoms use; as appropriate
 Contact Tracing and Treatment

as appropriate

 FOLLOW UP AFTER 7 DAYS

 Vaginal discharge
 Urethral discharge
 Lower ABD pain
 Genital ulcers (male&female)
 Scrotal swelling
 inguinal swelling
 Ophthalmia neonatorum

Requirements :
 adequate medical history
 good sexual history
 complete STI exam
 good supply of effective STIs drugs

Start point Action box Decision
Other flow
chart
Other genital
ulcer ? treatment


NO

 Treatment options for Gonorrhoea
 Treatment options for Chlamydia
 Ciprofloxacin
 Doxycycline
 Azithromycin
 Azithromycin
 Ceftriaxone
 Cefixime
 Spectinomycin
 Alternatives
 Alternatives

 Drug options for syphilis Drug options for
chancroid Drug options for granuloma
inguinale Drug options for LGV
 Benzathine
 Ciprofloxacin
 Azithromycin
 Doxycycline
 benzylpenicillin
 Erythromycin
 Doxycycline
 Erythromycin
 Azithromycin

 Recommended syndromic treatment
 ¦ ciprofloxacin, 500mg orally, twice daily for
3 days
 15
 AND
 ¦ doxycycline, 100mg orally twice daily for 14
days
 OR
 ¦ erythromycin, 500mg orally four times daily
for 14 days

 Neonatal conjunctivitis
 For details, see section 3.1 and 3.2.
 Drug options for gonorrhoea
 Drug options for chlamydia
 Ceftriaxone
 Erythromycin
 Alternatives
 Alternatives
 Kanamycin
 Trimethoprim/Sulfamethoxazole
 Spectinomycin

 high accuracy
 no Specialized equipment
 Clinical protocols are standardized
 Uniformity in collecting data
 used by any level of health care providers
 Diagnosis and treatment provided at first
visit
 In many cases, no referral

Thank you
any question ?